Despite 320,000 eligible adults, only 1.8% initiated GLP-1 weight loss medications, with significant racial, socioeconomic, and geographic disparities.
1.8%of eligible adults actually initiated GLP-1 RA weight loss medications
What the researchers 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.
Why it 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 numbers in context
N=319,949 eligible adults; 1.8% initiated GLP-1 RAs; semaglutide 77.9%, tirzepatide 19.7%, liraglutide 17.8%.
How the study worked
Retrospective cohort study using OneFlorida+ electronic health records (2015-2024) with multivariable logistic regression to identify factors associated with GLP-1 RA initiation.
Who was studied
Adults with BMI >=30 or BMI 27-29.9 with comorbidities in Florida
What this study cannot 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.
How to read the evidence
Large retrospective cohort study with nearly 320,000 patients and multivariable analysis provides strong real-world evidence on medication utilization patterns.
When this study was published
Published in 2025 with data through 2024, capturing the recent surge in GLP-1 RA availability.
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.
Questions still open
- 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?
Common questions
Why do so few eligible people start GLP-1 weight loss drugs?
Who is most likely to miss out on GLP-1 medications?
Read the original research
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
Citation
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