Treating class 2–3 obesity with glucagon‐like peptide‐1 agonists: A 2‐year real‐world cohort study
Authors' conclusion
Nearly half of the patients who were started on GLP1RA, a treatment intended for indefinite use, stopped taking GLP1RA within 2 years. Patients who stopped treatment experienced similar weight loss to those who never started treatment. For real-world patients who stayed on treatment for 2 years, a lower TWL% was observed than previously reported in clinical trials.
Study context
- Population
- Patients prescribed GLP1RA for class 2–3 obesity, January 2020–November 2022, large non-profit healthcare system in the Midwestprescribed GLP1RA
- Participants
- 853 patients
- Exposure
- Stayed on GLP1RA vs never started vs stopped within 2 years
- Never startedn = 211reference
- Stoppedn = 304
- Outcome
- Total weight loss percentage (TWL%)
- Follow-up
- 2 years
Methodological detailsreal-world, single non-profit healthcare system, 211 (24.7%) never received the drug; 304 (35.6%) discontinued within 2 years
- Real-world
- Single non-profit healthcare system
- 211 (24.7%) never received the drug; 304 (35.6%) discontinued within 2 years
Main finding
As reported in the abstract
TWL%
Stayed on GLP1RA
9.22%
average · SD 9.73%
Difference (95% CI)P value
Stayed on GLP1RAvs Never startedmore weight loss with stayed on GLP1RA
3.98%(1.57%–6.41%)
P = 0.001Stayed on GLP1RAvs Stoppedmore weight loss with stayed on GLP1RA
5.82%(3.56%–8.09%)
P < 0.001Between Stopped and Never startedsimilar weight loss
1.83%(−1.30% to 4.97%)
P = 0.251Observational data: associations, not effects.
Further findings
Reasons for discontinuation (among 304 who stopped)
- Loss to follow-up with original prescriber
- n = 81, 26.6%
- Side effects
- n = 72, 23.7%
- Cessation of insurance coverage
- n = 65, 21.4%
GLP1RA prescription numbers · study period
- Growth in GLP1RA prescriptions
- six-fold
Safety
Discontinuation due to side effects · within 2 years
- Discontinued due to side effects
- n = 72, 23.7%
Original publication
Treating class 2–3 obesity with glucagon‐like peptide‐1 agonists: A 2‐year real‐world cohort study. Diabetes Obes Metab. Published 19 March 2025. doi:10.
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