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

ABSTRACT Objective 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. Methods 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. Results 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. Conclusions 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.