---
type: source
title: "GLP-1 Trends 2025: Real-World Data, Patient Outcomes and Future Therapies"
author: "HealthVerity"
url: https://blog.healthverity.com/glp-1-trends-2025-real-world-data-patient-outcomes-future-therapies
date: 2025
domain: health
secondary_domains: []
format: analysis
status: unprocessed
priority: medium
tags: [glp-1, adherence, persistence, real-world-data, weight-loss, outcomes, demographics]
---

## Content

Real-world GLP-1 outcomes data from HealthVerity's pharmacy claims and clinical data:

**Persistence (staying on drug):**
- **63%** of patients initiating Wegovy/Zepbound in early 2024 remained on therapy at one year (up from 40% in 2023)
- **Only 14% persisted after three years**
- 22% of semaglutide users and 16% of tirzepatide users stopped within the first year

**Weight loss outcomes (real-world vs. trial):**
- Semaglutide: **7.7% weight loss** after one year (real-world)
- Tirzepatide: **12.4% weight loss** after one year (real-world)
- These represent "roughly half the weight loss seen in randomized trials"
- SURMOUNT-5 trial: tirzepatide 20% vs. semaglutide 14%

**Demographics:**
- Women use GLP-1s at higher rates than men, particularly ages 50-64
- Ages 30-49: women more than twice as likely as men to use

**Safety signals:**
- ~50% report nausea; one-third report diarrhea (GI effects are primary discontinuation reason)
- Emerging concerns: psychiatric effects, respiratory risks in asthma patients, nutrient deficiencies

**Pipeline:**
- Oral GLP-1 formulations in development
- Amylin mimetics and dual agonists (mazdutide)
- Muscle-preserving combination therapies

## Agent Notes

**Why this matters:** The 14% three-year persistence figure is the most damning data point in the entire GLP-1 landscape. Even with a year-one improvement (40% → 63%), the three-year data shows a cliff. Combined with the known metabolic rebound within 28 weeks of stopping (Session 22), this means the population receiving durable metabolic benefit is approximately 14% of those who start — or roughly 1.7% of eligible obese/overweight adults (14% of 23% who start).

**What surprised me:** The year-one improvement (40% → 63% from 2023 to 2024 cohort) suggests adherence programs and better prescribing practices are working. But the three-year cliff persists. This is consistent with the behavioral program data from Sessions 22-23 (near-term improvement with structural exit).

**What I expected but didn't find:** Any data on adherence by income or insurance type within this real-world dataset. The gender breakdown is useful but the income/race gap remains documented by other sources (Wasden 2026).

**KB connections:**
- The 63% year-one / 14% year-three pattern directly supports the "continuous treatment required, continuous treatment being removed" pattern from Sessions 17, 20, 22 (journal)
- Real-world outcomes at roughly half trial efficacy strengthens the "structural barriers reduce population-level impact" claim
- Connects to behavioral program data: Omada's 63% post-discontinuation weight maintenance (Session 23) looks even more significant given the standard 14% persistence context

**Extraction hints:**
- ENRICH existing adherence claims with real-world cohort data: 63% year-one (2024 cohort), 14% year-three
- The real-world/trial gap (7.7% vs. 14% weight loss for semaglutide) could support a claim about effectiveness under real-world access conditions
- Note the denominator problem: persistence data is among those who START, not among all eligible

**Context:** HealthVerity is a health data company with access to large pharmacy claims datasets. This is commercial analysis, not peer-reviewed research, but tracks with published studies.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: GLP-1 adherence trajectory claims (Sessions 22, 23) — specifically the year-one improvement vs. year-three cliff
WHY ARCHIVED: The 2024 cohort year-one improvement (40%→63%) is new and should update the existing year-one adherence figure. The three-year 14% figure remains the structural constraint.
EXTRACTION HINT: This source primarily enriches existing adherence claims rather than generating new ones. The key update is the 2024 cohort year-one figure (63%), which represents improvement but doesn't change the trajectory.
