A retrospective cohort used Cosmos electronic health records covering 92.4 million US adults with no documented approved indication for liraglutide, semaglutide or tirzepatide between January 2021 and December 2025. Prescribing to this group rose 15-fold, from 0.1% to 1.5%, reaching 1,133,953 people, of whom 85.5% were female, 35.1% had a normal body mass index, and more were privately insured and from less socially vulnerable areas. Recorded eating disorders were six times more common among recipients than non-recipients, 1.8% against 0.3%.
Why it is interesting: It puts a figure on how much GLP-1 use now sits outside the populations in which the evidence on weight, diabetes and mortality was generated.