Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;27(6):3113-3123.
doi: 10.1111/dom.16318. Epub 2025 Mar 4.

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

Rotana M Radwan  1 , Yao An Lee  1 , Pareeta Kotecha  1 , Davene R Wright  2 , Inmaculada Hernandez  3 , Ronald Ramon  4 , William T Donahoo  5 , Yong Chen  6 , John M Allen  7 , Jiang Bian  8   9   10 , Jingchuan Guo  1
Affiliations

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

Rotana M Radwan et al. Diabetes Obes Metab. 2025 Jun.

Abstract

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/m2 or a BMI of 27-29.9 kg/m2 with 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.

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.

Keywords: GLP1 receptor agonists; anti‐obesity medications; health disparities; obesity.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None.

Update of

References

    1. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care 2016;22:s176–185 - PubMed
    1. Engin A The Definition and Prevalence of Obesity and Metabolic Syndrome. Adv Exp Med Biol 2017;960:1–17 - PubMed
    1. Ward ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax C, Long MW, Gortmaker SL. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med 2019;381:2440–2450 - PubMed
    1. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, Hubbard VS, Jakicic JM, Kushner RF, Loria CM, Millen BE, Nonas CA, Pi-Sunyer FX, Stevens J, Stevens VJ, Wadden TA, Wolfe BM, Yanovski SZ, Jordan HS, Kendall KA, Lux LJ, Mentor-Marcel R, Morgan LC, Trisolini MG, Wnek J, Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH, DeMets D, Hochman JS, Kovacs RJ, Ohman EM, Pressler SJ, Sellke FW, Shen WK, Smith SC Jr., Tomaselli GF, American College of Cardiology/American Heart Association Task Force on Practice G, Obesity S. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014;129:S102–138 - PMC - PubMed
    1. Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R, Reviewers of the AACEOCPG. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Endocr Pract 2016;22 Suppl 3:1–203 - PubMed

LinkOut - more resources