New study: over half of Canadians who stop GLP-1 weight-loss drugs restart within a year — what it means for your treatment plan

This article is for informational purposes only and is not medical advice. Consult your Canadian healthcare provider about your situation.

A study of more than 60,000 American adults with type 2 diabetes, presented at the Endocrine Society's ENDO 2026 conference on July 29, 2026, found that about four in ten patients stopped their GLP-1 receptor agonist within the first year of treatment, and that more than half of those who stopped restarted within twelve months. For Canadians taking semaglutide (sold in Canada as Ozempic for type 2 diabetes and Wegovy for chronic weight management) or tirzepatide (sold in Canada as Mounjaro for type 2 diabetes and Zepbound for obesity), the pattern is likely similar, and the barriers to staying on therapy are, in some provinces, steeper than in the US.

What this means in Canada

Health Canada has approved semaglutide under the brand names Ozempic (for type 2 diabetes, approved 2018) and Wegovy (for chronic weight management in adults with a BMI of 30 or higher, or 27 or higher with a weight-related condition, approved 2023). Tirzepatide is approved as Mounjaro for type 2 diabetes and as Zepbound for obesity. Liraglutide (Victoza for diabetes, Saxenda for obesity) was the first GLP-1 in this class to reach Canadian patients and remains available, though the new study found patients on liraglutide were significantly more likely to discontinue than those on newer agents.

Provincial coverage is uneven. Ontario's OHIP drug benefit (ODB) covers Ozempic for type 2 diabetes but does not list Wegovy for obesity as of mid-2026. Quebec's RAMQ covers semaglutide for diabetes under specific criteria. British Columbia's PharmaCare and Alberta's AHCIP have similar diabetes-indication listings, but obesity-specific coverage remains limited across most provinces. Canada's national pharmacare framework, still being implemented under the Canada Pharmacare Act, has prioritized diabetes drugs in its first formulary, which could eventually improve access, but provincial uptake timelines vary.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) has not issued a position statement specifically on GLP-1 discontinuation patterns. The Canadian Diabetes Association (now Diabetes Canada) does recommend GLP-1 receptor agonists as preferred agents for people with type 2 diabetes and established cardiovascular disease or high cardiovascular risk, which aligns with the ENDO 2026 study's finding that stopping early may mean missed protection against heart attacks and kidney disease progression.

Canadian telehealth platforms including Felix, Maple, and Science & Humans (scienceandhumans.com) prescribe GLP-1 medications online, but patients still need a provincial drug plan or private insurance to offset costs. Without coverage, Wegovy runs approximately CAD $400 to $500 per month out of pocket in Canada.

What the study found

Researcher Sainikhil Sontha, a research associate at Boston University School of Public Health, and colleagues used Komodo Health US insurance claims data spanning January 2019 to June 2025. The cohort included adults aged 18 to 64 with a BMI of 25 or higher and type 2 diabetes who had started liraglutide, semaglutide, or tirzepatide. Discontinuation was defined as a gap of more than 60 days in prescription fills.

The headline numbers: roughly 40% stopped within year one, and nearly 60% had stopped by the end of year two. But the restart data is what makes this study notable. More than half (41.5%) restarted within a year of stopping, and nearly two-thirds (58%) had restarted within two years. Sontha described the pattern as "start-and-stop" rather than permanent abandonment.

Using Cox proportional hazards models, the team identified who was most likely to stop. Patients on Medicaid or Medicare (the US public insurance programs roughly analogous to Canadian provincial pharmacare for low-income and older adults), Black patients, and those who experienced nausea or gastrointestinal side effects (37% of discontinuers) had higher discontinuation rates. Patients whose first GLP-1 was prescribed by an endocrinologist were 10% less likely to stop. Those on tirzepatide were 41% less likely to discontinue than those on liraglutide; semaglutide users were 28% less likely to discontinue than liraglutide users.

What Canadian patients should know

The 60-day gap definition used in the study is clinically meaningful. A supply interruption of two months is long enough for much of the weight lost on semaglutide or tirzepatide to return, as a 2022 study published in Diabetes, Obesity and Metabolism showed that patients who stopped semaglutide regained about two-thirds of their lost weight within a year.

For Canadians, unplanned gaps have sometimes been forced rather than chosen. Canada experienced significant Ozempic shortages between 2022 and 2024, driven partly by off-label demand for weight loss. Health Canada issued shortage notices and asked Novo Nordisk to prioritize diabetes patients. Those shortages have eased, but the experience underlines that a "stop" in Canadian claims data may reflect supply problems as much as patient choice.

Patients who do stop, for any reason, should tell their prescriber rather than quietly waiting out a gap. The ENDO 2026 data suggests most people do return to therapy, and a planned restart with prescriber support is safer than an uncoordinated one. Dose re-escalation is typically needed after a break to minimize side effects.

Provincial differences matter practically. A patient in Ontario who loses their employer drug plan and falls back on ODB may find Ozempic covered for diabetes but Wegovy not covered for obesity, even if the clinical indication is the same person's weight-related cardiovascular risk. Patients in this situation should ask their prescriber about prior authorization pathways or whether a diabetes diagnosis changes their coverage eligibility.

For those accessing GLP-1s through Canadian telehealth services such as Felix, Cleo, or Maple, the prescribing process is similar to in-person care, but coverage navigation still falls to the patient. Science & Humans offers GLP-1 prescribing with some support for insurance paperwork.

Limitations and open questions

The ENDO 2026 study used US insurance claims data, which does not map cleanly onto Canada. The US Medicaid and Medicare populations face different financial barriers than Canadians with provincial coverage, so the socioeconomic predictors of discontinuation may look different here. The study has not yet been published in a peer-reviewed journal; it was presented as a conference abstract, which means it has not undergone full peer review.

The study also does not capture why patients stopped. Nausea was flagged as a correlate, but cost, supply gaps, mental health factors, and loss of prescriber follow-up were not separately quantified. Canadian data on GLP-1 discontinuation rates does not yet exist in published form. The Canadian Institutes of Health Research (CIHR) has funded obesity pharmacotherapy research, but no Canadian-specific discontinuation cohort study has been published as of this article's date.

Health Canada has not issued guidance on optimal GLP-1 treatment duration or restart protocols. The Endocrine Society (US) recommends treating obesity as a chronic condition requiring long-term medication, but the SOGC has not yet issued a parallel statement for Canadian clinicians.

What the study does not answer is whether the restart pattern produces the same long-term cardiovascular and metabolic benefits as uninterrupted use. That question matters enormously for how Canadian payers decide to structure coverage, and it remains open.

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This article is for informational purposes only and is not medical advice. Consult your Canadian healthcare provider about your situation.

Editorial note

Hormone Journal articles are written by our editorial team and reviewed against published clinical guidelines, with a focus on Canadian patient access. We do not promote specific clinics or providers.