Patients on semaglutide who followed a structured virtual integrative medicine program lost an average of 19.5% of their body weight at one year, with nearly half losing 20% or more.
19.5% body weight lost at 52 weeksAmong 1,131 patients on semaglutide with the IVIM virtual program, the average weight loss exceeded typical clinical trial results, with 99.2% achieving clinically meaningful weight loss.
What the researchers found
Among 1,131 patients with obesity who completed at least one year of semaglutide therapy combined with the Individualized Virtual Integrative Medicine (IVIM) protocol, the average weight loss was 19.5% of total body weight at 52 weeks. Nearly half (47.8%) lost 20% or more of their body weight, and 99.2% lost at least 5%. Weight loss followed a consistent trajectory of approximately 0.739 pounds per week (p < 0.0001). Patients who continued to 68 weeks lost an average of 21.8% of their body weight.
At milestone timepoints: 12 weeks saw 6.5% weight loss (14.9 lbs), 24 weeks 12.6% (28.6 lbs), 36 weeks 16.4% (36.8 lbs), and 52 weeks 19.5% (45.95 lbs).
Why it matters
Clinical trials of semaglutide typically report 15-17% weight loss at one year. This real-world study suggests that combining semaglutide with a structured integrative medicine approach — delivered via telehealth — may enhance weight loss outcomes beyond what the medication achieves alone in trials. With 99.2% of patients achieving clinically meaningful weight loss (≥5%), the results point to the potential value of comprehensive clinical support programs alongside GLP-1 therapy.
The numbers in context
n=1,131 · 19.5% body weight loss at 52 weeks · 47.8% lost ≥20% · 99.2% lost ≥5% · -0.739 lbs/week · p<0.0001
How the study worked
This retrospective analysis examined 1,131 patients with BMI ≥30 who completed at least 365 days on the IVIM protocol while taking semaglutide. Patients were prescribed individualized semaglutide therapy based on weight goals, insurance coverage, medication accessibility, and socioeconomic factors. The protocol was delivered via telehealth. A Linear Mixed Effects Model assessed the relationship between time on the protocol and weight loss.
Who was studied
1,131 adults with obesity (BMI ≥30) who completed at least one year on semaglutide with the IVIM telehealth protocol
What this study cannot tell us
This is a retrospective study with no control group — there is no way to determine how much of the weight loss is attributable to semaglutide alone versus the IVIM protocol. Only patients who completed at least 365 days were included, which creates survivorship bias by excluding those who dropped out early (who may have lost less weight). The study does not detail the specific components of the IVIM protocol or what "integrative medicine" entailed. Dosing of semaglutide varied among patients, including during GLP-1 shortages.
How to read the evidence
This is a large retrospective cohort study (n=1,131) with statistically robust results. However, the lack of a control group, survivorship bias from including only year-long completers, and the inability to separate medication effects from program effects limit the strength of causal conclusions.
When this study was published
Published in 2025, this is a very recent real-world evidence study reflecting current clinical practice with semaglutide, including the challenges of the GLP-1 shortage period. Highly relevant to ongoing discussions about optimizing GLP-1 therapy.
The bigger picture
As GLP-1 drugs become mainstream obesity treatments, a key question is how to maximize their effectiveness. Clinical trials show impressive weight loss, but real-world results often fall short due to dose inconsistency, side effects leading to discontinuation, and lack of lifestyle support. This study suggests that structured programs — combining medication management with integrative medicine via telehealth — could help bridge the gap between clinical trial results and real-world outcomes. It also reflects the growing trend toward virtual-first obesity care.
Questions still open
- How much of the weight loss is attributable to semaglutide versus the integrative medicine components of the IVIM protocol?
- What were the dropout rates before the 365-day mark, and how did patients who discontinued early compare in their weight trajectories?
- Can the IVIM protocol improve weight maintenance after GLP-1 therapy is discontinued?
Common questions
Is 19.5% weight loss better than semaglutide alone?
What is the IVIM protocol?
Read the original research
Individualized virtual integrative medicine (IVIM): A clinical model for enhanced GLP-1 therapeutic outcomes.
Obesity pillars, 15, 100188
Citation
Duncan, Jessica; Lee Stevens, Patrick; Bigby, Emily; Floyd, Courtney; Malina, Josh; Nickens, Jennifer; Lambert, Amber; Kantor, Taylor. (2025). Individualized virtual integrative medicine (IVIM): A clinical model for enhanced GLP-1 therapeutic outcomes.. Obesity pillars, 15, 100188. https://doi.org/10.1016/j.obpill.2025.100188