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Weekly Semaglutide for Weight Loss in Adults

Feb 11, 2021 6:06 pm

NEJM has reported the results of a trial showing semaglutide once weekly plus lifestyle intervention was associated with sustained, weight loss in overweight or obese adults; such that nearly one-third lost over 20% of their body weight.

Semaglutide, a once weekly glucagon-like peptide-1 (GLP-1) analog, has been available since 2017 (as Ozempic and Rybelsus) for the treatment of type 2 diabetes.  A common consequence of GLP-1 treatment in diabetics is weight loss of 9-12 lbs.  

This weight loss trial enrolled 1961 non-diabetic adults with a BMI > 30 and ≥1 weight-related coexisting condition. Patients were randomized 2:1 to either once-weekly subcutaneous semaglutide (at a dose of 2.4 mg) or placebo, plus lifestyle intervention. The coprimary end points were the percentage change in body weight and weight reduction of at least 5%.

The 68 week mean change in body weight was −14.9% in the semaglutide group as compared with −2.4% with placebo (P<0.001).

The number who achieved weight reductions:

  • 5% or more: semaglutide 86.4% vs. PBO 31.5%
  • 10% or more: SEM 69.1% vs.  2.0%
  • 15% or more 50.5% SEM vs. 4.9% PBO at week 68 (P<0.001 for all comparisons).

The mean change in body weight at week 68 was −15.3 kg in the semaglutide group as compared with −2.6 kg in the placebo group.

Common side effects were nausea and diarrhea (transient, mild-to-moderate and subsided with time). There were more drug disconstinuations with semaglutide than placebo from gastrointestinal events (4.5% vs. 0.8%).

In patients who are overweight or obese, 2.4 mg of semaglutide once weekly plus lifestyle intervention was associated with sustained, clinically important weight loss. 

Disclosures
The author has no conflicts of interest to disclose related to this subject

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