A Cleveland Clinic examine reveals that semaglutide and tirzepatide—injectable GLP-1 medication for weight problems—produce smaller weight reduction in a real-world setting as a result of sufferers discontinue therapy or use decrease upkeep dosages. Remedy discontinuation additionally negatively impacted blood sugar management in sufferers with prediabetes. The examine was printed within the Weight problems Journal.
Hamlet Gasoyan, Ph.D., lead creator of the examine and a researcher with Cleveland Clinic’s Heart for Worth-Primarily based Care Analysis, stated, “Our examine reveals that sufferers handled for weight problems with semaglutide or tirzepatide misplaced much less weight on common in a daily scientific setting in contrast to what’s noticed in randomized scientific trials.
“Based on our knowledge, this might be defined by increased charges of discontinuation and decrease upkeep dosages utilized in scientific observe, in comparison with randomized scientific trial settings.”
Semaglutide (bought below the model names Wegovy and Ozempic) and tirzepatide (bought below the model names Zepbound and Mounjaro) are FDA-approved medicines for the therapy of sort 2 diabetes and continual weight administration.
Whereas randomized scientific trials have proven the efficacy of these medicines, Dr. Gasoyan and colleagues studied their impact on weight discount and blood sugar regulation (glycemic management) in a real-world setting.
This Cleveland Clinic retrospective cohort examine included 7,881 grownup sufferers with a median physique mass index (BMI) higher than 39, which is assessed as clinically extreme weight problems. Among the many members, 1,320 had pre-diabetes initially of the examine, outlined by blood sugar ranges between 5.7–6.4%. Sufferers who’ve pre-diabetes are at a better threat of creating sort 2 diabetes, which is without doubt one of the most typical problems of weight problems.
The examine members started therapy for weight problems with injectable types of semaglutide or tirzepatide between 2021 and 2023. Researchers grouped sufferers who discontinued their weight problems medicines into those that discontinued early (inside three months) and late (inside three to 12 months). The examine’s follow-up led to December 2024.
Researchers discovered that greater than 20% of sufferers discontinued their medicines early and 32% discontinued their medicines late. As well as, greater than 80% of examine members have been on decrease upkeep dosages of these medicines (i.e., equal to or lower than 1 mg for semaglutide and equal to or lower than 7.5 mg for tirzepatide). The upkeep dose refers back to the quantity of treatment wanted to maintain a therapeutic impact.
One yr after the beginning of the therapy, researchers discovered that the common weight discount was 3.6% among the many members who discontinued their therapy early, in comparison with 6.8% for many who discontinued their therapy late. Those that didn’t discontinue therapy misplaced on common 11.9% physique weight.
Those that didn’t discontinue therapy and have been on excessive upkeep dosage of the medicines misplaced 13.7% of their physique weight with semaglutide and 18.0% with tirzepatide.
“Our findings concerning the real-world use patterns of those medicines and related scientific outcomes may inform the selections of well being care suppliers and their sufferers on the position of therapy discontinuation and upkeep dosage in reaching clinically significant weight reductions,” stated Dr. Gasoyan.
Researchers additionally recognized what elements have been related to increased odds of reaching weight lack of 10% or extra, which offers clinically important well being advantages on this affected person inhabitants. Sufferers had increased odds of reaching 10% or higher weight discount after one yr of therapy in the event that they:
- didn’t discontinue their medicines or discontinued late (vs. early)
- have been on excessive upkeep dosage
- acquired tirzepatide (vs. semaglutide)
- have been feminine (vs. male).
Along with trying on the elements that have an effect on an individual’s weight trajectory, researchers tracked glycemic management in sufferers who had pre-diabetes initially of the examine.
Among the many members with pre-diabetes, 33% of those that discontinued their therapy early skilled regular blood sugar ranges (outlined by an HbA1c stage of 5.6 or decrease), in comparison with 41% who discontinued their therapy late, and 67.9% who didn’t discontinue therapy.
“In our examine, nearly all of the sufferers with pre-diabetes skilled regular blood sugar ranges once they continued their therapy,” stated Dr. Gasoyan. “Sort 2 diabetes is without doubt one of the most typical problems of weight problems, so diabetes prevention is essential. This examine highlights that therapy discontinuation, particularly early, negatively impacts each weight and glycemic management outcomes.”
The most typical causes for discontinuation of therapy included the price of the medicines and insurance coverage protection–associated points, uncomfortable side effects, and treatment shortages. A follow-up examine is within the works to quantify why sufferers discontinue their weight problems medicines in a real-world setting.
As well as, researchers noticed that whereas sufferers who discontinued weight problems medicines misplaced considerably much less weight in comparison with those that continued, their weight trajectories remained comparatively steady.
This will likely be studied additional to establish what further weight administration strategies sufferers are utilizing in actual world settings after discontinuation of weight problems medicines.
Extra data:
Modifications in weight and glycemic management following weight problems therapy with semaglutide or tirzepatide by discontinuation standing, Weight problems (2025). DOI: 10.1002/oby.24331
Quotation:
Injectable medicines for weight problems discovered to provide smaller weight reduction in a real-world setting (2025, June 10)
retrieved 10 June 2025
from https://medicalxpress.com/information/2025-06-medications-obesity-smaller-weight-loss.html
This doc is topic to copyright. Aside from any truthful dealing for the aim of personal examine or analysis, no
half could also be reproduced with out the written permission. The content material is supplied for data functions solely.
