18/09/2025
Introduction
🟢 A real-world study in Denmark examined semaglutide (Wegovy) use for weight loss among adults without diabetes
🟢 Clinical trials show high adherence, but in daily practice many patients stop early
🟢 Key reasons include cost, side effects, and unmet expectations
🟢 The study highlights particular challenges for younger adults and lower-income groups
🟡 Main Findings
🟡 Study population: 77,310 adults without diabetes who started semaglutide between Dec 2022–Oct 2023
🟡 Median age: 50 years; 71% were women; population mostly Caucasian
🟡 Within 1 year, 52% of patients discontinued treatment
🟡 Dropout rates: 18% at 3 months, 31% at 6 months, 42% at 9 months
🟠 Age and Discontinuation
🟠 Younger adults (18–30 years) were nearly 50% more likely to stop than those aged 45–60 years (RR 1.48; CI 1.45–1.51)
🟠 Younger people have higher obesity burden but less disposable income to cover drug costs
🟠 This pattern raises concerns that treatment may worsen social inequalities
🔴 Socioeconomic Disparities
🔴 Living in low-income areas raised discontinuation risk by 14% (RR 1.14; CI 1.10–1.17)
🔴 Lower-education and lower-income groups have nearly double the obesity prevalence but are less likely to continue treatment
🔴 Prescription rates show only 1.3% of the lowest income quartile received semaglutide compared with 3.6% of the highest quartile
🔵 Comorbidities and Prior Medications
🔵 Prior gastrointestinal medication use raised discontinuation risk by 9% (RR 1.09; CI 1.08–1.11)
🔵 Prior psychiatric medication use raised risk by 12% (RR 1.12; CI 1.10–1.14)
🔵 Some patients initiated psychiatric medications after starting semaglutide, suggesting possible psychiatric side effects
🔵 Cardiovascular disease or other chronic conditions raised discontinuation risk by ~10% (RR 1.11 and 1.09)
🔵 Men were more likely than women to discontinue (RR 1.12; CI 1.11–1.14)
🟣 Reasons for Stopping & Broader Implications
🟣 Financial burden significant: ~€2000/year for lowest dose (2025)
🟣 Side effects common: gastrointestinal (nausea, vomiting) and psychiatric (mood changes)
🟣 Some patients satisfied with modest weight loss and did not pursue long-term therapy
🟣 Many underestimate the risk of regaining weight after discontinuation
🟣 Real-world discontinuation is much higher than in trials, where adherence exceeded 80% with free treatment and close monitoring
🟣 Findings underscore the need for better patient communication on realistic goals, side effect management, and the importance of sustained therapy.
