Diabetic Status, Advanced Age, and Hispanic Ethnicity Predict Poorer Weight Loss in Patients With Obesity Receiving...

Define demographic and clinical predictors of weight loss outcomes in patients with obesity prescribed semaglutide in real-world practice.

We identified 163 patients with elevated body mass index (>25 kg/m²) taking weekly semaglutide for at least 12 months, seen at a gastroenterology-based, multidisciplinary obesity clinic in New York City. The primary outcome was percent total weight loss (%TWL) after 12 months on weekly injectable semaglutide. Secondary outcomes included % of patients achieving >5% TWL and clinical factors affecting treatment course, including gastrointestinal side effects, dosing achieved, and number of provider visits.

In total, 163 of the 294 (55.4%) patients prescribed semaglutide during the study period continued it for at least 12 months. Mean weight loss achieved at this timepoint was 8.1 ± 18.5 kg (8.1% ± 8.3% TWL). Patient-identified Hispanic ethnicity (95% CI, -6.82 to -0.55; P = .02), history of type 2 diabetes (95% CI, 0.74-5.76; P = .01), and age >60 years (95% CI, -14.76 to -2.41; P = .007) were associated with reduced weight loss on univariable analysis. Development of gastrointestinal side effects (95% CI, 1.86-3.36; P = .57) and provider visit number were not associated with weight loss outcomes (95% CI, 0.15-0.28; P = .56). Patient-identified Hispanic ethnicity was independently associated with failure to achieve 5% TWL on multivariable regression (odds ratio, 0.32; 95% CI, 0.14-0.74).

This study suggested weight loss with weekly semaglutide was influenced by specific factors, including diabetes status, older age, and Hispanic ethnicity in our real-world clinic, although further research is needed to define prognosticators of weight loss across populations.