A nested case-control study found that women of reproductive age using hormonal contraception were more likely to subsequently initiate semaglutide for weight management. The findings suggest that weight gain and metabolic symptoms associated with hormonal contraceptive use may contribute to increased demand for anti-obesity treatment. Results demonstrated that all patterns of hormonal contraceptive use differed in association with initiation of semaglutide compared to non-user controls. When examining the patterns with one type of contraceptive used, adjusted hazard ratios ranged between 1.42 (95% CI, 1.34-1.51) for combined oral pills and 1.63 (95% CI, 1.46-1.82) for progestin-only IUDs. In conclusion, the use of hormonal contraceptives has been identified as a predictor of semaglutide use in all usage scenarios relative to the control group.