A real-world study published in Frontiers in Nutrition reports that 80.5% of surveyed patients prescribed semaglutide or tirzepatide for weight management were still taking the medication, while only 27.0% said they had been referred to any additional health service. The gap between filling a prescription and getting supportive care is the most useful thing in this paper.

The drugs involved are semaglutide (sold as Wegovy and Ozempic) and tirzepatide (Zepbound and Mounjaro), a GLP-1 receptor agonist and a dual GIP/GLP-1 receptor agonist respectively, both prescribed here for obesity treatment rather than diabetes. The CAMP study was run inside the University of Pennsylvania Health System and drew on electronic health records plus a patient survey, so this is clinical practice rather than a trial population.

Who is actually getting these prescriptions

Phase I identified 21,610 adults prescribed one of the two medications for weight management between July 2023 and June 2024, with a mean age of 49 years and a mean BMI of 36 kg/m2. The authors describe the cohort as predominantly female, White and privately insured, with most prescriptions written by primary care providers.

Key results

Of the 2,628 patients who completed the Phase II survey, 90.1% reported filling their initial prescription and 80.5% reported still being on treatment. Among the 512 who had stopped, the reasons given were loss of insurance coverage (37.7%), side effects (27.1%) and high medication cost (20.3%).

Money, not tolerance, ends treatment

Add the insurance and cost figures together and financial barriers outweigh side effects as a reason for stopping, which the authors flag directly in their conclusions. That is a different story from the one the tolerability debate usually tells, and it points at payers rather than pharmacology.

Limitations

This was a single academic health system in Philadelphia, and the analyses were descriptive and bivariate rather than designed to establish cause. Survey respondents opted in without compensation, so the people who replied may not represent the full 21,610, and the Phase I data were a one-year snapshot rather than a longitudinal follow-up.

What the referral gap suggests next

The authors position the findings as identifying leverage points for improving access, continued use and multidisciplinary obesity treatment. Whether adding nutrition and behavioral referrals changes outcomes is a question this study design cannot answer.