Observational studyJMIR formative research2025

Semaglutide and Tirzepatide in a Remote Weight Management Program: 12-Month Retrospective Observational Study.

Rebecca Richards, William Lunt, Michael Whitman, Giulia Spaltro, Rachel Hall

Abstract readObservational Study
In one paragraph

Observational study in JMIR formative research, 2025. The graph read 1 number from its abstract, feeding 1 cell of the map: it . Cited by 1 paper.

1number the graph read from it
1cell of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

← favours the treatmentfavours the comparator →
-22.90 · no effect
Mean weight changetirzepatide vs semaglutidefavours the treatment · obesityfeeds one cell of the map
Δ -22.9<.001
RESULTS: Mean weight change at 12 months was -22.9 kg (-22.1% of baseline weight, SD 8%; P<.001) in the tirzepatide cohort and -18.1 kg (-17.1% of baseline weight, SD 8.1%; P<.001) in the semaglutide cohort.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GIP/GLP-1 & amylin agonists×body weight & composition

No readable resultOpen on the map →What to test next →

29 readable studies in this cell: 28 favour the treatment, 1 find no difference, 0 favour the comparator.

Belief with this paper
1.00replicated · 19 families support, 0 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
Δ -17.3-18.1 to -16.6
NCT041846222,539 enrolled · 2019
Δ -13.5-14.6 to -12.5
NCT037306622,002 enrolled · 2018
Δ -9.00-9.80 to -8.30
NCT039879191,879 enrolled · 2019
Δ -1.70-2.60 to -0.70
NCT038829701,444 enrolled · 2019
Δ -9.80-10.8 to -8.80
NCT045379231,428 enrolled · 2020
Δ -10.7-11.5 to -9.90
Δ -10.4-11.2 to -9.50
NCT04657003938 enrolled · 2021
Δ -10.1-11.5 to -8.80
NCT04093752917 enrolled · 2019
Δ -6.50-7.40 to -5.60
NCT04660643783 enrolled · 2021
Δ -21.4-22.9 to -20.0
NCT05822830751 enrolled · 2023
Δ -6.50-8.10 to -4.90
NCT04847557731 enrolled · 2021
Δ -11.6-12.8 to -10.4

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors.

Rebecca RichardsSecond Nature, London, United Kingdom.ORCID 0000-0001-7122-6822
William LuntSecond Nature, London, United Kingdom.ORCID 0009-0000-0749-0725
Michael WhitmanSecond Nature, London, United Kingdom.ORCID 0000-0001-7144-7545
Giulia SpaltroSecond Nature, London, United Kingdom.ORCID 0009-0007-9256-6181
Rachel HallSecond Nature, London, United Kingdom.ORCID 0009-0001-9438-2219

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundObesity affects >890 million adults worldwide, and traditional lifestyle interventions often lack long-term success. While glucagonlike peptide-1 receptor agonists (GLP-1RAs) have shown strong weight loss outcomes, access to specialist care is limited by cost and capacity.

objectiveThis study evaluated the effectiveness, feasibility, acceptability, and potential cost-effectiveness of a 12-month remote GLP-1RA-supported weight management program, comparing outcomes between tirzepatide and semaglutide.

methodsThis retrospective analysis included 339 participants (n=278, 82% women) who completed a 12-month remote weight management program using either tirzepatide (n=209, 61.7%) or semaglutide (n=130, 38.3%) between February and June 2024. The program combined medication, app-based behavioral support, coaching from registered dietitians and nutritionists, and clinical oversight. It featured 5 phases with evidence-based behavior change techniques, monthly monitoring, and safety protocols. Primary outcomes were mean weight change and proportions achieving ≥10% and ≥15% weight loss. Secondary outcomes included behavior changes, side effects, acceptability, feasibility, and estimated cost-effectiveness compared to National Health Service care.

resultsMean weight change at 12 months was -22.9 kg (-22.1% of baseline weight, SD 8%; P<.001) in the tirzepatide cohort and -18.1 kg (-17.1% of baseline weight, SD 8.1%; P<.001) in the semaglutide cohort. Achievement of ≥10% weight loss occurred in 95.2% (199/209) of participants using tirzepatide and 83.1% (108/130) of participants using semaglutide, whereas ≥15% weight loss was achieved by 83.7% (175/209) and 56.2% (73/130) of the participants, respectively. The proportion of inactive participants (no weekly exercise) decreased substantially in both cohorts (tirzepatide: 31/209, 14.8% to 14/209, 6.7%; semaglutide: 29/130, 22.3% to 7/130, 5.4%; P<.001). Side effects decreased significantly over the 12-month period, with participants who reported no side effects increasing from 41.6% (87/209) to 60.3% (126/209; P<.001) in the tirzepatide cohort and from 53.8% (70/130) to 67.7% (88/130) in the semaglutide cohort (P=.02), whereas common initial side effects, including constipation, nausea, and fatigue, showed significant reductions (P<.001). Economic modeling suggested a 60% to 70% cost saving compared to specialist weight management services and a 10% to 60% cost saving compared to primary care in the National Health Service.

conclusionsThis real-world evaluation demonstrates that remotely delivered, GLP-1RA-supported weight management programs can achieve weight loss outcomes that align closely with clinical trial results while potentially reducing health care costs by 10% to 70% compared to traditional UK services. Both the tirzepatide and semaglutide cohorts exceeded clinically significant weight loss thresholds with acceptable safety profiles and positive behavior changes. These findings support the feasibility and effectiveness of digital delivery models for expanding access to specialist obesity treatment within resource-constrained health care systems, with outcomes that compare favorably to pharmacological intervention alone.

Indexed as

Glucagon-Like PeptidesObesityTirzepatideWeight Reduction ProgramsAdultCost-Benefit AnalysisFeasibility StudiesFemaleGlucagon-Like Peptide 1HumansMaleMiddle AgedRetrospective StudiesSemaglutideTreatment OutcomeWeight LossGlucagon-Like Peptide 1Glucagon-Like PeptidesSemaglutideTirzepatidebehavioral interventiondigital healthGLP-1RAglucagonlike peptide-1 receptor agonistobesityremote health care deliverysemaglutidetelemedicineweight lossweight management

Identifiers

PMID40838489
PMCPMC12475876

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.