Regional trends and disparities in newer GLP1 receptor agonist initiation among real‐world adult patients eligible for obesity treatment

🥉 Top 5% JournalMar 4, 2025Diabetes, obesity & metabolism

Differences across regions in starting new GLP-1 medicines among adults eligible for obesity treatment

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Abstract

Only 1.8% of 319,949 adults initiated newer anti-obesity medications.

Semaglutide was the most commonly initiated medication, accounting for 77.9% of all initiations.
Liraglutide uptake peaked at 5% in 2018 but has since declined, while semaglutide and tirzepatide use has increased significantly since 2022.
Lower initiation odds were observed in Black and Hispanic populations compared to White individuals.
Medicaid and uninsured patients had lower initiation odds than those with private insurance.
Higher initiation odds were associated with being female, middle-aged, more outpatient visits, and consultations with endocrinologists.

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AIMS: To characterize trends in the initiation of newer anti-obesity medications (AOMs) and determine factors associated with their use among obese/overweight populations.

MATERIALS AND METHODS: This study utilized electronic health record data from OneFlorida+ (2015-2024). Adults eligible for AOMs were included, defined as having a body mass index (BMI) ≥30 kg/mor a BMI of 27-29.9 kg/mwith at least one obesity-related comorbidity. The primary outcome was the initiation of newer AOMs, specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs) including liraglutide, semaglutide and tirzepatide. Trends across years were examined, and a multivariable logistic regression identified sociodemographic, clinical and healthcare utilization factors associated with AOM initiation. 2 2

RESULTS: Of 319,949 adults, 1.8% initiated newer AOMs. Semaglutide accounted for 77.9% of initiations, tirzepatide 19.7% and liraglutide 17.8%. Initiation trends showed liraglutide uptake peaked at 5% in 2018 but declined afterward, while semaglutide and tirzepatide uptake increased exponentially since 2022. Odds of initiation were lower for Black (aOR [95% CI]: 0.87 [0.80-0.94]) and Hispanic (0.84 [0.78-0.91]) groups versus Whites, and for Medicaid (0.69 [0.63-0.76]) and uninsured (0.81 [0.74-0.87]) patients versus privately insured. Higher odds were associated with being female, middle-aged, having more outpatient visits and visiting endocrinologists.

CONCLUSIONS: The initiation of newer AOMs among overweight and obese populations remains low, but uptake has increased exponentially since 2022. Our findings reveal significant disparities in obesity care, highlighting the importance of addressing inequities in AOM access to improve obesity outcomes.

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