New ‘weight-loss’ drugs have lower impact in real life compared to clinical trial results: study

By Admin

11 Jun, 2025

Recent advancements in weight-loss medications, particularly GLP-1 receptor agonists like semaglutide and tirzepatide, have raised global interest due to their promising outcomes during clinical trials. However, a new U.S.-based study has now revealed that these medications may not deliver the same dramatic results in real-world settings. This discrepancy, as experts explain, is largely due to treatment discontinuation and lower maintenance dosages outside of controlled environments.

Real-World vs Clinical Trials: A Notable Gap

A study conducted by researchers at the Cleveland Clinic, Ohio, and published in the peer-reviewed journal Obesity on June 10, analyzed electronic health records from a large health system in Ohio and Florida. The researchers, led by Dr. Hamlet Gasoyan, examined adults with overweight or obesity   but without type 2 diabetes   who initiated injectable semaglutide or tirzepatide between 2021 and 2023.

The findings highlighted that early discontinuation (within 3 months) and late discontinuation (3–12 months) were common, and significantly impacted weight-loss outcomes. Patients who continued medication or discontinued late were more likely to achieve a clinically meaningful weight loss of 10% or more after a year.

Why the Drop-off?

Dr. V. Mohan, senior diabetologist and chairman of Dr. Mohan’s Diabetes Specialities Centre in Chennai, wasn’t surprised by these findings. “The bottom line is that these drugs work as long as they are taken. That is how it is with most drugs. If you stop statins, for instance, cholesterol levels go up,” he noted.

He emphasized the contrast between clinical trials and real-world settings. “In a randomised clinical trial (RCT), there is constant follow-up with participants to continue with the drug regimen. In the real world, especially when patients pay for medications themselves, they often stop due to cost or motivation. Even otherwise, compliance rates in real life are much poorer than in an RCT.”

Who Benefits the Most?

The study also identified factors that correlated with a higher chance of achieving significant weight loss:

• Continuing medications or late discontinuation
  
  

• Taking a higher maintenance dosage
  
  

• Being on tirzepatide rather than semaglutide
  
  

• Being female
  
  

These insights not only reflect physiological and behavioral patterns but also underscore the need for sustained medication and adherence to dosage for best results.

Indian Context: Cost & Compliance

Dr. Anoop Misra, chairman of Fortis C-DOC Hospital for Diabetes and Allied Sciences in Delhi, echoed similar thoughts, adding that India may see even higher discontinuation rates due to cost concerns. “Non-compliance to diet and exercise are additional reasons that may cause lower weight loss,” he added.

Both semaglutide and tirzepatide are now available in India and are FDA-approved for treating type 2 diabetes and chronic weight management. However, their real-world efficacy will depend greatly on patient education, affordability, and continuous medical follow-up.

Key Takeaway for Patients and Providers

As Dr. Gasoyan rightly pointed out, “Our findings about the real-world use patterns of these medications and associated clinical outcomes could inform the decisions of healthcare providers and their patients on the role of treatment discontinuation and maintenance dosage in achieving clinically meaningful weight reductions.”

This study serves as a crucial reality check   emphasizing that while these drugs offer great potential, their success hinges on consistent usage, proper medical guidance, and holistic lifestyle management.