GLP-1 Drugs Require Endoscopy Delays; Cleveland Clinic Finds Weight Maintenance After Stopping
New research shows patients on GLP-1 drugs may need to delay endoscopy procedures due to retained gastric contents, while a Cleveland Clinic study found 45% of obesity patients maintained weight loss one year after stopping the medications.
Patients taking GLP-1 or GLP-1/GIP agonist medications had significant residual gastric volume if the medication wasn't held prior to upper endoscopy unless they were on a clear liquid diet the day before, according to the OCULUS randomized trial. In the trial, some patients who took their GLP-1 drug while prepping for an endoscopy were found to have "clinically significant" content in their stomachs. Researchers suggested that patients should be advised to hold at least one dose of the medication or to reschedule the procedure in order to avoid the risks of aspiration or unplanned intubation.
A new Cleveland Clinic study analyzed what happens when patients stop taking injectable GLP-1 drugs like semaglutide and tirzepatide for obesity or type 2 diabetes. The retrospective study looked at nearly 8,000 adult patients in Ohio and Florida who stopped taking semaglutide or tirzepatide within 3-12 months. The study was published on March 12, 2026.
Patients treated for obesity lost an average of 8.4% of body weight before discontinuation, and regained an average of 0.5% one year later. For those treated for type 2 diabetes, the average weight loss was 4.4% before stopping, with an additional 1.3% loss one year later. Overall, 45% of the obesity group and 56% of the diabetes group kept losing or maintained weight after stopping the medication.
A researcher with Cleveland Clinic's Center for Value-Based Care Research who led the study stated that real-world data show that many patients who stop semaglutide or tirzepatide restart the medication or transition to another obesity treatment, which may explain why they regain less weight than patients in randomized trials. The researcher noted that many patients do not give up on their obesity treatment journey, even if they need to stop their initial medication.
For patients with obesity and atrial fibrillation, GLP-1 receptor agonist drugs may be the weight loss approach that better addresses their arrhythmia, observational data suggested.
Researchers plan to further examine the comparative effectiveness of alternative obesity treatment options for patients who discontinue GLP-1 drugs like semaglutide and tirzepatide.