Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records

William J.B. Powell; Diego R. Mazzotti; Stephen D. Herrmann; Ann M. Davis; Bettina Mittendorfer; Jared Bruce; Xing Song; Lemuel R. Waitman; Sravani Chandaka; Kelechi Anuforo; Lav Patel; Daryl Budine; Nathan Hensel; Siddharth Satyakam; Sharla Smith; Dennis Ridenour; Cheryl Jernigan; Carol Early; Kyle Stephens; Kathy Jurius; Kyle Stephens; Kathy Jurius; Abbey Sidebottom; Cassandra Rodgers; Hong Zhong; Angie Hare; Roman Melamed; Curtis Anderson; Thomas Schouweile; Christine Roering; Philip Payne; Snehil Gupta; John Newland; Joyce Balls-Berry; Janine Parham; Evin Fritschle; Shanelle Cripps; Kirk Knowlton; Channing Hansen; Erna Serezlic; Benjamin Horne; Jeff VanWormer; Judith Hase; Janet Southworth; Eric Larose; Mary Davis; Laurel Hoeth; Sandy Strey; Brad Taylor; Kris Osinski; April Haverty; Alex Stoddard; Sarah Cornell; Phoenix Do; Lucy Bailey; Beth McDonough; Betsy Chrischilles; Ryan Carnahan; Brian Gryzlak; Gi Yung Ryu; Katrina Oaklander; Pastor Bruce Hanson; Brad McDowell; Jarrod Field; Abu Mosa; Sasha Lawson; Jim McClay; Soliman Islam; Vasanthi Mandhadi; Kim Kimminau; Dennis Ridenour; Jeff Ordway; Bill Stephens; Russ Waitman; Deandra Cassone; Xiaofan Niu; Lori Wilcox; Janelle Greening; Carol Geary; Goutham Viswanathan; Jim Svoboda; Jim Campbel; Frances Wolfe; Haddy Bah; Todd Bjorklund; Jackson Barlocker; Josh Spuh; Louisa Stark; Mike Strong; Otolose Fahina Tavake-Pas; Rachel Hess; Jacob Kean; Annie Risenmay; Olivia Ellsmore; Lissa Persson; Kayla Torres Morales; Sandi Stanford; Mahanaz Syed; Rae Schofield; Meredith Zozus; Brian Shukwit; Matthew Decaro; Natalia Heredia; Charles Miller; Alice Robinson; Elmer Bernstam; Fatima Ashraf; Shiby Antony; Juliet Fong Zechner; Philip Reeder; Cindy Kao; Kate Wilkinson; Tracy Greer; Alice Robinson; Lindsay Cowel

doi:10.1111/cob.70076

Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records

William J.B. Powell
, Diego R. Mazzotti
, Stephen D. Herrmann
, Ann M. Davis
, Bettina Mittendorfer
, Jared Bruce
, Xing Song
, Lemuel R. Waitman
, Sravani Chandaka
, Kelechi Anuforo
, Lav Patel
, Daryl Budine
, Nathan Hensel
, Siddharth Satyakam
, Sharla Smith
, Dennis Ridenour
, Cheryl Jernigan
, Carol Early
, Kyle Stephens
, Kathy Jurius

Kyle Stephens, Kathy Jurius, Abbey Sidebottom, Cassandra Rodgers, Hong Zhong, Angie Hare, Roman Melamed, Curtis Anderson, Thomas Schouweile, Christine Roering, Philip Payne, Snehil Gupta, John Newland, Joyce Balls-Berry, Janine Parham, Evin Fritschle, Shanelle Cripps, Kirk Knowlton, Channing Hansen, Erna Serezlic, Benjamin Horne, Jeff VanWormer, Judith Hase, Janet Southworth, Eric Larose, Mary Davis, Laurel Hoeth, Sandy Strey, Brad Taylor, Kris Osinski, April Haverty, Alex Stoddard, Sarah Cornell, Phoenix Do, Lucy Bailey, Beth McDonough, Betsy Chrischilles, Ryan Carnahan, Brian Gryzlak, Gi Yung Ryu, Katrina Oaklander, Pastor Bruce Hanson, Brad McDowell, Jarrod Field, Abu Mosa, Sasha Lawson, Jim McClay, Soliman Islam, Vasanthi Mandhadi, Kim Kimminau, Dennis Ridenour, Jeff Ordway, Bill Stephens, Russ Waitman, Deandra Cassone, Xiaofan Niu, Lori Wilcox, Janelle Greening, Carol Geary, Goutham Viswanathan, Jim Svoboda, Jim Campbel, Frances Wolfe, Haddy Bah, Todd Bjorklund, Jackson Barlocker, Josh Spuh, Louisa Stark, Mike Strong, Otolose Fahina Tavake-Pas, Rachel Hess, Jacob Kean, Annie Risenmay, Olivia Ellsmore, Lissa Persson, Kayla Torres Morales, Sandi Stanford, Mahanaz Syed, Rae Schofield, Meredith Zozus, Brian Shukwit, Matthew Decaro, Natalia Heredia, Charles Miller, Alice Robinson, Elmer Bernstam, Fatima Ashraf, Shiby Antony, Juliet Fong Zechner, Philip Reeder, Cindy Kao, Kate Wilkinson, Tracy Greer, Alice Robinson, Lindsay Cowel

Research output: Contribution to journal › Article › peer-review

Abstract

To evaluate the effectiveness of semaglutide compared with lifestyle counselling alone for weight loss in diabetic and non-diabetic patients with obesity. This multi-site, retrospective, observational study uses data from electronic health records which are part of the Greater Plains Collaborative (GPC) in a time-to-event analysis for comparative effectiveness. Participants were adults with obesity receiving semaglutide for a minimum of 16 weeks or lifestyle counselling with at least three sessions within the first 16 weeks. The primary outcome is incidence of 10% or greater reduction in weight from baseline. Of 3927 eligible participants, 615 were prescribed semaglutide and 3312 received lifestyle counselling. Following propensity score matching, each group (diabetic and non-diabetic) consisted of 120 and 495 participants, respectively. Hazard ratios for 10% weight loss were significantly higher from semaglutide for non-diabetic (1.63 [95% CI: 1.32, 2.01; p < 0.001]) and diabetic (2.45 [95% CI: 1.47, 4.09; p < 0.001]) populations. These data from our study suggest that semaglutide therapy compared with lifestyle counselling alone is more effective in achieving at least 10% weight loss. This information may be used to inform clinical practice guidelines and stimulate future research on the long-term effectiveness of various weight loss options for individuals with obesity.

Original language	English
Article number	e70076
Journal	Clinical Obesity
Volume	16
Issue number	2
DOIs	https://doi.org/10.1111/cob.70076
State	Published - Apr 2026

Keywords

databases
glucagon-like peptide 1 (GLP-1)
lifestyle modifications

Access to Document

10.1111/cob.70076

Cite this

Powell, W. J. B., Mazzotti, D. R., Herrmann, S. D., Davis, A. M., Mittendorfer, B., Bruce, J., Song, X., Waitman, L. R., Chandaka, S., Anuforo, K., Patel, L., Budine, D., Hensel, N., Satyakam, S., Smith, S., Ridenour, D., Jernigan, C., Early, C., Stephens, K., ... Cowel, L. (2026). Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records. Clinical Obesity, 16(2), Article e70076. https://doi.org/10.1111/cob.70076

@article{43773144d738484980b32dad76748d70,

title = "Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records",

abstract = "To evaluate the effectiveness of semaglutide compared with lifestyle counselling alone for weight loss in diabetic and non-diabetic patients with obesity. This multi-site, retrospective, observational study uses data from electronic health records which are part of the Greater Plains Collaborative (GPC) in a time-to-event analysis for comparative effectiveness. Participants were adults with obesity receiving semaglutide for a minimum of 16 weeks or lifestyle counselling with at least three sessions within the first 16 weeks. The primary outcome is incidence of 10\% or greater reduction in weight from baseline. Of 3927 eligible participants, 615 were prescribed semaglutide and 3312 received lifestyle counselling. Following propensity score matching, each group (diabetic and non-diabetic) consisted of 120 and 495 participants, respectively. Hazard ratios for 10\% weight loss were significantly higher from semaglutide for non-diabetic (1.63 [95\% CI: 1.32, 2.01; p < 0.001]) and diabetic (2.45 [95\% CI: 1.47, 4.09; p < 0.001]) populations. These data from our study suggest that semaglutide therapy compared with lifestyle counselling alone is more effective in achieving at least 10\% weight loss. This information may be used to inform clinical practice guidelines and stimulate future research on the long-term effectiveness of various weight loss options for individuals with obesity.",

keywords = "databases, glucagon-like peptide 1 (GLP-1), lifestyle modifications",

author = "Powell, \{William J.B.\} and Mazzotti, \{Diego R.\} and Herrmann, \{Stephen D.\} and Davis, \{Ann M.\} and Bettina Mittendorfer and Jared Bruce and Xing Song and Waitman, \{Lemuel R.\} and Sravani Chandaka and Kelechi Anuforo and Lav Patel and Daryl Budine and Nathan Hensel and Siddharth Satyakam and Sharla Smith and Dennis Ridenour and Cheryl Jernigan and Carol Early and Kyle Stephens and Kathy Jurius and Kyle Stephens and Kathy Jurius and Abbey Sidebottom and Cassandra Rodgers and Hong Zhong and Angie Hare and Roman Melamed and Curtis Anderson and Thomas Schouweile and Christine Roering and Philip Payne and Snehil Gupta and John Newland and Joyce Balls-Berry and Janine Parham and Evin Fritschle and Shanelle Cripps and Kirk Knowlton and Channing Hansen and Erna Serezlic and Benjamin Horne and Jeff VanWormer and Judith Hase and Janet Southworth and Eric Larose and Mary Davis and Laurel Hoeth and Sandy Strey and Brad Taylor and Kris Osinski and April Haverty and Alex Stoddard and Sarah Cornell and Phoenix Do and Lucy Bailey and Beth McDonough and Betsy Chrischilles and Ryan Carnahan and Brian Gryzlak and Ryu, \{Gi Yung\} and Katrina Oaklander and Hanson, \{Pastor Bruce\} and Brad McDowell and Jarrod Field and Abu Mosa and Sasha Lawson and Jim McClay and Soliman Islam and Vasanthi Mandhadi and Kim Kimminau and Dennis Ridenour and Jeff Ordway and Bill Stephens and Russ Waitman and Deandra Cassone and Xiaofan Niu and Lori Wilcox and Janelle Greening and Carol Geary and Goutham Viswanathan and Jim Svoboda and Jim Campbel and Frances Wolfe and Haddy Bah and Todd Bjorklund and Jackson Barlocker and Josh Spuh and Louisa Stark and Mike Strong and Tavake-Pas, \{Otolose Fahina\} and Rachel Hess and Jacob Kean and Annie Risenmay and Olivia Ellsmore and Lissa Persson and Morales, \{Kayla Torres\} and Sandi Stanford and Mahanaz Syed and Rae Schofield and Meredith Zozus and Brian Shukwit and Matthew Decaro and Natalia Heredia and Charles Miller and Alice Robinson and Elmer Bernstam and Fatima Ashraf and Shiby Antony and Zechner, \{Juliet Fong\} and Philip Reeder and Cindy Kao and Kate Wilkinson and Tracy Greer and Alice Robinson and Lindsay Cowel",

note = "Publisher Copyright: {\textcopyright} 2026 World Obesity Federation.",

year = "2026",

month = apr,

doi = "10.1111/cob.70076",

language = "English",

volume = "16",

journal = "Clinical Obesity",

issn = "1758-8103",

number = "2",

}

Powell, WJB, Mazzotti, DR, Herrmann, SD, Davis, AM, Mittendorfer, B, Bruce, J, Song, X, Waitman, LR, Chandaka, S, Anuforo, K, Patel, L, Budine, D, Hensel, N, Satyakam, S, Smith, S, Ridenour, D, Jernigan, C, Early, C, Stephens, K, Jurius, K, Stephens, K, Jurius, K, Sidebottom, A, Rodgers, C, Zhong, H, Hare, A, Melamed, R, Anderson, C, Schouweile, T, Roering, C, Payne, P, Gupta, S, Newland, J, Balls-Berry, J, Parham, J, Fritschle, E, Cripps, S, Knowlton, K, Hansen, C, Serezlic, E, Horne, B, VanWormer, J, Hase, J, Southworth, J, Larose, E, Davis, M, Hoeth, L, Strey, S, Taylor, B, Osinski, K, Haverty, A, Stoddard, A, Cornell, S, Do, P, Bailey, L, McDonough, B, Chrischilles, B, Carnahan, R, Gryzlak, B, Ryu, GY, Oaklander, K, Hanson, PB, McDowell, B, Field, J, Mosa, A, Lawson, S, McClay, J, Islam, S, Mandhadi, V, Kimminau, K, Ridenour, D, Ordway, J, Stephens, B, Waitman, R, Cassone, D, Niu, X, Wilcox, L, Greening, J, Geary, C, Viswanathan, G, Svoboda, J, Campbel, J, Wolfe, F, Bah, H, Bjorklund, T, Barlocker, J, Spuh, J, Stark, L, Strong, M, Tavake-Pas, OF, Hess, R, Kean, J, Risenmay, A, Ellsmore, O, Persson, L, Morales, KT, Stanford, S, Syed, M, Schofield, R, Zozus, M, Shukwit, B, Decaro, M, Heredia, N, Miller, C, Robinson, A, Bernstam, E, Ashraf, F, Antony, S, Zechner, JF, Reeder, P, Kao, C, Wilkinson, K, Greer, T, Robinson, A & Cowel, L 2026, 'Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records', Clinical Obesity, vol. 16, no. 2, e70076. https://doi.org/10.1111/cob.70076

TY - JOUR

T1 - Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records

AU - Powell, William J.B.

AU - Mazzotti, Diego R.

AU - Herrmann, Stephen D.

AU - Davis, Ann M.

AU - Mittendorfer, Bettina

AU - Bruce, Jared

AU - Song, Xing

AU - Waitman, Lemuel R.

AU - Chandaka, Sravani

AU - Anuforo, Kelechi

AU - Patel, Lav

AU - Budine, Daryl

AU - Hensel, Nathan

AU - Satyakam, Siddharth

AU - Smith, Sharla

AU - Ridenour, Dennis

AU - Jernigan, Cheryl

AU - Early, Carol

AU - Stephens, Kyle

AU - Jurius, Kathy

AU - Stephens, Kyle

AU - Jurius, Kathy

AU - Sidebottom, Abbey

AU - Rodgers, Cassandra

AU - Zhong, Hong

AU - Hare, Angie

AU - Melamed, Roman

AU - Anderson, Curtis

AU - Schouweile, Thomas

AU - Roering, Christine

AU - Payne, Philip

AU - Gupta, Snehil

AU - Newland, John

AU - Balls-Berry, Joyce

AU - Parham, Janine

AU - Fritschle, Evin

AU - Cripps, Shanelle

AU - Knowlton, Kirk

AU - Hansen, Channing

AU - Serezlic, Erna

AU - Horne, Benjamin

AU - VanWormer, Jeff

AU - Hase, Judith

AU - Southworth, Janet

AU - Larose, Eric

AU - Davis, Mary

AU - Hoeth, Laurel

AU - Strey, Sandy

AU - Taylor, Brad

AU - Osinski, Kris

AU - Haverty, April

AU - Stoddard, Alex

AU - Cornell, Sarah

AU - Do, Phoenix

AU - Bailey, Lucy

AU - McDonough, Beth

AU - Chrischilles, Betsy

AU - Carnahan, Ryan

AU - Gryzlak, Brian

AU - Ryu, Gi Yung

AU - Oaklander, Katrina

AU - Hanson, Pastor Bruce

AU - McDowell, Brad

AU - Field, Jarrod

AU - Mosa, Abu

AU - Lawson, Sasha

AU - McClay, Jim

AU - Islam, Soliman

AU - Mandhadi, Vasanthi

AU - Kimminau, Kim

AU - Ridenour, Dennis

AU - Ordway, Jeff

AU - Stephens, Bill

AU - Waitman, Russ

AU - Cassone, Deandra

AU - Niu, Xiaofan

AU - Wilcox, Lori

AU - Greening, Janelle

AU - Geary, Carol

AU - Viswanathan, Goutham

AU - Svoboda, Jim

AU - Campbel, Jim

AU - Wolfe, Frances

AU - Bah, Haddy

AU - Bjorklund, Todd

AU - Barlocker, Jackson

AU - Spuh, Josh

AU - Stark, Louisa

AU - Strong, Mike

AU - Tavake-Pas, Otolose Fahina

AU - Hess, Rachel

AU - Kean, Jacob

AU - Risenmay, Annie

AU - Ellsmore, Olivia

AU - Persson, Lissa

AU - Morales, Kayla Torres

AU - Stanford, Sandi

AU - Syed, Mahanaz

AU - Schofield, Rae

AU - Zozus, Meredith

AU - Shukwit, Brian

AU - Decaro, Matthew

AU - Heredia, Natalia

AU - Miller, Charles

AU - Robinson, Alice

AU - Bernstam, Elmer

AU - Ashraf, Fatima

AU - Antony, Shiby

AU - Zechner, Juliet Fong

AU - Reeder, Philip

AU - Kao, Cindy

AU - Wilkinson, Kate

AU - Greer, Tracy

AU - Robinson, Alice

AU - Cowel, Lindsay

PY - 2026/4

Y1 - 2026/4

N2 - To evaluate the effectiveness of semaglutide compared with lifestyle counselling alone for weight loss in diabetic and non-diabetic patients with obesity. This multi-site, retrospective, observational study uses data from electronic health records which are part of the Greater Plains Collaborative (GPC) in a time-to-event analysis for comparative effectiveness. Participants were adults with obesity receiving semaglutide for a minimum of 16 weeks or lifestyle counselling with at least three sessions within the first 16 weeks. The primary outcome is incidence of 10% or greater reduction in weight from baseline. Of 3927 eligible participants, 615 were prescribed semaglutide and 3312 received lifestyle counselling. Following propensity score matching, each group (diabetic and non-diabetic) consisted of 120 and 495 participants, respectively. Hazard ratios for 10% weight loss were significantly higher from semaglutide for non-diabetic (1.63 [95% CI: 1.32, 2.01; p < 0.001]) and diabetic (2.45 [95% CI: 1.47, 4.09; p < 0.001]) populations. These data from our study suggest that semaglutide therapy compared with lifestyle counselling alone is more effective in achieving at least 10% weight loss. This information may be used to inform clinical practice guidelines and stimulate future research on the long-term effectiveness of various weight loss options for individuals with obesity.

AB - To evaluate the effectiveness of semaglutide compared with lifestyle counselling alone for weight loss in diabetic and non-diabetic patients with obesity. This multi-site, retrospective, observational study uses data from electronic health records which are part of the Greater Plains Collaborative (GPC) in a time-to-event analysis for comparative effectiveness. Participants were adults with obesity receiving semaglutide for a minimum of 16 weeks or lifestyle counselling with at least three sessions within the first 16 weeks. The primary outcome is incidence of 10% or greater reduction in weight from baseline. Of 3927 eligible participants, 615 were prescribed semaglutide and 3312 received lifestyle counselling. Following propensity score matching, each group (diabetic and non-diabetic) consisted of 120 and 495 participants, respectively. Hazard ratios for 10% weight loss were significantly higher from semaglutide for non-diabetic (1.63 [95% CI: 1.32, 2.01; p < 0.001]) and diabetic (2.45 [95% CI: 1.47, 4.09; p < 0.001]) populations. These data from our study suggest that semaglutide therapy compared with lifestyle counselling alone is more effective in achieving at least 10% weight loss. This information may be used to inform clinical practice guidelines and stimulate future research on the long-term effectiveness of various weight loss options for individuals with obesity.

KW - databases

KW - glucagon-like peptide 1 (GLP-1)

KW - lifestyle modifications

UR - https://www.scopus.com/pages/publications/105032790954

U2 - 10.1111/cob.70076

DO - 10.1111/cob.70076

M3 - Article

C2 - 41830068

AN - SCOPUS:105032790954

SN - 1758-8103

VL - 16

JO - Clinical Obesity

JF - Clinical Obesity

IS - 2

M1 - e70076

ER -

Comparison of Semaglutide and Lifestyle Counselling for Weight Loss Using Multi-Site Electronic Health Records

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this