Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi‐Site Electronic Health Records

To evaluate the effectiveness of semaglutide compared with lifestyle counselling alone for weight loss in diabetic and non-diabetic patients with obesity. This multi-site, retrospective, observational study uses data from electronic health records which are part of the Greater Plains Collaborative (GPC) in a time-to-event analysis for comparative effectiveness. Participants were adults with obesity receiving semaglutide for a minimum of 16 weeks or lifestyle counselling with at least three sessions within the first 16 weeks. The primary outcome is incidence of 10% or greater reduction in weight from baseline. Of 3927 eligible participants, 615 were prescribed semaglutide and 3312 received lifestyle counselling. Following propensity score matching, each group (diabetic and non-diabetic) consisted of 120 and 495 participants, respectively. Hazard ratios for 10% weight loss were significantly higher from semaglutide for non-diabetic (1.63 [95% CI: 1.32, 2.01; p < 0.001]) and diabetic (2.45 [95% CI: 1.47, 4.09; p < 0.001]) populations. These data from our study suggest that semaglutide therapy compared with lifestyle counselling alone is more effective in achieving at least 10% weight loss. This information may be used to inform clinical practice guidelines and stimulate future research on the long-term effectiveness of various weight loss options for individuals with obesity.