Unindicated GLP-1 Prescriptions Climb Since 2021 in the US

More than 6 million patients in the U.S. started GLP-1 use between 2021 and 2025, and a growing share received prescriptions without documented clinical indications, according to a study analyzing Epic Cosmos data. Researchers reviewed 6,295,965 patients who got a first prescription for semaglutide or tirzepatide between January 2021 and December 2025 and had medical encounters at least a year before and after starting. Patients were considered to have no documented indications if their BMI was below 27 (below 25 for Asian individuals) and they had no recorded diagnoses such as diabetes, prediabetes, cardiovascular disease, or other approved conditions. Overall, 25,762 patients (0.4%) fit that category, and the rate rose steadily to about 0.74% by December 2025. Women and White patients were more likely to receive these prescriptions.