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# Anti-obesity drugs in routine care: short exposure, smaller weight loss than in trials
- URL: https://www.coios.me/anti-obesity-drugs-in-routine-care-short-exposure-smaller/
- Published: 2026-10-23T13:18:37.000Z
- Updated: 2026-10-24T06:06:05.000Z
- Description: In routine care, nearly half of tirzepatide users did not reach 10% weight loss after at least 72 weeks.
- Author: Daniel Ryan
- Tags: Health today, Obesity, diabetes and GLP-1, United States, #peer-reviewed, #refines, #item, #source-2026-10, #score-78

This record study covered 610,372 UT-Physician patients and about one million sampled from the nationwide COSMOS database. Pharmacy dispensing defined exposure, and weight, lipids, blood pressure and HbA1c were compared before and after each treatment session. Exposure was recorded for 71,318 and roughly one million individuals, and about 70% had two or more sessions. Median exposure to tirzepatide and semaglutide fell far short of the 72-week duration used in trials. After at least 72 weeks on tirzepatide, nearly 50% missed the 10% target and 25% missed the 5% target. Exposure was inferred from dispensing records, so adherence, dose titration and compounded medicines were not captured.

*Why it is interesting: Real-world weight loss on GLP-1 and GLP-1/GIP drugs falls well short of trial figures. Exposure was far shorter than trial protocols, and response varied widely at every duration.*

Source

[BMC Endocrine Disorders, 20 October 2026](https://doi.org/10.1186/s12902-026-02423-7?ref=coios.me)

Paper

Current status of anti-obesity medications and performance, an EHR based survey

Authors

Ruan X, Li R, Wang L, Lu S, Wen A, Sameer M et al.

DOI

10.1186/s12902-026-02423-7

Full text

[Open copy](https://pmc.ncbi.nlm.nih.gov/articles/PMC13681875/?ref=coios.me) (open-access copy, PubMed Central)

Type

Peer-reviewed article

Design

Retrospective EHR cohort study, two US databases (UT-Physician and EPIC COSMOS), \~71,318 and \~1M individuals with anti-obesity medication exposure; follow-up to ≥72 weeks

Verdict

Refines prior evidence

Driver

[Obesity, diabetes and GLP-1](https://www.coios.me/d-obesity-diabetes/)

Free full text

[Free to read at the publisher](https://doi.org/10.1186/s12902-026-02423-7?ref=coios.me)