Stopping Ozempic or Wegovy Reverses Cardiovascular Benefits, New Study Warns
A study published March 18, 2026, in BMJ Medicine analyzed more than 333,000 U.S. veterans with type 2 diabetes and found that stopping GLP-1 drugs such as Ozempic and Wegovy reversed cardiovascular benefits gained during treatment. Researchers from Washington University School of Medicine in St. Louis said interruptions of six months or more increased risks of heart attack, stroke, and death compared to continuous use.
The study found that interruptions of six months or more in glucagon-like peptide-1 receptor agonist (GLP-1) therapy, including drugs like Ozempic (semaglutide) and Wegovy, were associated with a 4% to 8% increased risk of major adverse cardiovascular events (MACE)—heart attack, stroke, or death—compared to continuous use, according to researchers at Washington University School of Medicine in St. Louis. Veterans who discontinued GLP-1 treatment for one to two years experienced even higher risks, ranging from 14% to 22%, the study published March 18, 2026, in BMJ Medicine reported.
The analysis tracked more than 333,000 U.S.
veterans with type 2 diabetes over a three-year period. About 26% of GLP-1 users discontinued their medication, and 23% had interruptions lasting six months or longer, the researchers said. The data revealed that cardiovascular benefits accrued during treatment were quickly lost upon stopping, with longer treatment gaps amplifying the risk. Veterans who used GLP-1s for 18 months or less before stopping showed no significant cardiovascular risk reduction, the study noted.
Lead author Ziyad Al-Aly, MD, of Washington University, said the findings highlight a “metabolic whiplash” effect resulting from stopping GLP-1 therapy. This phenomenon entails metabolic changes detrimental to heart health, beyond weight regain, which was also observed in participants after discontinuation. Al-Aly added that restarting GLP-1 medication partially restored cardiovascular protection but did not fully reverse the increased risks caused by treatment interruption.
GLP-1 receptor agonists have gained prominence for their ability to reduce cardiovascular events in patients with type 2 diabetes and obesity. The SELECT trial, published in 2023 in the New England Journal of Medicine, demonstrated a 20% lower risk of major cardiac events with weekly Wegovy (2.4 mg semaglutide) in non-diabetic individuals with obesity and cardiovascular disease. The trial showed a 28% reduction in heart attacks, a 7% decrease in non-fatal strokes, and a 15% decline in cardiovascular deaths, according to trial investigators. Additionally, semaglutide has been shown to reduce heart failure symptoms and hospitalizations by 70% in obese patients with heart failure with preserved ejection fraction (HFpEF), based on pooled data published in The Lancet and the New England Journal of Medicine.
Washington University researchers emphasized that GLP-1 therapy acts more as a long-term risk-reduction treatment than a short-term intervention. “Persistence and follow-up truly matter; benefits accumulate slowly but are lost surprisingly fast,” the study stated. Sanjiv Shah, MD, a cardiologist involved in HFpEF trials, noted semaglutide’s role in doubling weight loss, improving walking distance, and reducing biomarkers such as NT-proBNP and C-reactive protein, which are linked to heart failure prognosis.
The study’s findings also align with the December 2024 FDA expansion of Wegovy’s approval to include secondary cardiovascular disease prevention in overweight and obese non-diabetic patients. This regulatory decision was informed by accumulating evidence of semaglutide’s cardiovascular benefits.
The research team compared veterans who maintained continuous GLP-1 use with those who experienced treatment interruptions or full discontinuation. Records showed that nearly half of GLP-1 users stopped shortly after starting therapy, prompting investigation into the cardiovascular consequences of such discontinuation. The study found that stopping GLP-1 drugs led to weight regain and reversal of improvements in cardiovascular risk factors, including blood pressure and cholesterol levels. These changes contributed to the observed increase in adverse cardiovascular outcomes.
Mandy French, who authored an article summarizing the study’s findings for Healthline on March 20, 2026, highlighted that cardiovascular protection from GLP-1s builds gradually but deteriorates rapidly after stopping treatment. The Washington University news release accompanying the BMJ Medicine publication underscored the importance of continuous therapy for sustained heart protection.
Harlan Krumholz, MD, a Yale University cardiologist, described the SELECT trial as a “major breakthrough” for managing cardiovascular risk in non-diabetic patients with obesity. The current study’s demonstration that stopping GLP-1 therapy reverses these benefits reinforces the need for long-term adherence in chronic disease management.
The study adds to a growing body of evidence supporting GLP-1 receptor agonists as integral components of cardiovascular risk reduction strategies in patients with type 2 diabetes and obesity. It also raises clinical considerations regarding treatment persistence and monitoring to prevent interruptions that may negate cardiovascular gains.
