Few areas of medicine have captured public interest over the past two years quite like glucagon-like peptide-1 (GLP-1) receptor agonists. Originally developed to improve glycemic control in type 2 diabetes, drugs like semaglutide (Ozempic/Wegovy) and tirzepatide (Mounjaro/Zepbound) have proven remarkably effective at helping patients lose weight. Physicians, employers and investors are watching closely as the market grows, supply ebbs and flows and new research emerges.
This post digs deep into the latest real-world data, safety signals and market dynamics shaping GLP-1 therapies. It summarizes clinical trial results with new evidence on adherence, demographics and emerging indications and explains what it all means for patients and providers. A section reserved for HealthVerity Marketplace data illustrates the richness of real-world evidence available to inform strategic decisions. Finally, we close with guidance on how to stay ahead of the curve and a call to action to harness these insights.
HealthVerity Marketplace has real-world GLP-1 data
HealthVerity Marketplace provides real-time visibility into one of the most important shifts in modern therapeutics. By linking privacy-protected pharmacy records, HealthVerity Marketplace includes prescription data on more than 19.1 million patients taking GLP-1 drugs such as Ozempic, semaglutide, and Rybelsus. These insights reveal how GLP-1 therapies are being used in the real world, including how much weight patients are actually losing, a topic that’s driving intense interest across healthcare and policy circles.
GLP-1 trends in type 2 diabetes
Analysis from two EHR (electronic health record) sources in HealthVerity Marketplace shows the rapid adoption of GLP-1 therapy among people with type 2 diabetes. Between early 2022 and mid-2024, more than 6 million patients were identified with a type 2 diabetes diagnosis. Of those, roughly 1 in 5 had an active GLP-1 prescription. This provides a clear view into how these therapies are being integrated into diabetes care at scale and highlights the value of Marketplace data for tracking treatment adoption and patient outcomes in real time (Figure 1).
Figure 1: Data from 2 EHR sources in HealthVerity Marketplace showing GLP-1 prescription use in type 2 diabetes patients.
The Marketplace also captures prescribing activity from over 790,000 providers at the NPI level, offering one of the broadest and most detailed resources for understanding adoption patterns nationwide. With this unmatched coverage, pharmaceutical manufacturers and healthcare researchers can move beyond traditional claims analysis to access verified insights that illuminate real-world treatment dynamics across diverse patient populations.
GLP-1 prescriptions for weight-loss
In a separate analysis between 2020 and 2023, one HealthVerity closed claims dataset had more than 1.5 million patients who had at least one prescription for tirzepatide or semaglutide. Notably, about one in four of these patients did not carry a type 2 diabetes diagnosis, suggesting that a substantial portion of GLP-1 use is being driven by weight loss and other emerging indications outside of diabetes care (Figure 2).
Figure 2: Distribution of GLP-1 closed claims from one source in HealthVerity Marketplace indicating patients with tirzepatide or semaglutide prescriptions from 2020–2023.
GLP-1 trends: tirzepatide vs. semaglutide
For years, semaglutide held the spotlight. That changed when the SURMOUNT-5 trial compared tirzepatide (the active ingredient in Zepbound) and semaglutide directly. The trial showed that tirzepatide achieved roughly 20% weight loss (about 50 pounds) versus 14% weight loss (33 pounds) with semaglutide.¹ This significant difference prompted analysts to declare tirzepatide the winner.¹ As a result, clinicians are updating treatment algorithms and patients on semaglutide are asking about switching. Still, insurance coverage and cost considerations mean both drugs remain relevant, and patient-centred conversations about therapy choice are critical.¹
GLP-1s beyond weight loss as multi-system therapies
Liver disease and metabolic steatohepatitis
Non-alcoholic fatty liver disease (NAFLD) and the more severe metabolic dysfunction-associated steatohepatitis (MASH) have few effective pharmacologic treatments. Recent research suggests GLP-1 therapy may help. Wegovy has shown promise in improving MASH.¹ If confirmed in larger trials, GLP1 drugs could become a cornerstone of liver disease management.
Cardiovascular benefits of GLP-1
The SELECT trial demonstrated that GLP-1 therapy rapidly reduces heart attacks and strokes.¹ These cardiovascular benefits have long been hinted at in diabetes trials, but the magnitude observed in SELECT surprised even seasoned cardiologists. As a result, payers and guideline bodies are considering broader coverage for patients at high cardiovascular risk.
GLP-1 for sleep apnea, alcohol use and cancer risk
GLP-1s may address conditions well beyond metabolic diseases:
- Obstructive sleep apnea: Emerging data suggest GLP-1s improve apnea symptoms.¹
- Alcohol use disorder: Patients using liraglutide or semaglutide reduced alcohol consumption by nearly two-thirds.¹
- Obesity-related cancers: An observational study of 6,000 adults found that GLP-1 receptor agonists halved the risk of obesity-related cancers compared with usual care.2 Bariatric surgery reduces cancer risk by about 30–42%, whereas GLP-1 therapy seems to offer an even stronger protective effect.
The takeaway? GLP-1s are no longer just “weight-loss drugs”; they may soon be used to treat liver disease, cardiovascular conditions, sleep apnea and even reduce cancer risk.2
Digital care and dosing for GLP-1 therapy
One of the most promising innovations in obesity management is the integration of digital coaching with flexible medication dosing. A Danish cohort study evaluated an online weight-loss program that combined behavioral support with individualized semaglutide dosing. Participants lost 16.7% of baseline weight over 64 weeks, matching clinical trial outcomes despite using half the typical drug dose. Only 28.8% of participants exceeded 1 mg/week. The “treat-to-target” strategy allowed patients to start low and increase the dose only when weight loss stalled. Side effects were mostly mild.3
These results suggest that robust digital support can optimize dosing, reduce costs and improve adherence.3 As more employers incorporate digital GLP-1 programs, expect to see insurers incentivize treat-to-target approaches.
GLP-1 patient trends: demographics and adherence patterns
Usage across the population
A nationally representative survey conducted by RAND found that 11.8% of Americans have used GLP-1 drugs for weight loss, and about 14% express interest, while 74% say they do not plan to take them. Women use GLP-1s at higher rates than men, particularly those aged 50–64.4 Among individuals aged 30–49, women are more than twice as likely as men to have used the drugs.4 This demographic skew underscores the importance of gender-specific messaging and benefit design.
Side effects
About 50% of users reported nausea and one-third reported diarrhea in RAND’s survey.4 Gastrointestinal side effects are the most common reason for discontinuation.5
Persistence and discontinuation
Persistence with GLP-1 therapy has been a major concern. Real-world analyses show that half of patients discontinue within a year.5,6 However, persistence appears to be improving. A recent analysis of pharmacy claims found that 63% of patients starting Wegovy or Zepbound in early 2024 were still taking the drug one year later.7 This is up from 40% among patients who started in 2023. The improvement may reflect easing drug shortages, expanded insurance coverage and better management of side effects. Despite this progress, only 14% of patients remain on Wegovy after three years (Figure 3).7
For patients who stop treatment early, weight regain is common. In a recent observational study, individuals who discontinued semaglutide or tirzepatide within the first three months lost only 3.6% of their body weight, while those who quit between three and twelve months lost 6.8%. The same study showed that patients taking higher doses and remaining adherent achieved weight loss comparable to clinical trials.5
Figure 3: Pharmacy claims data show that 63% of patients initiating Wegovy or Zepbound in early 2024 remained on therapy at one year, up from 40% in the 2023 cohort. Despite these improvements, persistence declines sharply over longer durations, with only 14% of patients remaining on Wegovy after three years. Created using data from Prime Therapeutic's study.7
Why real-world GLP-1 results differ from clinical trials
Clinical trials enrol carefully selected participants, provide intensive coaching and deliver high medication doses. The real world is messier. A 2025 study published in Obesity found that GLP1 users lost 7.7% of body weight on semaglutide and 12.4% on tirzepatide after one year, roughly half the weight loss seen in randomized trials.5 Two factors drive this gap:
- Early discontinuation: About 22 % of semaglutide users and 16% of tirzepatide users stopped treatment within the first year, and many more quit after the one-year mark.5
- Lower doses: Eight in ten real-world patients were on maintenance doses below 1.7 mg of semaglutide or 10 mg of tirzepatide. Those who reached higher doses achieved weight loss comparable to trials.5
Even modest weight loss is clinically meaningful: reductions of 5% of baseline weight can improve blood pressure, glucose levels and cardiovascular risk.5 Providers should set realistic expectations, encourage lifestyle changes and address barriers such as cost and insurance hurdles.
GLP-1 safety trends and emerging side effects
While gastrointestinal discomfort is the most common issue, new safety signals continue to emerge. Recent analyses have raised questions about psychiatric side effects, particularly mood changes and anxiety.¹ Patients with asthma may be at increased risk of respiratory complications,¹ and nutrient deficiencies can occur with long-term therapy.¹ Monitoring mental health and nutritional status should be part of any GLP-1 program.
GLP-1 market trends: pricing, supply and policy shifts
The GLP-1 market has matured quickly but remains volatile. Zepbound’s price has fallen to $349–$499 per month.¹ Competition has intensified as insurers respond to rising utilization, sometimes switching patients to “second-choice” drugs.¹ Meanwhile, supply shortages have eased; both semaglutide and tirzepatide are off the FDA shortage list.6
Employers and government agencies are weighing whether to broaden coverage. While early data show improved persistence, only a minority of patients remain on therapy beyond two years.6 Payers must balance high upfront costs against potential long-term savings from reduced complications.
Future GLP-1 trends: new drugs and therapies on the horizon
The future of weight management may soon involve more than current GLP-1s:
- Amylin mimetics: These compounds mimic another satiety hormone and may complement GLP-1s.¹
- Mazdutide: A dual glucagon/GLP-1 agonist showing strong Phase 3 results and promising greater weight loss.¹
- Oral GLP-1s: Pills in development could improve convenience.¹
- Muscle-preserving combinations: Researchers are exploring co-therapies to prevent loss of lean mass during weight loss.¹
Providers should prepare for a rapidly evolving landscape and educate patients about upcoming options.¹
Key takeaways on GLP-1 trends for providers and patients
- Efficacy varies across drugs and doses. Tirzepatide produces more weight loss than semaglutide,¹ but individualized dosing with robust support can achieve similar outcomes using lower doses.3
- GLP-1s are multi-system therapies. They can improve liver disease, cardiovascular health, sleep apnea and may lower cancer risk.2
- Adherence remains challenging. Roughly half of users stop within a year,5 though persistence has improved to 63% when supply and coverage issues are addressed.7
- Side effects are common but manageable. Gastrointestinal symptoms and occasional psychiatric concerns require monitoring.1,4
- Real-world results may differ. Expect smaller weight loss than in trials; encourage patients to combine medication with diet, exercise and behavioral support.5
- New drugs are coming. Stay informed about dual agonists, oral formulations and combination therapies.¹
Why data matters and how to get ahead
Real-world evidence is essential for guiding coverage decisions, tailoring treatment protocols and maximizing patient outcomes. By linking pharmacy claims, electronic medical records, social determinants and lab results, we can uncover patterns in adherence, dosing and comorbidities that clinical trials can’t reveal. HealthVerity Marketplace offers a privacy-protected, interoperable platform that makes these insights accessible at scale.
If you’re a payer, employer or provider navigating the GLP-1 revolution, don’t rely solely on published trials. Use comprehensive, longitudinal data to understand how these medications perform in the populations you serve. Whether you’re evaluating cost-effectiveness, optimizing adherence or designing a lifestyle program to accompany pharmacotherapy, the right data makes the difference.
Ready to explore real-world GLP-1 data?
Visit HealthVerity Marketplace to access robust, real-world data on GLP-1 therapies and other high-impact drugs. Our platform can help you answer pressing questions about utilization, adherence, outcomes and more, empowering you to deliver better care and make smarter decisions. Reach out today to learn how HealthVerity Marketplace can support your team.
References
- IAPAM. (2025, June). What providers need to know: June 2025 GLP-1 trends & updates. IAPAM. Retrieved August 21, 2025, from https://iapam.com/what-providers-need-to-know-june-2025-glp-1-trends-and-updates
- Weight-loss jabs could halve risk of obesity-related cancers, study finds. (2025, August 14). The Guardian. Retrieved August 21, 2025, from https://www.theguardian.com/society/2025/may/11/weight-loss-jabs-could-halve-risk-of-obesity-related-cancers-study-finds
- A half dose of semaglutide yields weight loss equivalent to clinical trial doses in combination with online support program. (2025, June). PatientCare Online. Retrieved August 21, 2025, from https://www.patientcareonline.com/view/a-half-dose-of-semaglutide-yields-weight-loss-equivalent-to-clinical-trial-doses-in-combination-with-online-support-program
- Bozick, R., Donofry, S. D., & Rancaño, K. M. (2025, August 6). New weight loss drugs: GLP-1 agonist use and side effects in the United States (Research Report No. RR-A4153-1). RAND Corporation. https://www.rand.org/pubs/research_reports/RRA4153-1.html
- Spichak, S. (2025, June 17). Think GLP-1s guarantee major weight loss? Real-world data says otherwise. Health. Retrieved August 21, 2025, from https://www.health.com/glp-1-drugs-real-world-weight-loss-11752679
- Terhune, C. (2025, June 25). New data show most U.S. patients now stay on Wegovy, Zepbound after a year. Reuters. Retrieved August 21, 2025, from https://www.reuters.com/business/healthcare-pharmaceuticals/new-data-show-most-us-patients-now-stay-wegovy-zepbound-after-year-2025-06-25/
- Prime Therapeutics. Leading research shows only 1 in 12 remain on a GLP-1 drug for obesity at three years. Prime Therapeutics. Published June 25, 2025. Accessed August 21, 2025. https://www.primetherapeutics.com/w/prime-therapeutics-leading-research-shows-only-1-in-12-remain-on-a-glp-1-drug-for-obesity-at-three-years
