As the new year begins, many patients refocus on weight management and long-term health goals. At the same time, GLP-1 drugs have reshaped the obesity treatment landscape.1,2 With semaglutide and other GLP-1 medications in high demand for weight loss, researchers are asking a fundamental question that clinical trials can’t fully answer:
How long do patients stay on GLP-1 therapy once they start?
Real-world data is the only way to understand true GLP-1 patient adherence and persistence. Clinical trials offer controlled environments, but they do not reflect how patients use GLP-1 drugs in everyday settings. To understand real world semaglutide outcomes and real world effectiveness, we need longitudinal data that captures the full patient journey.
The persistence problem in real world GLP-1 use
Using HealthVerity Marketplace, we analyzed nearly 3.9 million semaglutide patients between June 2021 and May 2025 (Table 1). By utilizing closed claims and electronic health records. the dataset provides one of the most comprehensive pictures available of real world GLP-1 behavior.
Out of the full population of semaglutide users, only 36,780 initiated the 1.7 mg or 2.4 mg dose during the key uptake window. Of those, 28,841 remained continuously observable in the data for at least two years. Only 13,647 met obesity or overweight criteria with a weight related comorbidity.
Most striking is the persistence trend. Only 4,358 patients continued GLP-1 therapy for at least two years, and only 534 had a documented BMI value at the two year mark. That means real world GLP-1 adherence is far lower than clinical expectations, and measurable real world outcomes are difficult to capture without deep longitudinal visibility.
Table 1: Semaglutide cohort funnel (June 2021 – May 2025). Sourced from taXonomy and Veradigm EHR data accessed through HealthVerity Marketplace.
|
Cohort filter |
Patients retained |
% of total |
|
Any semaglutide use (June 2021–May 2025) |
3,849,994 |
100% |
|
Initiated 1.7 mg or 2.4 mg (2021–2022) |
36,780 |
0.96% |
|
Continuously observable ≥2 years |
28,841 |
0.75% |
|
Obesity/overweight + comorbidity |
13,647 |
0.35% |
|
Maintained therapy ≥2 years |
4,358 |
0.11% |
|
Recorded BMI at 2 years |
534 |
0.01% |
These findings highlight the need for high quality GLP-1 real world data to understand why patients stop therapy, how dosing patterns evolve over time, and what factors drive long term success.
Why this matters for teams working with GLP-1 drugs
For pharmaceutical innovators developing GLP-1 therapies or competing in the obesity market, real world semaglutide data uncovers insights that trial data cannot provide. Teams can use GLP-1 real world evidence to:
- Quantify real world GLP-1 adherence and persistence across patient types
- Identify reasons for GLP-1 discontinuation by comorbidity, payer, or prescriber pattern
- Measure real world semaglutide outcomes, including BMI change for long term users
- Benchmark performance across GLP-1 weight loss drugs in real market conditions
- Strengthen RWE strategies using verified longitudinal patient journeys
Understanding how patients use GLP-1 medications in real life is essential for refining patient support programs and improving persistence
How HealthVerity solves the GLP-1 data gap
HealthVerity Marketplace is the nation’s largest ecosystem of linked healthcare and consumer data. It combines closed claims, EHR, labs and even consumer activity to deliver a complete and privacy protected view of the GLP-1 patient journey.
By using advanced identity resolution like privacy-preserving record linkage (PPRL), HealthVerity provides unmatched precision and stability for GLP-1 data analysis. Each patient journey is longitudinal, which allows teams to study real world GLP-1 outcomes with confidence.
Explore current GLP-1 trends and insights
Semaglutide persistence is only one example of how complete, longitudinal data can reveal real world GLP-1 behavior. For life sciences organizations shaping their GLP-1 strategy, the opportunity lies in exploring the data behind the patient story.
See what real world GLP-1 data can unlock. Build your own semaglutide cohorts and understand how patients behave in the market through HealthVerity Marketplace
References
- The GLP-1 trend: What the real-world data reveals. June 16, 2025. Accessed December 3, 2025. https://blog.healthverity.com/the-glp-1-surge-what-the-real-world-data-reveals
- FAIR Health. Use of GLP-1 Drugs to Treat Overweight or Obesity Increased 587 Percent from 2019 to 2024, According to New FAIR Health Study. May 27, 2025 https://www.fairhealth.org/press-release/use-of-glp-1-drugs-to-treat-overweight-or-obesity-increased-587-percent-from-2019-to-2024-according-to-new-fair-health-study
