New research suggests that discontinuing GLP-1 medications, commonly prescribed for weight loss, prior to pregnancy may be associated with increased risks of complications such as gestational diabetes, preeclampsia, and excessive gestational weight gain.
The study reviewed several hundred singleton pregnancies within the Mass General Brigham system from 2016 to 2025, identifying approximately 450 cases where participants had used a GLP-1 medication in the three years leading up to conception or during the first 90 days of pregnancy.
Researchers found that individuals who stopped GLP-1 drugs before pregnancy were more likely to experience:
- Excessive gestational weight gain, averaging around 30 pounds compared to 23 pounds in participants who had never used GLP-1s.
- Gestational diabetes and hypertensive disorders such as high blood pressure and preeclampsia.
- Preterm birth at a slightly higher rate than those who had never used the medications.
Understanding the Findings
Experts emphasize that these results do not prove a direct cause-and-effect relationship. Many participants had obesity or metabolic conditions prior to pregnancy, which themselves increase the risk of complications. Stopping GLP-1s can also lead to rebound weight gain and fluctuations in blood sugar, adding further challenges during early pregnancy.
“GLP-1s clearly support metabolic health outside of pregnancy,” says Dr. Andrea Braden, OB-GYN. “However, we do not yet have strong, pregnancy-specific trials to confirm their safety or benefit if continued during pregnancy.”
Prenatal dietitian Shyamala Vishnumohan adds that abrupt discontinuation may trigger increased appetite and changes in blood sugar, highlighting the importance of having a structured plan for those stopping these medications before conception.
Guidance for Pregnant Individuals
GLP-1 medications are not recommended during pregnancy. Experts suggest focusing on safer strategies to support healthy weight and metabolic health, including:
- Balanced nutrition: Regular meals with proteins, high-fiber carbohydrates, vegetables, fruits, and healthy fats.
- Gentle physical activity: Short bouts of movement, like walking after meals or light resistance exercises, if medically appropriate.
- Stress and sleep management: Key factors that influence appetite and energy balance.
- Professional support: Behavioral counseling and nutrition guidance during pregnancy can reduce the risk of excessive weight gain, gestational diabetes, and complications during delivery.
Dr. Braden emphasizes that maintaining a healthy lifestyle and managing obesity and metabolic health before pregnancy remains critical. “We currently know far more about the risks of excess weight in pregnancy than about the risks of GLP-1 exposure,” she notes.
Bottom Line
While GLP-1 medications have proven benefits for weight management and metabolic health, their use should be discontinued before pregnancy, and individuals should work with healthcare providers to manage weight, nutrition, and blood sugar safely during this period. Structured support and practical lifestyle habits can help reduce risks for both the parent and the baby.
