Weight Loss in Veterans with Schizophrenia and Multimorbidity Prescribed Semaglutide: Results From a National Retrospective Cohort Study.

BACKGROUND AND HYPOTHESIS: People with schizophrenia are at heightened risk for physical multimorbidity and premature death. Semaglutide improves cardiometabolic outcomes, yet research is limited among individuals with schizophrenia. This study explored weight loss in Veterans with schizophrenia and physical multimorbidity (ie, heart failure and diabetes) prescribed semaglutide and compared weight changes to those in Veterans without schizophrenia. We hypothesized that those with schizophrenia would experience less weight loss compared to those without schizophrenia. STUDY DESIGN: This retrospective cohort study examined national data from the Department of Veterans Affairs. The cohort included Veterans who filled a semaglutide prescription between 2018 and 2023 and had diagnoses of heart failure and diabetes. Body weight was examined one year prior to and one year following the first semaglutide prescription. Linear regression with inverse probability of treatment weighting (IPTW) was used to examine the relationship between schizophrenia status and one-year change in weight, accounting for hospital, demographic, clinical, and healthcare utilization factors. STUDY RESULTS: The sample comprised n = 36 482 Veterans with physical multimorbidity (n = 559 with schizophrenia). The schizophrenia sample lost 3.1% of their baseline weight (raw weight loss = 8.7 pounds) and the sample without schizophrenia lost 4.7% of baseline weight (raw weight loss = 12.1 pounds). IPTW-adjusted regression analyses demonstrated significantly lower percent weight loss for those with schizophrenia compared to those without schizophrenia (Estimate = -0.85, 95% confidence intervals (CIs): -1.63, -0.07). CONCLUSIONS: Semaglutide appears to confer weight loss in Veterans with schizophrenia and multimorbidity, albeit at slightly lower amounts than those without schizophrenia.