More New Moms Are Starting GLP-1 Drugs

Starting a GLP-1 receptor agonist after giving birth is becoming more common, an analysis of claims data showed.

The percentage of women who initiated a GLP-1 medication within 6 months of delivery rose more than 20-fold, from 0.08% in early 2018 to 1.9% by early 2025, reported Sih-Ting Cai, PhD, of the Schaeffer Center for Health Policy & Economics at the University of Southern California in Los Angeles, and colleagues.

This was particularly prevalent among women with type 2 diabetes, whose rate of initiation rose from 2.3% to 16.9% during that time, they reported in a research letter in JAMA.

More recently, however, most initiators were outside the type 2 diabetes group, they found. In the second half of 2024, 40.4% of initiators had overweight or obesity, 20.7% had no pre-delivery diagnosis, 20.6% had gestational diabetes mellitus, and only 18.3% had type 2 diabetes.

“Postpartum GLP-1 use is likely rising even faster than our numbers show, while the safety evidence hasn’t kept pace. That gap is worth more attention,” Cai told MedPage Today, noting this study is the first to break down which clinical subgroups are driving the growth.

“The clinical need is real and growing, but the safety evidence needs to catch up to match it,” Cai added.

GLP-1 medications are increasingly popular, but research on pregnant and postpartum women is lagging. Recent systematic reviews and meta-analyses found that GLP-1 medication use around pregnancy didn’t seem to increase adverse maternal or perinatal outcomes, but experts still urged caution until better evidence is available.

While GLP-1 receptor agonists are generally not used in pregnancy, the authors suggested they “may represent an important postpartum treatment for persistent metabolic risk.”

A Danish study published in JAMA last year found that postpartum prescriptions rose once semaglutide (Ozempic, Wegovy) was approved for weight loss. Cai said this study offers a natural benchmark against the Danish one, showing that U.S. trends are comparable despite the differences in healthcare systems.

Nikki Zite, MD, MPH, an ob/gyn at the University of Tennessee Graduate School of Medicine in Knoxville, who was not involved in the research, told MedPage Today that these findings aren’t surprising considering expanding indications and increased insurance coverage for GLP-1 medications.

She noted that many people didn’t have a pre-pregnancy diagnosis, “so it is unclear if these medications are being used in a population that might not need them if they were more patient with post-partum weight loss.”

Zite added that more research on the safety profile of GLP-1 drugs during and after pregnancy and while breastfeeding is still needed and hopes future research illuminates “if these medications decrease the known risk of someone with gestational diabetes developing type 2 diabetes mellitus” and “to confirm that we are not impacting mental health or over-encouraging rapid weight loss of ‘baby weight.'”

For this study, the researchers analyzed Merative MarketScan Commercial claims data and ICD-10 codes to identify live-birth deliveries between January 1, 2018 and March 31, 2025. Postpartum initiation was defined as at least one GLP-1 medication pharmacy claim within 6 months post-delivery.

Eligible women were ages 18 to 49 at delivery and had continuous insurance enrollment from 6 months before to 6 months after delivery. Their diagnoses were determined using claims data up to 12 months before delivery. Those with type 1 diabetes or a GLP-1 medication fill within the 180 days before delivery were excluded.

In total, 911,908 eligible women had 1,104,417 deliveries during the study period. Before delivery, most women had no qualifying diagnosis (68.2%) while 2% were classified as type 2 diabetes, 12% as gestational diabetes, and 17.8% as overweight or obesity.

Most (61.6%) initiated GLP-1 medication use 3 to 6 months after delivery rather than immediately postpartum. The median time to initiation was 95 days among women with type 2 diabetes compared to 117 days among those with no relevant diagnoses.

A bit more than half of the GLP-1 medication initiators who didn’t have a qualifying pre-delivery diagnosis did have a diagnosis between delivery and their first medication fill (55.2%), most commonly overweight or obesity (52.3%). Authors noted this “may reflect newly developed or newly documented risk or incomplete pre-delivery ascertainment.”

Authors listed the reliance on claims-based diagnoses was as a limitation in addition to the inability to know breastfeeding status and the possible misclassification of some women who used GLP-1 drugs before the 180 day pre-delivery cutoff. Plus, the study only included women with commercial insurance, limiting the generalizability of the findings.

Cai said future research should dive into what’s driving prescribing in the no-documented-diagnosis group and trends within cash-pay telehealth prescriptions and compounded formulations obtained outside traditional insurance channels.