Obesity (Silver Spring)Weight LossCohortDecember 10, 2025

Real-World Evidence on Weight Loss and Safety With Semaglutide in Obesity Telehealth: A Large Retrospective Cohort Study.

Tchang B, Broffman L, Manalac R, Chai S, Samonas N, Barnes M, Allison DB

Key Finding

Patients using semaglutide through telehealth lost an average of 16.6% of their body weight over 68 weeks, with women achieving significantly better results than men.

What This Study Found

Think of this study like tracking the performance of a nationwide weight loss program delivered through video calls instead of in-person visits. Researchers followed 655 people who started semaglutide through telehealth platforms, watching them like a coach would track athletes over more than a year. The results were impressive - imagine if someone weighing 200 pounds lost about 33 pounds on average. But here's where it gets interesting: being female was like having a secret advantage in this weight loss game. Women were more than 4 times more likely to lose at least 5% of their weight, and nearly 6 times more likely to hit the 10% milestone compared to men. It's as if women had a turbo button that men didn't have access to. The side effect profile looked familiar too - about 1 in 3 people dealt with nausea and vomiting (like having a mild stomach bug), while 1 in 6 experienced constipation. The researchers found no scary new side effects, suggesting telehealth delivery didn't create any hidden dangers.

Statistics Decoded

Mean weight loss of -16.6% (SD 7.5%): On average, people lost about 1/6 of their body weight, with most people falling between 9% and 24% loss. OR 4.26 for ≥5% weight loss in females: Women were over 4 times more likely than men to lose at least 5% of their weight - this probably wasn't just luck (p<0.001 is like flipping heads 13+ times in a row). OR 5.90 for ≥10% weight loss in females: Women had nearly 6x better odds of hitting double-digit percentage weight loss. 37.3% experienced nausea/vomiting: More than 1 in 3 people dealt with stomach upset. 15.6% had constipation: About 1 in 6 people experienced digestive slowdown.

Why This Matters

This proves that telehealth can deliver the same powerful weight loss results as clinical trials, potentially making effective obesity treatment accessible to millions more people who can't easily get to specialty clinics. The dramatic gender difference suggests doctors may need to adjust expectations and dosing strategies differently for men and women.

Original Abstract

This study aimed to assess weight and safety outcomes in a large national cohort of patients with overweight and obesity treated with GLP-1 medications via telehealth. Data were obtained from deidentified EHRs for a random sample of 4500 patients who initiated semaglutide treatment via telehealth for overweight and obesity between December 1, 2022, and June 1, 2023. Outcomes and predictors of outcomes were analyzed for patients who reported a follow-up weight within ±14 days of week 68. Of 655 patients (n = 445 female, n = 210 male), mean body weight reduction was -16.6% (SD 7.5%, 95% CI: -17.1% to -16.0%). Female sex was the only factor consistently associated with categorical weight loss, with significantly higher odds at ≥ 5% (OR 4.26, p < 0.001), ≥ 10% (OR 5.90, p < 0.001), and ≥ 20% (OR 2.51, p < 0.001). The most common adverse events were nausea/vomiting (37.3%) and constipation (15.6%); no new safety signals were observed. Findings suggest semaglutide treatment via telehealth can achieve trial-level weight loss with similar safety profiles, supporting telehealth as an evidence-based approach to medical weight management.