Ziyad Al-Aly, epidemiologist, on dangers of quitting GLP-1s: “People need to realize that there’s a price of stopping”

GLP-1 drugs have become one of the biggest health stories in America. Interestingly, though, while there are often doubts for many about whether or not to start the treatment, it may be what happens when people stop that is of more concern.

That is the warning from Ziyad Al-Aly, a WashU Medicine clinical epidemiologist, after new research found that stopping GLP-1 medications such as semaglutide and tirzepatide was linked to a higher risk of heart attack, stroke and death compared with staying on them continuously.

The hidden risk of stopping GLP-1 drugs

The study followed more than 333,000 U.S. veterans with type 2 diabetes over three years. Researchers found that people who remained on GLP-1 treatment saw the strongest cardiovascular protection, while those who stopped or interrupted treatment lost much of that benefit.

Al-Aly’s point is rather blunt: “People need to realize that there’s a price of stopping.”

That “price” is not only the weight regain many patients fear. According to the research, stopping the drugs may also bring a rebound in inflammation, blood pressure and cholesterol. The less visible part may be most dangerous.

Why GLP-1 benefits may fade quickly

The study found that continuous GLP-1 use over three years was linked to an 18% reduction in major cardiovascular events compared with sulfonylureas, another type of diabetes medication. But interruptions weakened that protection.

A gap of just six months before restarting was associated with a higher risk than continuous use. After one or two years off the drugs, the increased risk of heart attack, stroke and death rose by 14% and 22%, respectively, compared with staying on treatment.

Al-Aly described this as “metabolic whiplash,” noting that restarting helped restore some protection, but not all of it.

A long-term treatment, not a quick fix

The findings add a serious wrinkle to the GLP-1 boom. Many people stop because of cost, side effects or shortages, but the study suggests health systems need to treat continuity as a central part of care.

The message is not that patients should never stop medication on their own terms. It is that stopping should be discussed with a doctor, because GLP-1s are increasingly being viewed less like short-term weight-loss tools and more like long-term treatment for chronic conditions.

(This article is for informational purposes only and does not constitute medical advice. GLP-1 medications, including semaglutide and tirzepatide, should only be started, stopped, or adjusted under the guidance of a qualified healthcare professional. Individual risks and benefits vary, and patients should consult their doctor before making any changes to their treatment plan.)

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