Are Black and Latina women more likely to stop a GLP-1 early?
# Are Black and Latina women more likely to stop a GLP-1 early?
Key takeaways
Dr. Linda's take
If you are a Black or Latina woman who started a GLP-1, or is thinking about it, you may have heard a worrying version of this question: are people like me more likely to quit early? I want to answer it honestly, and gently. The pattern in the research is real, but it is not about your willpower and it is not about the medicine working differently in your body. It is mostly about the barriers built up around you: cost, insurance coverage, refills, and access to consistent care.
Naming that clearly matters, because the story often gets told backwards, as if certain women simply do not stick with treatment. The data tell a different story. Below I walk through what the studies actually show, where the gaps come from, and what stays true no matter your race or ethnicity. If you want to understand your own options first, you can start with our eligibility quiz.
What are GLP-1 medicines?
Semaglutide, one of the most widely used GLP-1 medicines, is in a class of medications called incretin mimetics. This same class is used to help manage type 2 diabetes and, for some people, weight and related cardiovascular risk. Staying on any long-term medicine depends on far more than the prescription itself, which is exactly where equity comes in. For a closer look at whether these medicines are equally effective, see whether these medicines work as well for Black and Latina women.
Do Black and Latina women get started on GLP-1s at the same rate?
Often, no, and that is where the disparity begins. In a retrospective study of more than one million U.S. adults with type 2 diabetes, Black and Hispanic patients were less likely than White patients to be treated with a GLP-1 receptor agonist. In that study, the adjusted odds of GLP-1 use were 0.81 for Black patients and 0.91 for Hispanic patients, compared with White patients. Who gets started shapes who is even in a position to continue, and you can read more in are Black and Latina women less likely to be prescribed one of these medicines.
Do studies show lower persistence and adherence?
Yes, several do. Nationally, in an analysis of survey data from 2005 to 2018, Black and Hispanic adults with diabetes had lower adherence to newer non-insulin glucose-lowering drugs than White adults, measured as a lower proportion of days covered. In that analysis, socioeconomic and health status were the main contributors to these disparities.
More recent work looked specifically at these medicines. In a study of more than 7,000 patients with type 2 diabetes in Wisconsin, people living in majority-Black communities had lower odds of staying adherent to GLP-1 receptor agonists, with an odds ratio of 0.67. In that same study, patients in the lowest-income neighborhoods had lower odds of GLP-1 adherence than those in the highest-income neighborhoods, with an odds ratio of 0.76. This is a strong signal that place, income, and access, not personal resolve, drive the gap. Overall in that study, only about 40 percent of patients were still adherent one year after their first GLP-1 prescription. That means early stopping is common for everyone in that group.
There is also a signal specific to women. In a real-world study of semaglutide for obesity, female sex was associated with lower odds of persistence than male sex, with an odds ratio of 0.32. At the same time, the honest picture is mixed. In that same obesity cohort, race and ethnicity were not statistically significantly associated with persistence or adherence, a reminder that results differ from study to study.
Is the medicine itself the problem?
No, and this is the reassuring part. When people do stay on treatment, the medicine itself appears to work similarly across groups, because a post hoc analysis of three semaglutide trials found no significant interactions between treatment effect and race. In that analysis, the treatment effect of semaglutide was statistically significant versus placebo and clinically relevant across all racial and ethnic subgroups. If early stopping were about the drug performing worse in Black or Latina women, we would expect to see it in the trial results, and we do not. For related reassurance on metabolic benefit, see whether these medicines lower diabetes risk for Black and Latina women.
What is really driving early stopping?
Structure, more than anything. The researchers who documented these gaps concluded that strategies to lower barriers to GLP-1 use, such as lower cost, are needed. They noted that patients who are marginalized by racism have less access to novel therapeutics. Read together, the studies point at cost, coverage, and access rather than the medicine or the person taking it. Side effects can also shape how treatment feels early on, which we cover in do Black and Latina women report different side effects.
Frequently asked questions
Does this mean a GLP-1 will not work for me?
No. The evidence on how well the medicine lowers weight and blood sugar is consistent across racial and ethnic groups. The disparities researchers find are about who starts, who can afford to continue, and who has steady access to care, not about the biology of how the medicine works in your body.
If persistence is lower on average, is stopping my fault?
No. The studies consistently trace lower persistence back to cost, income, insurance coverage, and access. Those are structural barriers, and a licensed clinician can help you plan around them rather than treat early stopping as a personal shortcoming.
What can help someone stay on treatment?
Practical support tends to matter most: understanding your insurance coverage, planning for cost, keeping refills predictable, and having a care team you can reach with questions. A clinician who knows your situation can tailor a plan, which is different from any general article telling you what to do.
References
1. Eberly LA, et al. Racial, Ethnic, and Socioeconomic Inequities in Glucagon-Like Peptide-1 Receptor Agonist Use Among Patients With Diabetes in the US. JAMA Health Forum. 2021. PMID 35977298. https://pubmed.ncbi.nlm.nih.gov/35977298/
2. Li P, et al. Changes in racial and ethnic disparities in glucose-lowering drug utilization and glycated haemoglobin A1c in US adults with diabetes: 2005-2018. Diabetes Obes Metab. 2023. PMID 36251173. https://pubmed.ncbi.nlm.nih.gov/36251173/
3. Differences in GLP-1 RA medication adherence across place-based variables in patients with diabetes living in Wisconsin. J Manag Care Spec Pharm. 2025. PMID 41296314. https://pubmed.ncbi.nlm.nih.gov/41296314/
4. Real-world use of semaglutide for obesity treatment: A cohort study in an integrated health care delivery system. J Manag Care Spec Pharm. 2026. PMID 42166306. https://pubmed.ncbi.nlm.nih.gov/42166306/
5. Rubino D, et al. Efficacy and safety of semaglutide 2.4 mg by race and ethnicity: A post hoc analysis of three randomized controlled trials. Obesity (Silver Spring). 2024. PMID 38932728. https://pubmed.ncbi.nlm.nih.gov/38932728/
6. MedlinePlus. Semaglutide Injection. https://medlineplus.gov/druginfo/meds/a618008.html
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*This article is general education and is not medical advice. It cannot tell you what is right for your body. Talk with a licensed clinician about your own situation.*
*Written and clinically reviewed by Dr. Linda Moleon, MD. Last reviewed 2026-07-26.*
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