A large real‑world study of 655 people who got semaglutide through telehealth showed they lost about 16% of their body weight on average, with side effects like nausea and constipation that matched what clinical trials have reported. Women were more likely to hit bigger weight‑loss milestones.

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.