Real-World Use of Semaglutide for Weight Management: Dose Titration, Discontinuation Patterns and Weight Changes

In December 2022, semaglutide injections for weight management were marketed in Denmark. Pre-marketing trials documented high efficacy when adherence to the treatment and the recommended dose titration schedule was followed. This study aimed to describe real-world use of semaglutide, including dose titration, discontinuation patterns and effectiveness on body weight in adults with overweight or obesity treated in primary care.

This retrospective, observational study included adults prescribed semaglutide for weight management between December 2022 and May 2024 in one general practise in Denmark. The primary outcome was the relative mean change in body weight from baseline to 12-months follow-up in individuals who had not discontinued treatment and who had a baseline and a follow-up weight.

A total of 206 individuals were included (76% women; mean age 48 years, standard deviation (SD) 13). Mean baseline body weight was 105 kg (SD 23.8). Twelve months after treatment initiation, 38% (n = 78) had permanently discontinued semaglutide, whilst 15% (n = 30) had temporarily discontinued (paused) semaglutide. Approximately 48% (n = 98) remained on treatment. Amongst these, 40% were treated with ≤ 1.0 mg/week, 30% with 1.7 mg/week and 30% with 2.4 mg/week. Relative mean body weight change after 12 months was -13.6 (95% CI -15.0 to -12.2)%.

Based on the experience from utilisation in a single general practise, semaglutide for weight management is frequently discontinued and titrated slower and to lower maintenance doses in real-world clinical practise than in the approved labelling. Despite this, the observed mean weight loss for individuals who had not discontinued treatment was substantial.