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The World Health Organization notes that obesity—a chronic disease defined by a body mass index (BMI) of 30 or more—can result in a multitude of severe health issues, such as cardiovascular disease, chronic kidney diseases, hepatic steatosis, type 2 diabetes, and certain cancers.1 In the United States, its prevalence has risen exponentially, from 30.5% in 1999-2000 to 42.4% in 2017-2018, 2 and also during these timeframes, severe obesity (a BMI greater than or equal to 40) jumped from 4.7% to 9.2%.2
Besides the traditional obesity treatments of a healthy diet and exercise, the pharmaceutical industry has played a role in these efforts with the introduction of glucagon-like-peptide-1 (GLP-1) receptor agonists, such as semaglutide (Wegovy) and tirzepatide (Zepbound).
In fact, GLP-1s had been previously approved for the treatment of type 2 diabetes, but that has since changed; more recent clinical trials have been demonstrating that this drug class has been effective toward treating weight management and cardiovascular disease prevention, resulting in FDA approving these indications.3
Given the increase in available research on the topic, along with the rise in popularity, a cross-sectional study published in JAMA Network Open4 aimed to explore the possible correlation of prescription trends and societal interest for being able to predict future market dynamics in the space.
The repeated cross-sectional study pulled prescription data from the IQVIA National Prescription Audit—which is reportedly able to gather approximately 90% of US retail prescription dispensing—and online searches for FDA-approved obesity management drugs (OMDs) from July 1, 2017, through Feb. 29, 2024.
The drugs were catalogued based on brand names as either:
- FDA-approved OMDs (naltrexone and bupropion [Contrave; Orexigen Therapeutics], orlistat [Alli (GlaxoSmithKline), Orlistat (generic), Xenical (Roche)], phentermine [Lomaira (KVK-Tech), Phentermine (generic), Qsymia (Vivus)], semaglutide ([Wegovy, Novo Nordisk)], liraglutide [Saxenda, Novo Nordisk]), and tirzepatide [Zepbound, Eli Lilly])
- GLP-1RAs with weight loss effects (tirzepatide [Mounjaro; Eli Lilly], semaglutide [Ozempic (Novo Nordisk;), Rybelsus (Novo Nordisk)], and liraglutide [Victoza; Novo Nordisk]).
The analysis found thata total of 69,213,936 prescriptions for OMDs were dispensed in the US during the aforementioned timeframe, with an overall increase of 0.76 to 0.80 million from July 2017 to June 2018, and 1.29 to 1.51 million from March 2023 to February 2024. There was also a mean (SD) annual growth rate of 5.3% (9.4%). In February 2024, total monthly OMD prescriptions reached 1.5 million, representing 0.41% of all prescriptions that month.
Phentermine, semaglutide (Wegovy; Novo Nordisk), liraglutide (Saxenda; Novo Nordisk), and tirzepatide (Zepbound; Eli Lilly) were considered to be the most prescribed. By February 2024, phentermine had the most monthly prescriptions at approximately 0.74 million, while Wegovy and Zepbound had 0.42 million and 0.25 million respectively.
A majority of prescriptions were written by advanced practice practitioners (APP) and primary care physicians (PCPs) and internists. The APPs’ share increased from 25.3% in July 2017 to 40.6% in February 2024, while PCPs’ and internists’ share decreased from 57.9% to 48.1%.
Also in February 2024, Wegovy’s share of total OMDs increased to 27.7% and 28.3% among APPs and PCPs and internists respectively, while Zepbound’s share represented 16.1% and 16.5%. Phentermine’s dropped from 86.3% and 85.1% (July 2017) to 50.8% and 49.7%.
When it came to online searches per every 10 million during that same time, they accurately reflected prescription trends, with Wegovy, Zepbound, and phentermine coming in at 636.3, 468.9, and 301.8 respectively. However, the greatest correlations between prescriptions and search volumes were represented by semaglutide (Wegovy; r = 0.97) and tirzepatide (Zepbound; r = 0.90).
The study investigators concluded that, “This repeated cross-sectional study that examined trends in drug usage and online searches from 2017 to 2024 revealed a dynamic shift in obesity medication patterns, with semaglutide and tirzepatide gaining a significant share of all prescriptions. The parallel surge in prescriptions and online searches, and their strong correlation, highlight the association between internet search activity and clinical adoption.
“These findings may provide insight for healthcare professionals and policy makers, as they highlight the rapid adoption by clinicians (including non-physician professions) of state-of-the-art obesity treatments and their growing public interest. Our data provide a foundation to guide epidemiologic trends and harness real-time search patterns to estimate future trends in the adoption of obesity treatment.”
References
1. Obesity and overweight. World Health Organization; 2023. Accessed November 17, 2023. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief. 2020;(360):1-8.
3. Saraceno N. The Association Between Semaglutide Initiation and Obese Individuals Without Diabetes. Pharmaceutical Commerce. January 22, 2025. https://www.pharmaceuticalcommerce.com/view/association-between-semaglutide-initiation-obese-individuals-without-diabetes
4. Berning P, Adhikari R, Schroer AE, et al. Longitudinal Analysis of Obesity Drug Use and Public Awareness. JAMA Netw Open. 2025;8(1):e2457232. doi:10.1001/jamanetworkopen.2024.57232