Stopping GLP-1s raises complicated questions for pregnancy

During pregnancy, using popular weight loss drugs like Ozempic is not recommended. However, a new study suggests that stopping the medications just before conception or in the early stages of pregnancy may come with some risks. However, without further studies, experts say the data paints a complicated picture of the relationship between GLP-1s and pregnancy.

What are the key implications of the study?

People who discontinued use of the GLP-1 class of weight-loss drugs before or during pregnancy were associated with more gestational weight gain when compared to those who were not prescribed the drugs before, according to a new observational study recently published in JAMA. They also had a higher risk of preterm delivery, hypertensive disorders of pregnancy and gestational diabetes, which is linked to a greater risk of developing Type 2 diabetes later on in life.

Researchers from Boston’s Mass General Brigham reviewed medical records from almost 150,000 pregnancies between June 2016 and March 2025. People who were prescribed GLP-1 drugs were more likely to gain more weight than recommended during pregnancy. Among people previously prescribed the medication, 65% of 448 pregnancies experienced excessive gestational weight gain, compared with 49% of 1,344 pregnancies that did not take a GLP-1.

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The analysis had “key limitations,” said Live Science. Women who did and did not take the drugs “may not have been completely comparable,” and the study “was not designed to capture potential benefits of taking Ozempic or a similar drug before pregnancy.”

Due to the documented weight gain associated with discontinuing the drugs outside of pregnancy, the increases shown in the study were not surprising, pediatric endocrinologist and lead study author Jacqueline Maya told Medscape Medical News. The team was “reassured that there were no changes in infant birth weight,” however, they were “concerned that there were increases in the risk of obstetric outcomes,” Maya said. Still, given the limitations of observational studies, they could not determine whether stopping the medications caused the adverse outcomes.

What remains unanswered?

The study highlights potential risks that would need closer monitoring and “underscores the need for new strategies to support patients during the transition off these medications,” Maya said, per The Washington Post. The findings highlight critical gaps in care and can help influence future studies, clinical counseling and approaches to weight management during pregnancy.

Some experts said the study should clarify who actually used the medication, since the study “relied on medical records of people who were prescribed the drug” but did not “confirm whether they took the medications,” said the Post. Another limitation noted in the study was that the researchers measured the degree of obesity among the women based on their weight after GLP-1-related weight loss, rather than at their initial higher weight. This approach of comparing these different cohorts of patients is “not matching apples to apples” and may underestimate the benefits of reducing obesity before pregnancy, said Taraneh Soleymani, an associate professor of medicine and director of obesity medicine at Penn State College of Medicine, who was not involved in the study, to the Post. While safety concerns based on animal studies mean GLP-1 drugs must be stopped before pregnancy, that does not diminish the benefits they have on obesity before conception, she said.

One question that still needs to be answered is the optimal timing for discontinuing GLP-1 to ensure optimal pregnancy outcomes, Maya said to Medscape Medical News. Experts need to “exclude any potential long-term impact on childhood metabolic health,” she said. These medications are known to be “beneficial for weight, blood sugar, and cardiovascular health,” so the focus needs to be on “finding ways to support women who come off these medications for pregnancy.”