Title: How Real-World Use of GLP‑1 Drugs Undermines Obesity Treatment Goals

In clinical trials, GLP‑1 medications like semaglutide and tirzepatide promise extraordinary weight loss and improved blood sugar control. Yet, in everyday practice, only half of the results materialize. Understanding why can revolutionize how we manage obesity in the real world.

Obesity treatments are evolving fast. Semaglutide (Wegovy/Ozempic) and tirzepatide (Mounjaro/Zepbound), two injectable GLP‑1 drugs, showed dramatic trial results, with 15‑17 % weight reduction and substantial metabolic benefits. But a recent real-world retrospective cohort study of 7 881 U.S. patients (BMI >39, without type 2 diabetes) reveals a stark reality: the average one-year weight loss was only 10.9 % for semaglutide and 15.3 % for tirzepatide, but that’s only for patients who stayed on therapy and in high maintenance doses.

The study tracked usage from 2021 to 2023. Early discontinuation, within three months, or reducing doses were common. Less use meant less weight loss, and in patients with pre‑diabetes, deterioration in glycemic control. Notably, even among late discontinuers, some lost stability in A1c outcomes.

Key lessons:

1. Continuity matters: Early discontinuation correlates with substantially lower weight loss and loss of blood sugar gains.

2. Maintain high dosage: Patients on full maintenance doses after 12 months fared best, losing an average of 15 % weight with tripeptide.

3. Bridging the efficacy gap: Clinical trials often include motivated patients with regular support. In routine care, adherence and dosing can falter.

🚀 Actionable Insights for LinkedIn Leaders

1. Build a retention-first care model. Ensure early follow-up visits within weeks of starting GLP‑1s. Address common barriers: side effects, dosing concerns, cost, and scheduling. Frequent check-ins in months 1–3 can reduce early drop-off.

2. Create dosing clarity protocols. Clarify dosing goals upfront. Encourage patients and providers to stick with titration schedules and maintenance doses. Use automated reminders and dose tracking tools.

3. Integrate behavioral and lifestyle support. Pair pharmacotherapy with lifestyle coaching, such as nutrition, physical activity, and sleep hygiene. Drug effects peak when behavior is also aligned.

4. Track and respond to data. Incorporate EMR alerts for missed refills or lab values. Prompt teams to reach out when a dose is missed, or glycemic markers drift.

5. Focus on high-risk subgroups. Prediabetic patients are particularly vulnerable. Prioritize them for follow-up labs and intervention if A1c begins to rise.

Why it matters: When GLP‑1s aren’t used as designed, both patient outcomes and healthcare ROI suffer.

Next‑Step Takeaways for Clinicians & Organizations

• Adopt “GLP‑1 onboarding pathways” to ensure first-month check-ins.

• Train teams on subtle signs of disengagement.

• Create patient dashboards to monitor doses, labs, and appointments.

• Educate patients on the importance of sustained dosage, not just short-term wins.

💡 Stronger Together

In trials, the promise of GLP‑1s is spectacular. But real-world effectiveness hinges on sticking to the course. As leaders in healthcare, obesity treatment, or health tech, we can narrow the gap between how these drugs should work and what they do in practice.

Let’s commit to closing the loop: keep patients engaged, dosing consistently, supported holistically, and deliver the life-changing outcomes these therapies offer.

Source: https://onlinelibrary.wiley.com/doi/10.1002/oby.24331