Only 1.8% of Eligible Patients Actually Start GLP-1 Weight Loss Medications — With Major Disparities

Despite 320,000 eligible adults, only 1.8% initiated GLP-1 weight loss medications, with significant racial, socioeconomic, and geographic disparities.

Radwan, Rotana M et al.·Diabetes·2025·Moderate EvidenceObservational
RPEP-13163ObservationalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
N=N=319,949
Participants
Adults with BMI >=30 or BMI 27-29.9 with comorbidities in Florida

What This Study Found

Only 1.8% of 319,949 eligible adults initiated newer GLP-1 RA anti-obesity medications, with significant sociodemographic and clinical disparities in who starts treatment.

Key Numbers

N=319,949 eligible adults; 1.8% initiated GLP-1 RAs; semaglutide 77.9%, tirzepatide 19.7%, liraglutide 17.8%.

How They Did This

Retrospective cohort study using OneFlorida+ electronic health records (2015-2024) with multivariable logistic regression to identify factors associated with GLP-1 RA initiation.

Why This Research Matters

The enormous gap between eligibility and actual medication use suggests major access barriers — cost, insurance, provider awareness, and systemic inequities — that must be addressed for GLP-1 medications to achieve their public health potential.

The Bigger Picture

As GLP-1 medications demonstrate transformative weight loss and cardiovascular benefits, the extremely low initiation rate and demographic disparities raise urgent questions about health equity and medication access in obesity care.

What This Study Doesn't Tell Us

Single regional health network (Florida); EHR data may miss prescriptions filled outside the network; cannot distinguish between patient choice and provider/system barriers.

Questions This Raises

  • ?What specific barriers drive the racial and socioeconomic disparities in GLP-1 RA initiation?
  • ?How will expanding insurance coverage for obesity medications change these initiation rates?

Trust & Context

Key Stat:
1.8% of eligible adults actually initiated GLP-1 RA weight loss medications
Evidence Grade:
Large retrospective cohort study with nearly 320,000 patients and multivariable analysis provides strong real-world evidence on medication utilization patterns.
Study Age:
Published in 2025 with data through 2024, capturing the recent surge in GLP-1 RA availability.
Original Title:
Regional trends and disparities in newer GLP1 receptor agonist initiation among real-world adult patients eligible for obesity treatment.
Published In:
Diabetes, obesity & metabolism, 27(6), 3113-3123 (2025)
Database ID:
RPEP-13163

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Why do so few eligible people start GLP-1 weight loss drugs?

Despite nearly 320,000 eligible adults, only 1.8% started these medications. Barriers likely include high cost, limited insurance coverage, provider prescribing patterns, and systemic disparities in healthcare access.

Who is most likely to miss out on GLP-1 medications?

The study found significant disparities by race, socioeconomic status, and geography, suggesting that minority and lower-income populations face greater barriers to accessing these effective weight loss treatments.

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Cite This Study

RPEP-13163·https://rethinkpeptides.com/research/RPEP-13163

APA

Radwan, Rotana M; Lee, Yao An; Kotecha, Pareeta; Wright, Davene R; Hernandez, Inmaculada; Ramon, Ronald; Donahoo, William T; Chen, Yong; Allen, John M; Bian, Jiang; Guo, Jingchuan. (2025). Regional trends and disparities in newer GLP1 receptor agonist initiation among real-world adult patients eligible for obesity treatment.. Diabetes, obesity & metabolism, 27(6), 3113-3123. https://doi.org/10.1111/dom.16318

MLA

Radwan, Rotana M, et al. "Regional trends and disparities in newer GLP1 receptor agonist initiation among real-world adult patients eligible for obesity treatment.." Diabetes, 2025. https://doi.org/10.1111/dom.16318

RethinkPeptides

RethinkPeptides Research Database. "Regional trends and disparities in newer GLP1 receptor agoni..." RPEP-13163. Retrieved from https://rethinkpeptides.com/research/radwan-2025-regional-trends-and-disparities

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.