Telehealth has expanded access to obesity care, yet data on the safety and effectiveness of digital weight-loss services (DWLS) combining lifestyle and pharmacological therapy remain limited. This study retrospectively assessed the safety and effectiveness of the Juniper Australia weight loss program, a medicated DWLS offering combined lifestyle and pharmacotherapy for people with overweight and obesity. Data was extracted from Eucalyptus’ electronic records for patients initiating Semaglutide-supported treatment between January 1, 2023, and May 1, 2025. Exclusion criteria included discontinuing the program before 8 medication orders, receiving more than 15 orders, pausing treatment for over three months, or failing to submit weight data within a 12-month window (341-379 days post-initiation). Of 14,171 patients, 3120 met the inclusion criteria (78% dropout rate). The mean %WL for this group was 15.4%, with 91.1% achieving clinically significant weight loss (≥5%) and 71.2% losing ≥10%. 2119 patients reported at least one side effect, and 24 experienced severe adverse events. A limitation of the study was that over 80 percent of patients were women of Caucasian ethnicity. In conclusion, despite these limitations and the high prevalence of mild adverse events, the Juniper Australia program demonstrated substantial weight loss for adherent patients, with a high proportion achieving clinically significant weight reduction. These findings, combined with the fact that program cost was a major factor in discontinuation and pause decisions, highlight the need for strategies to improve accessibility, address cost barriers, and ensure equitable effectiveness of medicated DWLS across diverse populations. Further research should investigate strategies to enhance long-term adherence and the impact of different cost structures on program accessibility.