Study wrapper · #837
Patterns of Use for GLP-1 Receptor Agonists in a Weight Management Cohort: A Military Health System Database Analysis of Active Duty Service Members From 2021 to 2025.
Editor's note
This retrospective cohort tracks how long people actually stay on weight-management injectables — a real-world adherence question that matters as much as trial efficacy. Among 10,649 active-duty service members starting liraglutide (Saxenda), semaglutide (Wegovy), or tirzepatide (Zepbound) between 2021 and 2025, tirzepatide showed the highest one-year persistence (81.9%) and adherence, semaglutide was intermediate (70.7%), and liraglutide trailed badly (34.2%). Adjusted models put tirzepatide's discontinuation hazard 33% below semaglutide's. Both tracked peptides are central here. Caveats: this is observational, so persistence differences may reflect dosing schedule (weekly vs daily), supply and formulary dynamics, tolerability, and patient selection rather than any intrinsic superiority — and the cohort is a specific, relatively young and health-screened military population, which limits generalizability. It measures whether people keep taking the drug, not how much weight they lost. Read it as useful real-world adherence signal favoring the weekly agents, not as comparative efficacy evidence.
Plain-language abstract
This study looked at how long people kept taking three weight-loss injections in real-world use, rather than how much weight they lost. Researchers reviewed records for 10,649 active-duty U.S. military members who started liraglutide (Saxenda, a daily shot), semaglutide (Wegovy, weekly), or tirzepatide (Zepbound, weekly) between 2021 and 2025. They measured 'persistence' — staying on the drug without a gap longer than 90 days. Tirzepatide had the highest one-year persistence at about 82%, semaglutide about 71%, and liraglutide only about 34%. After accounting for other factors, people on tirzepatide were about a third less likely to stop than those on semaglutide, while liraglutide users were more likely to stop. Men were somewhat more likely to stop than women. Important limits: because this simply observed real-world use, the differences may partly reflect that the weekly drugs are more convenient than the daily one, along with cost, supply, and side-effect factors — not necessarily that one drug is better. The group studied was a fairly young, health-screened military population, so results may not apply to everyone.