A new study suggests that patients using GLP-1 weight-loss medications may not need weekly injections to maintain weight loss and health improvements.
Dr. Mitch Biermann, an obesity and internal medicine specialist at Scripps Clinic in San Diego, noticed a pattern among his patients. After losing weight with GLP-1 drugs, several began spacing out their injections, taking them every two to three weeks instead of weekly. “By the time the third person told me they were maintaining their weight this way, I started recommending it to other patients,” he said.
To investigate, Dr. Biermann conducted a study tracking 34 patients over 36 weeks. The findings, published in February in the journal Obesity, revealed that most patients who reduced injection frequency kept off the weight they had lost and maintained metabolic benefits such as lower blood pressure and improved blood sugar levels. Only four patients regained weight and returned to weekly injections.
The study group was small and relatively homogeneous, mostly white and privately insured, and data were drawn from medical chart reviews rather than a randomized trial. Experts caution that the results should be interpreted carefully. Dr. Fatima C. Stanford, an obesity specialist at Harvard Medical School, noted that the patients who reduced dosing had already achieved their target weight and voluntarily participated, which could influence outcomes. About 12% of participants eventually resumed weekly shots after gaining weight.
Despite these limitations, the research highlights a potential alternative for patients concerned about the cost, long-term commitment, or possible side effects of weekly GLP-1 injections. “Chronic treatment does not necessarily mean maximal weekly dosing forever,” Dr. Stanford said.
Patients in the study had reduced their body mass index (BMI) from an average of 30, the obesity threshold, to 25.2, considered just overweight. Seventeen patients spaced injections every other week, six every 10 to 14 days, and seven extended intervals beyond two weeks, with the longest gap being six weeks. Most maintained or modestly reduced weight, and after 36 weeks, the average BMI dropped to 24.6, within the normal range. Importantly, the weight loss primarily came from fat, not muscle, and participants retained improvements in prediabetes, triglycerides, HDL cholesterol, and blood pressure.
Scott McMillin, 65, a patient of Dr. Biermann, described his experience. After losing 20 pounds with weekly Wegovy injections, he initially regained weight when stopping the drug entirely. Spacing out injections every two weeks allowed him to maintain his weight loss while keeping blood pressure and cholesterol in healthy ranges. “It made no difference for me whether I was taking injections every week or every two weeks. Less is better,” he said.
Dr. Biermann presented the findings at the Obesity Society’s Obesity Week meeting in Atlanta, where the results drew significant attention from other physicians. He noted that many patients are hesitant to commit to lifelong weekly injections, with only 6% of eligible Americans currently using GLP-1 drugs despite over half meeting criteria. “The number one question patients ask is, ‘Will I have to take this every week forever?’” he said.
While larger, randomized studies are needed to confirm these findings, the research offers a promising approach for patients seeking flexibility in managing weight with GLP-1 medications.
