Association between socioeconomic factors and semaglutide use for weight loss: a population-based cross-sectional study in Denmark

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Background: Glucagon-like peptide-1 agonists like semaglutide are effective treatments for obesity. High costs may create economic barriers. This study examines the association between income and prescriptions for semaglutide for weight loss. Methods: . Findings: A total of 4,531,146 adult individuals were included after excluding individuals with diabetes (186,823, 3·8%), and individuals without income data (146,639, 3·0%). The proportion of individuals with a redeemed semaglutide prescription increased with income, from 1·3% (n = 13,925) in the lowest income quartile to 3·6% (n = 41,298) in the highest. Conversely, in a representative sample of 36,391 individuals, the proportion living with obesity was 26% (n = 1310) in the lowest income quartile compared to 13% (n = 1872) in the highest. During the year 2023 we found a general increase in Semaglutide use from 40,605 (0·9%) in the first quarter of 2023 to 85,250 (1·9%) in the fourth quarter, which was most pronounced in women in the highest income group with an increase from 10,818 (1·9%) to 23,069 (4·1%). Interpretation: Semaglutide use increased with income while obesity declined. This suggests that economic concerns lead to a systematic undertreatment for obesity for low-income individuals, potentially exacerbating existing health inequalities. Funding: None.