Stopping GLP-1 Medications May Raise Heart Risk, New Study Finds

By now, most people have heard of GLP-1 medications. Drugs like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have reshaped conversations about diabetes and weight management, and approximately one in eight American adults now takes one of them. But a major new study published today in BMJ Medicine is raising an urgent question that has not received nearly enough attention: What happens to your heart when you stop?

The answer, according to researchers at Washington University School of Medicine in St. Louis, is sobering. Stopping GLP-1 treatment, even briefly, significantly increases the risk of major cardiovascular events including heart attack, stroke and death. And the longer the break, the greater the danger.

“There is enormous exuberance about starting GLP-1 drugs, but not nearly enough attention to what happens when people stop,” said senior author Ziyad Al-Aly, M.D., a clinical epidemiologist at Washington University School of Medicine and chief of the Research and Development Service at the VA St. Louis Health Care System. “Many quit after a few months because of cost, side effects or shortages. When they stop, it’s not just weight that comes back; they experience a resurgence in inflammation, blood pressure and cholesterol. Weight regain is visible; the metabolic reversal is not.”

What the Study Found

Investigators followed more than 333,000 U.S. veterans with Type 2 diabetes for three years, comparing those who stayed on GLP-1 medications continuously with those who stopped or took extended breaks. During the study period, 26% of GLP-1 users stopped taking the medication and 23% took a break for six months or more before resuming treatment.

The findings were striking. Patients who stopped taking GLP-1s for two years faced up to a 22% increased risk of cardiovascular events compared with those who stayed on the medication, largely erasing all the heart-protective benefits they had built up during treatment.

Even a gap of just six months was enough to begin reversing those gains. Patients who interrupted treatment and later resumed did regain some protection, but never fully recovered the benefit they would have had from staying on the medication continuously.

Patients who stayed on GLP-1s for the full three years of the study saw the strongest protection: an 18% reduction in cardiovascular risk, or about four fewer major cardiac events per 100 people compared with those on a different diabetes medication.

Why This Happens

The mechanisms behind this reversal go beyond the number on the scale. When patients stop GLP-1 medications, inflammation rises, blood pressure climbs and cholesterol levels increase — changes that are not visible the way weight regain is, but that are just as real and potentially far more dangerous.

“Our data suggest this metabolic whiplash is detrimental to heart health,” Al-Aly noted. “Restarting the medication helped restore some protection, but only partially, showing that discontinuation leaves a lasting scar.”

What This Means for Patients

For patients currently taking a GLP-1 medication, the key takeaway is this: If you are considering stopping, talk to your doctor first. If cost or access is the barrier, ask about assistance programs, alternative dosing strategies or what a planned interruption might mean for your specific health situation. GLP-1 medications treat chronic conditions, and the research now suggests they may need to be approached with the same long-term commitment as blood pressure or cholesterol medications.

The cardiovascular protection these drugs offer builds slowly. According to this research, it can disappear far faster than it took to earn.