Aim: This study aimed to evaluate the effectiveness of hospital-funded incretin-based pharmacotherapy across two multidisciplinary weight management programs (WMP).
Methods: Adults with severe obesity who commenced hospital-funded tirzepatide (Mounjaro, needed BMI≥55kg/m2) in one WMP or semaglutide (Wegovy, BMI≥40kg/m2) in another WMP in Sydney, between May 2025 and June 2026, were included. Routinely collected anthropometric, clinical and treatment outcome data at baseline, 3, 6 and 9 months were retrospectively analysed. Continuous variables are presented as mean ±SD or median (Q1-Q3).
Results: Eighty-one adults commenced hospital-funded incretin-based pharmacotherapy (semaglutide n=51; tirzepatide n=30). Median baseline weight was 158.2 kg (128.4-177.3) in the semaglutide cohort and 180.0 kg (166.6-200.9) in the tirzepatide cohort. Corresponding median BMI values were 51.7 kg/m² (44.8-61.7) and 62.9 kg/m² (59.5-71.7), respectively.
Common comorbidities included hypertension (56.0% vs 30%), obstructive sleep apnoea (44.0% vs 54.8%), and hyperlipidaemia (30% vs 38.0%) in the semaglutide and tirzepatide cohorts, respectively. Median weight loss in the semaglutide cohort was 5.6 (2.9-10.1) kg, 10.7 (4.2-16.6) kg, and 10.6 (8.0-15.7) kg at 3 (n=33), 6 (n=27), and 9 months (n=13), respectively. Corresponding values for the tirzepatide cohort were 7.3 (1.5-11.3) kg, 15.6 (9.2-26.6) kg, and 16.7 (10.5-24.8) kg at 3 (n=26), 6 (n=21), and 9 months (n=16), respectively.
Body composition data were available only for the tirzepatide cohort and demonstrated median reductions in body fat percentage of 2.1% (1.2-3.6) and 2.6% (0.9-4.0) at 3 and 6 months, respectively. Corresponding reductions in fat-free mass were 2.9 kg (1.4-8.9) and 5.0 kg (1.8-16.0).
No participants receiving tirzepatide discontinued treatment; 8/51 (15.7%) participants receiving semaglutide discontinued therapy, most commonly due to progression to bariatric surgery (n=4;50%).
Conclusion: Real-world experience from two public multidisciplinary WMPs suggests that hospital-funded incretin-based pharmacotherapy may be practically delivered with low dropout rates, as part of evidence-based obesity management for adults with severe obesity.