This study examines the prevalence and associated factors of discontinuation of glucagon-like peptide 1 (GLP-1) receptor agonists among patients with type 2 diabetes (T2D) or obesity. The research, conducted from January 1, 2021, to December 31, 2023, used data from the Komodo Healthcare Map database. Patients aged 18 years or older who started using GLP-1 agonists (dulaglutide, exenatide, liraglutide, or semaglutide) in 2021 were included, with continuous enrollment in commercial, Medicare, or Medicaid plans for at least 12 months before and 17 months after the index date. Discontinuation was defined as no GLP-1 agonist fill in the 135 days following the 3-, 6-, and 12-month post-index date assessments. The overall prevalence of GLP-1 agonist discontinuation was 26.2%, 30.8%, and 36.5% at 3, 6, and 12 months, respectively. Patients with obesity only had a higher prevalence of discontinuation at 12 months (50.3%) compared to those with T2D only (35.8%) and those with both conditions (34.2%). Logistic regression analysis identified several factors associated with discontinuation, including race, gender, insurance status, social needs, baseline conditions, and adverse effects. Older patients had lower odds of discontinuation, while higher out-of-pocket (OOP) costs were associated with increased odds of discontinuation. The study highlights the higher discontinuation rates among patients with obesity and the impact of various demographic, clinical, and financial factors on discontinuation. These findings have implications for policy and medication coverage, especially if weight reduction is not sustained after discontinuation.This study examines the prevalence and associated factors of discontinuation of glucagon-like peptide 1 (GLP-1) receptor agonists among patients with type 2 diabetes (T2D) or obesity. The research, conducted from January 1, 2021, to December 31, 2023, used data from the Komodo Healthcare Map database. Patients aged 18 years or older who started using GLP-1 agonists (dulaglutide, exenatide, liraglutide, or semaglutide) in 2021 were included, with continuous enrollment in commercial, Medicare, or Medicaid plans for at least 12 months before and 17 months after the index date. Discontinuation was defined as no GLP-1 agonist fill in the 135 days following the 3-, 6-, and 12-month post-index date assessments. The overall prevalence of GLP-1 agonist discontinuation was 26.2%, 30.8%, and 36.5% at 3, 6, and 12 months, respectively. Patients with obesity only had a higher prevalence of discontinuation at 12 months (50.3%) compared to those with T2D only (35.8%) and those with both conditions (34.2%). Logistic regression analysis identified several factors associated with discontinuation, including race, gender, insurance status, social needs, baseline conditions, and adverse effects. Older patients had lower odds of discontinuation, while higher out-of-pocket (OOP) costs were associated with increased odds of discontinuation. The study highlights the higher discontinuation rates among patients with obesity and the impact of various demographic, clinical, and financial factors on discontinuation. These findings have implications for policy and medication coverage, especially if weight reduction is not sustained after discontinuation.