A recent large-scale study has raised fresh concerns about GLP-1 and pregnancy risk. It shows that stopping these widely used weight-loss drugs before or during pregnancy may lead to greater weight gain, preterm delivery, and other complications.
The findings underscore a growing dilemma for individuals and healthcare providers navigating the use of GLP-1 for weight loss, as it might cause future health complications in women.
What the Study Found
Researchers at Mass General Brigham analysed nearly 150,000 pregnancies between 2016 and 2025.
Among about 448 pregnancies in people previously prescribed GLP-1 drugs, 65% had excessive gestational weight gain, versus 49% in a matched group who never used GLP-1s.
Those who discontinued GLP-1 therapy had:
- A 32% higher risk of gaining more weight than medically recommended.
- A 30% higher risk of gestational diabetes.
- A 29% increased risk of hypertensive disorders in pregnancy (including high blood pressure).
- A 34% higher risk of preterm delivery (babies born too early).
- On average, individuals who stopped GLP-1s gained about 7.2 pounds more than those who had never taken them.
Why Are Weight Jabs Risky in Pregnancy?
1. Discontinuation Leads to Weight Rebound
GLP-1 medications (like Ozempic, Wegovy, Zepbound) help reduce appetite and slow digestion. But once people stop, many regain weight, and often quickly.
Meta-analyses show significant weight regain after stopping GLP-1, especially with powerful drugs like semaglutide or tirzepatide. This rebound may fuel some of the excess weight gain seen during pregnancy among former users.
2. Higher Pregnancy Risks Linked to Weight Gain
Excessive gestational weight gain is itself a known risk factor for problems like gestational diabetes and high blood pressure. When people stop GLP-1 therapy and gain more weight than is ideal, they may be more vulnerable to these complications.
3. Lack of Clinical Guidance
There is very limited advice for people who stop GLP-1s before conceiving. The researchers called for better evidence to guide obstetric care because current clinical recommendations mainly rely on data from animal studies and small cohorts.
Why Weight Loss Drugs are Concerning
- Growing Use of GLP-1s: These drugs are increasingly prescribed not just for type 2 diabetes but for obesity and weight management.
- Family Planning Reality: Many people of reproductive age use GLP-1s. When they plan to conceive, they’re advised to “stop taking GLP-1”, but that advice may not come with a clear plan for managing weight or health after stopping.
- Health Equity and Support: Without structured guidance, those who discontinue face higher risks, and they may not get the necessary follow-up, such as dietary counselling or metabolic monitoring.
- Policy Implications: For public health authorities and clinicians, the study highlights a gap in prenatal care, especially for those with obesity who use GLP-1s.
What Experts Are Saying About GLP-1 and Pregnancy Risk
Dr. Jacqueline Maya, lead author of the study, pointed out that while safety concerns force discontinuation of GLP-1s before pregnancy, “there is not enough information about their safety for unborn babies.”
Senior author Camille E. added that more strategies are needed to support people who stop GLP-1 therapy, especially around diet and metabolic health, as they continue with pregnancy.
What the GLP-1 Users Should Do
- Pre-pregnancy Consultation: People using GLP-1s who want to conceive should speak with their doctors about timing, risks, and a tailored exit strategy.
- Post-Discontinuation Support: Providers should offer structured support, such as dietitians, nutritional counselling, and weight monitoring, for people who stop taking GLP-1.
- Follow-Up Research: More studies are needed that look at pre-pregnancy weight (before GLP-1 use), the timing of stopping, and long-term outcomes for mother and child.
- Policy and Clinical Guidelines: Maternal health guidelines should include recommendations for managing weight and metabolic health after stopping GLP-1 therapy in people planning pregnancy.
Conclusion
The emerging evidence on GLP-1 and pregnancy risk demands urgent attention. Stopping these drugs before or during pregnancy may heighten the risk of serious complications, and yet many patients do not receive the guidance or support they need.
As GLP-1 use rises globally, it’s critical for healthcare leaders, clinicians, and policymakers to build frameworks that help people transition off these medications safely, particularly when they plan to build a family.
