Titration and discontinuation of semaglutide for weight management in commercially insured US adults
Open accessAbstract
Objective: The objective of this study is to examine real‐world dose titration patterns of semaglutide for weight management (Wegovy, Novo Nordisk A/S) in US adults and identify characteristics associated with early discontinuation. Methods: We identified 15,811 commercially insured adults who started semaglutide for weight management (administrated through single‐dose prefilled pens) between June 2021 and December 2023. We depicted dose‐titration patterns over 5 months and identified factors associated with discontinuation using multivariable Cox regression. Sensitivity analyses examined patterns after supply shortage resolution (after October 2023). Results: Most semaglutide users deviated from the recommended monthly dose‐escalation schedule within the first 5 months. By the fifth month, nearly one‐half (46%) had discontinued the treatment, with similar rates (48%) among those initiating after supply stabilization. Discontinuation was strongly associated with copayment amount, with rates increased from 41% in the lowest quintile ($1–$54 per month) to 51% in the highest quintile ($161–$1460 per month). Higher discontinuation rates were also associated with lower household income and education level. Conclusions: The deviations from the recommended dose‐escalation schedule and high discontinuation rate among real‐world semaglutide users indicate important challenges in the delivery of evidence‐based care. Policy interventions that reduce financial barriers to the persistence of semaglutide are needed.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a study of commercially insured adults with obesity and without diabetes, discontinuation rates reached 30-50% at one year despite comprehensive health coverage.
“discontinuation rates reached 30–50% at one year despite comprehensive health coverage”
From Weight maintenance after discontinuation of GLP-1 therapies (2026) · cites this paper as [17]
The Results report 41%–51% discontinuation across socioeconomic subgroups and 46% overall by month five, not at one year (page unavailable). The Methods describe adults with continuous commercial insurance coverage for the six-month study period; they do not establish comprehensive coverage or restrict the cohort to adults without diabetes. The Discussion also identifies limited insurance coverage as a possible barrier. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 17 · Cited by 16
- Authors
- Xu, Y., Carrero, J. J., Chang, A. R., Inker, L. A., Zhang, D., Mukhopadhyay, A., Blecker, S. B., Horwitz, L. I., Grams, M. E., & Shin, J.
- Affiliations
- Johns Hopkins University (US)
- Danderyds sjukhus (SE)
- Departments of Nephrology and Population Health Sciences Geisinger Danville Pennsylvania USA
- Tufts Medical Center (US)
- NYU Grossman Long Island School of Medicine (US)
- NYU Langone Health (US)
- Corresponding author
- Shin, Jung‐Im
- ORCID
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2025-06-04
- Volume
- 33
- Issue
- 7
- Pages
- 1243-1248
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC12213178
- OpenAlex
- W4411034223
- Cited by
- 16
- References
- 17
- Citations by year
- 2026: 13 · 2025: 3
- FWCI
- 9.05
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK115534, R01 DK139324)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- semaglutide, Wegovy, weight management, dose titration, treatment discontinuation, dose escalation, drug shortages, copayments, financial barriers to care, household income, educational attainment, commercially insured adults
- MeSH terms
- Semaglutide, Adult, Glucagon-Like Peptides, Female, Humans, Insurance, Health, Male, Middle Aged, Obesity, United States, Anti-Obesity Agents, Glucagon-Like Peptide 1
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
