Real-World Use of Ozempic, Wegovy, Mounjaro and Zepbound Shows Lower Weight Loss Than Clinical Trials, Cleveland Clinic Study Finds

Real-World Use of Ozempic, Wegovy, Mounjaro and Zepbound Shows Lower Weight Loss Than Clinical Trials, Cleveland Clinic Study Finds

A new study from the Cleveland Clinic reveals that real-world patients using semaglutide or tirzepatide (marketed as Ozempic, Wegovy, Mounjaro and Zepbound) tend to lose less weight than expected, primarily due to early discontinuation and the use of lower maintenance dosages than those prescribed in clinical trials.

The research, published in the journal Obesity, followed 7,881 adults with severe obesity (average BMI >39) between 2021 and 2023. Among them, 1,320 had prediabetes at the beginning of treatment. These injectable GLP-1 medications are FDA-approved for managing type 2 diabetes and chronic weight issues.

Key Findings:

• More than 50% of patients discontinued treatment within the first year.

  • 22% discontinued early (within 3 months).

  • 32% discontinued later (3 to 12 months).

• Over 80% used lower-than-recommended maintenance dosages:

  • ≤1 mg for semaglutide

  • ≤7.5 mg for tirzepatide

• Average weight loss after one year:

  • 3.6% for early discontinuers

  • 6.8% for late discontinuers

  • 11.9% for those who stayed on treatment

  • 13.7% with full-dose semaglutide

  • 18.0% with full-dose tirzepatide

The study also highlighted which patients were most likely to achieve at least 10% body weight loss, a clinically significant threshold:

• Patients who did not discontinue or discontinued late

• Those using higher maintenance dosages

• Patients treated with tirzepatide

• Women, compared to men

In the group with prediabetes, the effects on blood sugar control were also significant. After one year:

• 67.9% of patients who continued treatment normalized their blood sugar levels

• Compared to 41% who discontinued late

• And only 33% who discontinued early

According to the researchers, the main reasons for discontinuation included high cost, insurance issues, side effects, and drug shortages. A follow-up study is underway to better understand these factors.

While patients who stopped the medications lost less weight, their weight remained relatively stable, suggesting that some may be turning to other weight management strategies. This will also be explored further.

This study offers important insights into how these popular medications work in everyday clinical practice—not just in the controlled conditions of a trial. It underscores the importance of treatment continuity, appropriate dosage, and healthcare access in achieving meaningful outcomes.

Source: Cleveland Clinic