How Common GLP-1 Use Is in the United States
Roughly 6 to 8 percent of U.S. adults with diagnosed diabetes used a GLP-1 agonist in 2023, while around 4 to 5 percent of U.S. adults overall report current use, including many without diabetes. These estimates come from national health interview surveys, prescription claims data, and disease registries. Growth has been steep: prescription rates roughly tripled between 2020 and 2023, driven by widespread uptake for weight management and cardiovascular risk reduction in people with and without diabetes. The following sections define GLP-1 medications, review data sources and limitations, and explain who is using them and why prevalence is likely to keep changing.
What GLP-1 Agonists Are and How They Work
Glucagon-like peptide-1 (GLP-1) agonists are injectable or oral medicines that mimic a gut hormone. They increase insulin release in response to meals, slow stomach emptying, and reduce appetite. In people with type 2 diabetes, they lower blood sugar and can promote modest weight loss. Newer formulations and expanded indications for weight management and cardiovascular risk reduction have accelerated use. Commonly prescribed drugs include semaglutide and liraglutide, with oral semaglutide and emerging combinations also contributing to uptake.
Primary Data Sources for Prevalence in the U.S.
Prevalence estimates rely on several major data systems, each with strengths and limitations:
- National Health Interview Survey (NHIS): Large household interviews that self-report prescription use and diagnosis.
- National Health and Nutrition Examination Survey (NHANES): Biochemical measures and interviews, useful for validation.
- Retail and payer prescription claims: Actual dispensing data from large pharmacies and insurance claims.
- Disease registries and electronic health records (EHR): Clinical diagnoses and medication fills in health systems.
Together, these sources show a sharp rise in GLP-1 prevalence, especially from 2021 onward as regulatory approvals and media attention expanded.
Key Definitions for Interpreting Data
- Current use: Reports using the medication within the past 30 days.
- Prevalence: The proportion of a population using the drug at a given time.
- Incidence: New starts over a period, typically lower than prevalence.
- Diabetes vs weight management: Indicates primary labeled indication reported by users.
Approximate Percentages and Recent Estimates
Because methods differ, estimates vary. In 2023, best available evidence points to these approximate ranges among U.S. adults:
| Population | Metric | Estimate or Range | Source Type |
|---|---|---|---|
| Adults with diagnosed diabetes | GLP-1 use | ~6–8% | NHIS, claims data |
| Adults overall | Current use (any indication) | ~4–5% | NHIS, NHANES, claims |
| Adults with obesity (no diabetes) | Use for weight management | Low single digits, rising quickly | EHR, retail data |
| Adults with overweight/obesity combined | Reported use for weight | 4–7%, depending on definition | Survey and claims data |
Percentages are higher in certain subgroups, including women, White non-Hispanic adults, adults with higher income or insurance coverage, and people living in metropolitan areas. Prevalence among children and adolescents remains lower but is increasing, especially for obesity treatment. Incidence (new starts) has risen faster than prevalence in many health systems, reflecting both new prescriptions and longer durations of use as maintenance therapy.
Who Is Using GLP-1s and Why
Users are often older adults with type 2 diabetes, but growth is fastest among younger adults and people without diabetes who are using these medications for weight management and cardiometabolic risk reduction. In practice, people with obesity, overweight with cardiometabolic risk factors, and those with diabetes are the main populations of interest. Clinical guidelines in diabetes and obesity now include GLP-1 agonists as first-line options in many cases, which has accelerated uptake. Cardiovascular outcome trials showing reduced risk of major adverse cardiovascular events have also widened use, particularly for patients with established heart disease and multiple risk factors.
Demographic and Access Patterns
- Higher use among women than men.
- More common in White non-Hispanic adults, though use is increasing in other racial and ethnic groups.
- Greater prevalence in adults with private insurance or higher incomes, influenced by cost and prior authorization policies.
- Urban residents and larger integrated health systems often show higher measured prevalence due to EHR capture and formulary access.
Barriers remain, including cost, prior authorization, injection requirements, and varying provider familiarity. As more people stay on these medications long term, prevalence in chronic disease registries is expected to stabilize at higher levels than initial spikes suggest.
Trends, Duration, and Future Directions
Since 2020, prevalence has risen steeply and appears to be leveling off in some health systems as initial new-user growth slows. Sustained use is common: many people remain on GLP-1 agonists for years rather than months, which increases point prevalence. Real-world data show retention rates vary by drug, with higher persistence observed for semaglutide in both diabetes and weight management indications. Future prevalence will depend on guideline updates, reimbursement policies, new formulations (e.g., oral and combination products), and broader access through retail pharmacy programs and managed care formularies.
Limitations and Considerations in the Data
Estimates vary because data sources capture different populations and use different definitions. Surveys may over- or under-report use compared to claims, and they often do not capture doses, duration, or adherence. People using GLP-1s for weight management may not disclose use due to stigma or because they obtain medications through off-label or direct commercial channels. Geographic variation and differences in insurance coverage also affect measured prevalence. Interpretation should therefore focus on directional trends and relative differences rather than precise single-point percentages.
Key Takeaways
- Approximately 4–5% of U.S. adults currently use GLP-1 agonists, with higher rates among people with diabetes (6–8%).
- Prevalence has risen sharply since 2020 and is still evolving as indications expand and long-term use becomes more common.
- Use is concentrated among women, White non-Hispanic adults, and those with better access to care and prescription coverage.
- Growth is driven by weight management and cardiovascular benefit in people with and without diabetes.
- Data limitations mean estimates vary; trends and subgroup differences are more informative than any single percentage.
For people considering a GLP-1, discussing personal cardiovascular and weight-related risk with a clinician is the most reliable next step. As more real-world evidence accumulates, prevalence estimates will refine, but the broad trajectory toward greater use across U.S. populations is clear and well-supported by multiple data systems.