Can Taking a GLP-1 Drug Every Other Week Help You Keep the Weight Off?

Since the cost of these drugs can be prohibitive, these findings could have a major real-world impact, says Mitch Biermann, MD, PhD, an author of the study and an obesity medicine and internal medicine doctor at Scripps Clinic Carmel Valley in California.

While this research is promising, more studies and clearer guidance on less-frequent dosing are still needed. Any changes to the frequency of your GLP-1 medications should be made in consultation with your healthcare provider. Learn more about alternative GLP-1 dosing schedules and how to approach adjusting yours.

What the Science Says

Dr. Biermann’s study found that most people who halved the dosing frequency of a GLP-1 medication maintained their weight loss and improvements in blood sugar, cholesterol, and blood pressure. The study sample of 30 adults was drawn from a primary care obesity medicine practice; the participants had reached a normal weight or resolved their weight-related health conditions after being on a weekly GLP-1 therapy, in this case either Ozempic (semaglutide) or Zepbound (tirzepatide).

Here are some other key findings.

• Weight and fat-versus-muscle ratio stayed about the same. After switching to every-other-week injections, people lost an additional 2 to 4 pounds (lb) on average, and body fat loss improved slightly but stayed about the same.
• Metabolic health stayed stable. Improvements in blood sugar control, triglycerides, and systolic blood pressure stayed about the same after the reduced dosing.
• Most participants kept the weight off. Only 4 of the 30 people regained weight and chose to return to weekly dosing.

More Study Is Still Needed

Even before research on alternative dosing schedules emerged, some clinicians were already experimenting with off-label adjustments to injection frequency. Like many providers who prescribe GLP-1s, Yuval Pinto, MD, has worked with select patients to gradually reduce how often they take the medication.

“It can be effective, and the findings presented here are promising,” says Dr. Pinto, an obesity and family medicine doctor at Johns Hopkins Medicine in Baltimore, who wasn’t involved in the research. “But because the study involved a small number of people and the findings are from a retrospective chart review rather than a randomized study, they should be viewed as preliminary.”

Other doctors have concerns, too. Peminda Cabandugama, MD, an endocrinologist and obesity medicine specialist at Cleveland Clinic in Ohio, found the results to be “slightly surprising.”

“The pharmacokinetics [how drugs move through the body] of GLP-1 medications show a half-life of 5 days, which means the current standard of using these medications every 7 days is also stretching this out,” says Dr. Cabandugama, who wasn’t involved in the study. Half-life is the amount of time it takes for the drug’s initial concentration in the body to decrease by half.

The findings also could be influenced by the small number of people in the study, he adds.

“Whether or not people can successfully de-escalate could be related in part to how they metabolize the drug and the length of that ‘steady state,’” Pinto says. That can vary from person to person depending on age and how well their liver and kidneys are working.

Tapering Off GLP-1 Medications

Pinto says people taking a GLP-1 who want to adjust their dosing for whatever reason — finances, changes in insurance coverage, or they no longer want to be on the medication — should talk with their doctor about the best path forward.

“There's no standard of care for how to de-escalate therapy, and so different physicians have different experiences and practices,” adds Biermann.

When Pinto has a patient who asks about weaning off their GLP-1 or spacing out dosing, he is very receptive to the conversation. “Patient-centered medicine is the best medicine,” he says.

First he’ll review with his patients what their goals were and what they’ve accomplished so far. “Let's see if we were able to reverse your prediabetes. Did we improve your fatty liver, your sleep quality, your exercise, your diet?”

If the patient has improved their metabolic profile and reached a healthy weight, “I'm game,” says Pinto. After the new dosing schedule is agreed upon, he continues to monitor their weight and muscle mass.

“If after a few months the patient increases muscle mass and their weight doesn't change, amazing, right? If there is a rebound weight, we have a problem, because we're going to create the same problems that we started with,” says Pinto. Working with your provider, he says, can keep you on the right track.

How to Talk to Your Doctor About GLP-1 Weight Loss Drugs

• Be clear about the purpose. Be sure to discuss what goal you’re trying to accomplish by taking these drugs. It could be only about weight loss or weight maintenance, or you may also need the drug to improve other health issues like type 2 diabetes, heart disease, or metabolic syndrome.
• Share your health history. Typically, people with a personal or family history of certain types of thyroid cancer, those with a history of pancreatitis or gastroparesis, and those who are pregnant or planning to be should not take these medications.
• Ask about realistic expectations. People who are overweight may lose 5 to 15 percent of their body weight when taking these drugs, for example. Rapid and extreme weight loss isn’t healthy or what you should expect will happen.

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• Clarify the long-term plan. Whether you’re still trying to reach your goal weight or you’re already there, map out how you’ll transition to a lower, long-term maintenance dose, as well as how to include a healthy diet, regular exercise, and staying hydrated into your regular routine.

The Takeaway

• Emerging research suggests some people who’ve successfully reached their goal weight may not need weekly shots of GLP-1 medications to maintain their weight loss. Dosing every two weeks may keep the pounds off.
• While the results are promising, more research is needed to establish who may benefit from less frequent dosing, and what a lower dosing schedule should look like.
• Changes to your dosing schedule should always be made with the input of your doctor, who can help weigh your goals and health history before making changes to how often you take it.