Stopping GLP-1s can quickly reverse the cardiovascular benefits gained while taking them. Image Credit: the_burtons/Getty Images

A recent study found that stopping GLP-1s, such as Ozempic or Wegovy, can reverse the cardiovascular benefits they provide. 

The findings show that stopping the medications for as little as 6 months raises the risk of heart attack and stroke. 

GLP-1s have been proven to offer not only benefits for type 2 diabetes and weight loss, but also cardiovascular health. 

GLP-1 drugs like Ozempic and Wegovy have become popular medications for treating type 2 diabetes and obesity. This class of medications may also offer significant cardiovascular benefits. 

A recent study published in BMJ Medicine found that when people stop using GLP-1s, they not only tend to regain weight, but they also may experience an increased risk of heart attack, stroke, and even death. 

Around 1 in 8 adults in the United States is currently taking a GLP-1 medication.

“There is enormous exuberance about starting GLP-1 drugs, but not nearly enough attention to what happens when people stop,” senior study author Ziyad Al-Aly, MD, a Washington University School of Medicine clinical epidemiologist and chief of the Research and Development Service at the VA Saint Louis Health Care System, said in a press release.

Stopping GLP-1s raises cardiovascular risk

The researchers noted that many people who use these medications quit them after a short time, typically due to cost, side effects, or shortages.

They wanted to understand the consequences of discontinuing GLP-1 use, particularly on cardiovascular health. 

The study analyzed 333,687 veterans. It compared 132,551 individuals who were prescribed a GLP-1 medication to help manage type 2 diabetes with 201,136 who were prescribed sulfonylureas, another type of medication for diabetes. The researchers followed the participants’ outcomes for 3 years. 

Sulfonylureas include the medications: 

glipizide (Glucotrol)

glimepiride (Amaryl)

glyburide (Diabeta and others)

The researchers checked participants’ GLP-1 treatment status every 6 months.

Over the course of the study, 26% of participants stopped taking the medication, and 23% had an interruption of 6 months or more, followed by resuming treatment. 

The research team found a positive relationship between continuous use of GLP-1s and fewer cardiovascular events.  

“GLP-1 drugs likely help cardiovascular health through several pathways at once, not just by lowering weight,” said Robert Glatter, MD, attending physician in the Department of Emergency Medicine at Lenox Hill Hospital in New York City, and assistant professor of Emergency Medicine at Zucker School of Medicine at Hofstra/ Northwell, who was not involved in the study. 

“They improve blood sugar control, modestly lower blood pressure, may improve lipid and vascular function, and seem to reduce inflammation and atherosclerotic plaque growth and progression,” Glatter told Healthline.

“Some evidence also points to direct protective effects on the heart and blood vessels independent of weight loss. In practical terms, they appear to reduce the underlying process of inflammation that drives heart attacks, strokes, and heart failure over time,” he explained.

At the end of the study, compared with those who took sulfonylureas, participants who continuously used GLP-1s over the 3-year period had the most pronounced risk reduction. This group saw 18% fewer major cardiovascular events. 

Participants who had taken GLP-1s for 2 or 2.5 years before discontinuing use for the remainder of the study also saw a significant reduction in risk of 7% and 15%, respectively.

Those who took GLP-1s for 18 months or less before discontinuing did not experience a significant reduction in risk.

The study showed that an interruption of GLP-1 use of just 6 months before resuming treatment was enough to significantly decrease the cardiovascular benefit. It led to a 4% to 8% increase in risk compared with those with continuous use. 

Discontinued use of 1 to 2 years without resuming resulted in a 14% to 22% increased risk of a cardiovascular event, compared with continuous use. 

This shows that cardiovascular benefits gained while using GLP-1s are quickly lost when a person stops taking the medication. 

“The main message is that GLP-1 therapy behaves more like a long-term risk-reduction treatment than a short-term fix. The study reinforces a broader lesson in chronic disease management: benefits that accumulate slowly can be lost surprisingly fast when treatment is interrupted, so persistence and follow-up truly matter,” said Glatter. 

How can you stop taking GLP-1s safely? 

GLP-1 medications include semaglutides (Ozempic, Wegovy) and tirzepatides (Mounjaro, Zepbound).

If you are taking a GLP-1 medication and are considering discontinuing it, you should first speak with your healthcare professional. 

“When patients use GLP-1 medications primarily for weight loss, I caution them that it is very easy to regain the weight when these medications are discontinued and subsequently lose the health benefits gained from achieving a healthy weight,” said Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study. 

If you suddenly stop taking a GLP-1, like a semaglutide, you may experience withdrawal symptoms. These may include nausea, increased appetite, weight gain, and cardiovascular changes, like elevated blood pressure. 

Tapering off the medication slowly may allow your body to gradually adjust to having less support from the GLP-1 medication. 

It is also important to maintain your healthy eating habits and get regular physical activity when stopping these medications. This helps you maintain your weight loss.  

“Obesity should be viewed as a chronic, long-term disease that requires long-term treatment,” said Ali.

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