Clinical Effectiveness of Semaglutide for Weight Loss in a Veterans Affairs' Anti-Obesity Pharmacotherapy Clinic.

BACKGROUND: Obesity is a growing global health crisis. Clinical trials have found high-dose semaglutide to be a promising medication for weight loss, but real-world effectiveness data is limited. OBJECTIVE: In this study we assessed weight loss outcomes with semaglutide treatment in patients with overweight or obesity who received care in a Veterans Affairs' (VA) weight management clinic. DESIGN: We performed a retrospective review of patients at the Rocky Mountain Regional VA Medical Center who were started on semaglutide between January 1, 2021 and July 31, 2023. Patients included in the analysis were on the medication for the primary goal of weight loss regardless of their diabetes status, and those who were on semaglutide primarily for glycemic control were excluded. PARTICIPANTS: The study included 201 veterans who were seen in the VA weight management clinic. MAIN MEASURES: Our primary outcome of interest was mean percent weight loss at 12 months. Changes in body mass index (BMI), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and hemoglobin A1c (HbA1c) were also analyzed. KEY RESULTS: At 12 months, the mean (SEM) total and percent weight loss were 11.5 (0.5) kg and 10.0 (0.6) % (p < 0.001 from baseline), respectively. At 12 months, total body weight loss of ≥ 5%, ≥ 10%, ≥ 15%, and ≥ 20% was achieved in 74%, 50%, 24%, and 12% of patients, respectively. At 12 months there was a reduction in SBP (SEM) of 3.4 (1.5) mmHg (p = 0.029), reduction in HbA1c of 0.32 (0.1) % (p < .001), reduction in TG of 35.8 (11.8) mg/dL (p = .003), and reduction of LDL-C of 12.0 (4) mg/dL (p = 0.004). CONCLUSIONS: Semaglutide treatment in a real-world VA weight management clinic setting resulted in significant weight loss and improvements in cardiovascular and metabolic outcomes, highlighting its effectiveness for managing obesity in veterans.