Glucagon-like peptide 1 receptor agonists (GLP1-RAs) such as semaglutide has become more widely used over the past several years. This medication is approved for treating type 2 diabetes as well as for weight loss in people who are very overweight. While many people receive a significant benefit from taking semaglutide, they may also wonder whether it’s a good idea to stay on the medication for the long term.

Do you need to stay on semaglutide for the long term? How long is it safe to use semaglutide?

Key Takeaways

• People who take GLP-1 RAs such as semaglutide for weight loss may benefit from staying on the medication long-term, to help maintain their weight loss.

• Those using semaglutide for diabetes often use it long-term for blood sugar control.

• The data that we have so far indicates that long-term use of semaglutide is safe for most people.

• There is a small increase in the risk of gallbladder disease with longer-term use, but the risk is very small.

• No other major risks of long-term use of semaglutide have been found.

• There are only a few years of safety data currently available, so it’s not possible to rule out unknown long-term risks of semaglutide.

How long do you need to take GLP1-RAs (semaglutide) for weight loss?

When people first start to take semaglutide, they tend to lose weight rather quickly. After a few months, the weight loss starts to slow down. Eventually, people reach a stable weight on semaglutide.

For example, in one large study, participants lost an average of 10.6% of their body weight in the first 20 weeks (about five months). Those who continued taking semaglutide lost an additional 7.9% between weeks 20 and 68 (up to about a year and three months). In other words, although they did continue to lose weight, the weight loss slowed down over time.

Some people become concerned when they reach this weight loss plateau. They may believe that semaglutide has stopped working, because they aren’t losing weight anymore. However, this weight loss plateau is normal and expected. If a person were to continue to lose weight indefinitely, they would eventually become unhealthy. It’s actually a good thing for your weight to stabilize at some point.

Should you stop taking semaglutide once your weight is stable?

Once they’ve reached a stable weight, people sometimes believe that they should stop taking semaglutide, because they appear to have achieved all of the weight loss that’s possible with this medication. However, this may not necessarily be the best course of action.

In general, however, remaining on semaglutide can help many people to maintain a healthy and stable body weight. This is one of the major benefits of long-term use of semaglutide. Even once you’ve achieved a stable body weight, this doesn’t mean that semaglutide has stopped working – in fact, it’s still helping you to keep your weight under control. As long as you’re not experiencing any serious side effects, you may want to consider staying on the medication. In fact, many people who stop taking semaglutide regain some of the weight that they initially lost. 

Although weight gain after stopping semaglutide is common, it’s not inevitable. There are ways to help maintain weight loss even after stopping the medication. If you decide to stop taking semaglutide, then you may want to seek support in helping you to minimize the weight that you regain. However, you may also decide that you’d like to stay on semaglutide in order to help you maintain your weight loss.

Learn more about our medical weight loss program

Are there benefits of long-term GLP-1 RAs (semaglutide) use?

In addition to helping maintain a healthy body weight, semaglutide helps to keep blood sugar under control. This effect appears to last for the long term. In one study, people taking semaglutide for three years had significantly lower hemoglobin A1c levels than those taking a placebo. 

For people living with type 2 diabetes, keeping blood sugar under control can help to reduce the risk of long-term health effects, such as heart disease and kidney disease. It’s crucial to continue to keep blood sugar as stable as possible, and long-term use of semaglutide can help to accomplish this. In one large study, people with diabetes who took semaglutide experienced a 15-20% improvement in kidney function over about a year and three months, while those taking a placebo experienced an 18% decline in their kidney function.

In addition, people taking semaglutide have been found to have significantly lower blood pressure than those taking a placebo. High blood pressure is linked to a number of serious health problems, including strokes, heart failure, and kidney problems. Staying on semaglutide could help to keep blood pressure lower, which is likely to have significant benefits over the long term. 

Recent studies have also found benefits for those experiencing heart failure. Over one year, people taking semaglutide experienced significantly greater improvements in symptoms and physical function than those taking a placebo. Semaglutide reduced the risk of adverse cardiovascular events (like strokes, heart attacks, and sudden cardiac death) by 20%.

Are there risks of long-term semaglutide use?

It’s clear that long-term use of semaglutide may have benefits for blood sugar control and weight management. At the same time, many people are concerned that remaining on a medication for many years could have side effects. What does the research say about the long-term effects of semaglutide?

First, it’s important to note that semaglutide was first approved for diabetes treatment in 2017 in the US (with other countries approving it soon afterwards), and it wasn’t approved for weight loss until 2021. As a result, we only have a few years’ worth of data on the effects of semaglutide. The longest study to date followed people taking this medication for two years, and found no major safety concerns with semaglutide.

There isn’t necessarily enough data to be certain about the long-term effects of semaglutide at this point. In the future, we could discover side effects that only occur after taking semaglutide for decades. Without the long-term data, it’s impossible to be absolutely sure. Long-term studies of people taking exenatide (another medication in the same class) for up to six years have revealed no major safety concerns, but we still can’t know for certain what happens if people use these medications for a longer period. 

Still, the data that we have so far on long-term use of semaglutide generally indicates that it’s safe for most people. Here’s what the research has found so far about possible side effects of long-term semaglutide use.

Digestive side effects

The most common side effects of semaglutide are related to the digestive system. People taking this medication may experience nausea, vomiting, diarrhea, constipation, or abdominal pain. These effects usually resolve over time, and generally don’t cause major health problems. Unless you’re very bothered by these concerns, they’re not a reason that you’d need to stop taking semaglutide. 

Cancer

There has been some concern about a potential increased risk of thyroid and pancreatic cancer with semaglutide, based on the results of animal studies. Some studies have found a small increase in risk of these cancers in people who take semaglutide. However, a recent review of the scientific literature found that there was no increased risk of any cancers in people taking semaglutide, compared those with taking a placebo. 

Although more studies may be needed to clarify whether there’s an association between cancer and semaglutide, any possible increase in risk is likely to be very small. This may provide peace of mind to those who are considering taking this medication long-term.

Gallbladder disease

Another possible side effect of semaglutide is gallbladder disease (such as gallstones or inflammation of the gallbladder). This is quite uncommon; between 2005 and 2021, there were 36 cases of gallbladder disease associated with GLP-1RA use that were reported to the US FDA. 

Some studies have found that using semaglutide for longer than 26 weeks may increase the risk of gallbladder problems, compared with using it for a shorter period of time. Higher doses also increase the risk. It’s important to keep in mind that weight loss itself is associated with gallbladder disease, whatever means are used to achieve it, so it’s hard to be certain that it’s semaglutide itself, rather than weight loss in general, that’s causing the gallbladder issues.

Pancreatitis

Early on, there was concern that semaglutide could be associated with pancreatitis. This is a condition in which the pancreas becomes inflamed, leading to severe abdominal pain and other symptoms. Pancreatitis can be fatal. However, research has found no association between semaglutide and pancreatitis, so this isn’t something to worry about.

Eye disease

Diabetic retinopathy, a condition in which the light-sensing tissue at the back of the eye becomes damaged, is a known complication of high blood sugar. When people who have this condition begin taking semaglutide, their eye disease can sometimes get worse. This is actually a known effect of any medication that causes a drop in blood sugar – eye disease can get worse once the medication is started.

However, this complication appears to be associated with starting semaglutide. In those taking semaglutide for a year, studies have found no further worsening of diabetic retinopathy. If semaglutide is going to cause this problem, it will occur when the medication is started, rather than over the long term.

Is it safe to use semaglutide long-term?

Overall, semaglutide is considered to be safe for long term use. There does appear to be a slightly increased risk of gallbladder disease with longer-term use, although the risk is extremely small. People taking semaglutide should be monitored carefully for signs of gallbladder problems, because this condition is usually very treatable when caught early. Other than this, there don’t seem to be any major risks associated with using this medication over the long term, although we’ll have to wait a few years to have the data to be absolutely certain about this.

By helping to control blood sugar as well as body weight, semaglutide significantly decreases the risk of major health conditions like heart disease, stroke, and kidney disease. It’s important to weigh these benefits of semaglutide against the possible risks. 

GLP-1 RAs such as semaglutide are only available with a doctor’s prescription. When used for weight loss, the medication is most effective when combined with a lifestyle plan that includes a healthy diet and exercise. Support from professionals like health coaches and nutritionists can be very helpful for those who are trying to make healthy lifestyle changes. 

Clients on our NOVI Optimum Plus weight management program, or our NOVI Magnum diabetes management program, may receive semaglutide as part of their treatment plan. Support from coaches, nutritionists, and other health professionals is also included, to help you create and stick to a healthy lifestyle plan.