Stopping GLP-1 Medications Before or Early in Pregnancy May Lead to More Weight Gain and Higher Pregnancy Risks

A new study has taken a close look at what happens when people who have been using GLP-1 receptor agonists—the increasingly popular medications for weight loss and diabetes—stop taking them before or early in pregnancy. The findings raise some important questions about how discontinuing these medications may influence pregnancy outcomes, especially as more individuals of reproductive age begin using drugs in this class.

Researchers from Mass General Brigham analyzed electronic health records spanning 2016 to 2025, looking at 1,792 pregnancies among individuals who had obesity and who received care within the same health care system. Their goal was straightforward: understand how stopping GLP-1 medications—such as those used for weight loss—might affect gestational weight gain, metabolic complications, and delivery outcomes.

To make the comparison meaningful, each pregnancy in which the individual had been prescribed a GLP-1 drug within three years before conception or within 90 days after conception was matched with three pregnancies involving people of similar age, BMI, and health profile who had never used GLP-1 medications. This approach allowed researchers to evaluate whether discontinuation itself corresponded with different outcomes during pregnancy.

The study found notable differences. Individuals who had stopped GLP-1 drugs gained an average of 7.2 pounds more during pregnancy compared to those who had never taken these medications. On top of that, the GLP-1 discontinuation group showed a 32% higher risk of excessive weight gain, meaning they surpassed the recommended level of weight gain during pregnancy.

Metabolic complications also stood out. The group that discontinued GLP-1s experienced a 30% higher risk of developing diabetes during pregnancy and a 29% higher risk of hypertensive disorders, which include conditions like preeclampsia and gestational hypertension. These conditions can pose risks to both the pregnant individual and the fetus.

The study further showed a 34% higher risk of preterm delivery among those who previously used GLP-1 medications. Preterm birth comes with its own set of potential challenges, including increased risk for respiratory issues, feeding difficulties, and longer hospital stays for newborns.

Despite these increased risks, the researchers reported no difference between the groups in several major birth-related outcomes. There were no significant differences in the likelihood of having a baby with high or low birth weight, no difference in birth length, and no difference in the rate of Cesarean deliveries. This suggests that although discontinuing GLP-1 medications may influence pregnancy complications and weight gain, the actual physical attributes of the babies and delivery method do not appear to be affected.

The study’s authors emphasized the growing use of GLP-1 receptor agonists and the importance of better understanding their implications around pregnancy. Since current guidelines recommend discontinuing these drugs before becoming pregnant due to limited safety data for fetuses, many individuals who use these medications will face this transition. The researchers stress the need for more studies to understand how to best support people who must stop GLP-1s when preparing for pregnancy or upon learning they are pregnant.

They also highlight the balance clinicians must consider. GLP-1 drugs can help individuals achieve substantial weight loss and reduce metabolic risk before pregnancy, which can be beneficial. But once discontinued, the rebound in weight gain and associated health risks during pregnancy may introduce new complications. This study suggests that interruption of treatment, rather than the medication itself, plays a key role in these pregnancy-related outcomes.

All of this raises an important issue for health care providers: how to guide and support individuals who must stop GLP-1 medications due to pregnancy. Offering strategies for managing weight, monitoring blood pressure and blood sugar, and helping patients navigate the metabolic shifts that occur after discontinuation may become increasingly crucial.

Understanding GLP-1 Receptor Agonists

To give additional context, GLP-1 receptor agonists are medications originally designed to help manage type 2 diabetes, but they have rapidly gained popularity because of their powerful effects on weight loss. These drugs mimic a naturally occurring hormone called glucagon-like peptide-1, which helps regulate appetite, slows digestion, and improves blood sugar control.

As a result, many people who struggle with obesity or weight-related health conditions are now using GLP-1 medications as part of their treatment plan. Some individuals lose significant amounts of weight—in some cases, more than 15% of their total body weight.

However, because these medications also influence hormones and metabolic pathways, they come with recommendations regarding pregnancy. Animal studies have suggested potential fetal risks, so most guidelines advise stopping GLP-1 treatments before conception. The challenge is that stopping GLP-1 medications can lead to weight regain, increased appetite, and altered metabolic control. That makes pregnancy a complex time for individuals who previously relied on these medications.

As more people of reproductive age turn to GLP-1 drugs, understanding their effects—before, during, and after pregnancy—has become increasingly important. Studies like this one help fill the knowledge gaps, though the researchers themselves note that there is much more to learn.

Why These Findings Matter

Pregnancy already brings major hormonal and metabolic changes. For individuals who have been using GLP-1 medications, suddenly stopping them may amplify shifts in appetite, weight, and insulin sensitivity. The study’s findings support the idea that discontinuation might contribute to increased risk of gestational diabetes, hypertension, and excessive weight gain, which are already challenges for many pregnancies.

Even though the findings do not suggest any increased risks for birth defects or the need for surgical deliveries, the impact on the pregnant individual’s health could still be significant. Health care providers may need to monitor those who recently stopped GLP-1 medications more closely to catch early signs of metabolic or blood pressure changes.

What Comes Next?

The researchers behind this study make it clear that we need more data. While the study shows correlations between stopping GLP-1 drugs and pregnancy outcomes, it does not determine whether stopping the drug causes these issues directly. Many other factors—such as baseline weight, metabolic health, or the reasons someone was prescribed the medication in the first place—could also play roles.

Future research will need to examine whether:

• Different GLP-1 medications affect outcomes in different ways
• The timing of discontinuation matters
• There are safe strategies to ease the transition off GLP-1 medications before pregnancy
• Additional support or interventions can reduce the risks highlighted in this study

More information on how to best care for patients who rely on GLP-1 medications—yet must pause them during pregnancy—will be essential as their use becomes more widespread.

Research Reference:
Gestational Weight Gain and Pregnancy Outcomes After GLP-1 Receptor Agonist Discontinuation (JAMA Network Open, 2025)