Semaglutide Plus Lifestyle Change Shown Effective for Obesity

By Christine Judge

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Injectable semaglutide, approved to treat type 2 diabetes, is efficacious as an adjunct to diet and exercise for weight loss in nondiabetic overweight or obese adults, according to an industry-conducted trial published in the New England Journal of Medicine.

Researchers randomized nearly 2000 participants without diabetes who were either overweight with at least one weight-related comorbidity or obese to receive 2.4 mg subcutaneous semaglutide or placebo weekly for 68 weeks. All participants received counseling to reduce calorie intake and increase physical activity.

Mean weight loss was significantly greater with semaglutide than placebo (15% vs. 2%), as was the percentage of patients losing >5% of body weight (86% vs. 32%). Semaglutide users had a higher rate of adverse gastrointestinal effects, most mild. Cholelithiasis was also more common in the treatment group (1.8% vs. 0.6%). No difference in hypoglycemia was noted.

Editorialists say that the trial results are promising, but they note several limitations, including that only 6% of trial participants were Black, and 12% were Latinx, which is not reflective of the U.S. population.