Study Finds Some Patients Keep Weight Off with Fewer GLP-1 Injections
A recent small study highlights a promising approach for patients using GLP-1 medications for weight loss: spacing out injections while maintaining weight loss. Published in the journal Obesity, the research led by Dr. Mitch Biermann, an obesity and internal medicine specialist at Scripps Clinic in San Diego, examined whether fewer GLP-1 injections could sustain results after initial weight reduction. This finding addresses a common patient concern about lifelong weekly dosing with drugs like Wegovy and Ozempic.
The Origins of the Study
The idea for this investigation stemmed from real-world observations in Dr. Biermann's clinic. Several patients reported spacing out their GLP-1 injections—taking them every second or third week instead of weekly—and still keeping their weight off. "By the time the third person told me they were taking it every second or third week and still maintaining their weight, I started recommending it to other patients," Biermann told The New York Times.
Intrigued, Biermann reviewed medical charts from patients who had experimented with extended dosing intervals. The study focused on 34 patients who had already achieved significant weight loss on GLP-1 medications. These individuals then transitioned to less frequent injections, with follow-up over 36 weeks.
Key Study Results
- Only four patients gained weight after spacing out injections; they returned to weekly dosing.
- Average BMI dropped from 30 (obese range) to 25.2 (overweight) before extended dosing, and further to 24.6 (normal weight) by study's end.
- Participants used varied schedules: most every two weeks, some every three weeks, and a few every four weeks.
- While on these schedules, most continued losing small amounts of weight or maintained it; only five regained a small amount.
About 12% of patients eventually returned to weekly doses after some regain, but the majority sustained their health improvements.
A Patient's Real-World Experience
Scott McMillin, 65, exemplifies the potential benefits. After struggling with weight for years, he started weekly Wegovy injections in late 2023, losing 20 pounds and normalizing his blood pressure and cholesterol. Stopping completely led to a 10-pound regain, prompting a restart. He then spaced to every two weeks: "It made no difference for me whether I was taking injections every week or every two weeks, and I just thought, well, less is better," McMillin told The Times.
McMillin now combines biweekly dosing with regular elliptical exercise and a two-meal-a-day routine without snacks, supporting his maintenance.
Understanding GLP-1 Medications and Their Mechanisms
GLP-1 drugs like Wegovy (semaglutide) and Ozempic mimic glucagon-like peptide-1, a hormone that regulates blood sugar and appetite. They slow gastric emptying, signal fullness to the brain, and reduce calorie intake, leading to weight loss of 15-20% in many users. For obesity treatment, they've transformed care, yet weekly injections raise concerns about long-term adherence due to cost (often $1,000+ monthly without insurance) and inconvenience.
Only about 6% of Americans use GLP-1s, despite 51% of U.S. adults qualifying by BMI criteria. "The number one question patients give me about this drug is, 'Will I have to take this every week forever?'" Biermann noted. This study suggests that for some, metabolic adaptations post-weight loss allow less frequent dosing, potentially improving sustainability.
