Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
On June 12, 2025, we reported on a study published in Obesity that was designed to characterize changes in body weight and glycated hemoglobin through 12 months by obesity pharmacotherapy discontinuation status.
The study
Researchers conducted a retrospective cohort study using electronic health record data from a large health system in Ohio and Florida. They identified 7881 adults with overweight or obesity without type 2 diabetes (T2D) who initiated injectable semaglutide or tirzepatide between 2021 and 2023. The population included 6109 participants who received semaglutide and 1772 who received tirzepatide, with mean age 51.3 years, baseline weight 112.2 kg, and body mass index (BMI) of 39.7 kg/m². Three-quarters were women, 78% identified as White, and 73.7% had private insurance. Investigators defined treatment discontinuation as a gap greater than 90 days between prescription fills, classifying it as early (within 3 months) or late (3 to 12 months after initiation).
The findings
Participants who discontinued semaglutide early lost only 3.6% of their weight, compared to 10.9% among those who continued treatment. For tirzepatide, early discontinuation resulted in 3.6% weight loss versus 15.3% for those who persisted.
In multivariable analysis, participants who never discontinued treatment had 4.68 times higher odds of achieving 10% weight loss compared to early discontinuers (95% CI, 3.97-5.55), while late discontinuation resulted in 1.74 times higher odds (95% CI, 1.45-2.08). Tirzepatide users were nearly 2 and one-half times more likely to achieve a 10% reduction from baseline weight vs semaglutide users (OR 2.46; 95% CI, 2.16-2.80), and high-dose maintenance therapy increased the likelihood by nearly the same proportion (OR, 2.39; 95% CI, 2.08-2.75).
For participants with prediabetes at baseline, those who continued treatment achieved a mean 0.4% reduction in HbA1c levels, compared to 0.1% among early discontinuers (P < .001). More importantly, 67.9% of participants with prediabetes who maintained therapy achieved normal glucose levels at 1 year, compared to just 33.1% of early discontinuers.
Authors' comments
"Our findings indicate that treatment discontinuation and use of lower maintenance dosages might reduce the likelihood of achieving clinically meaningful weight reduction in patients who initiate obesity pharmacotherapy with semaglutide or tirzepatide."
