CagriSema Curbs 'Food Noise,' Organ Fat in Patients With Obesity, T2D Respectively

Cagrilintide-semaglutide (CagriSema), Novo Nordisk's investigational once-weekly amylin and glucagon-like peptide-1 (GLP-1) receptor agonist combination, changed how the brain responds to high-calorie food cues and reduced self-reported "food noise" over 52 weeks in adults with overweight or obesity, according to data presented at the European Association for the Study of Diabetes (EASD) Annual Meeting 2026.¹

Separate analyses in adults with type 2 diabetes showed reductions in fat around abdominal organs, including the liver and pancreas, along with early signals that bone health was maintained despite substantial weight loss.¹

For pharmacists fielding patient questions about cravings and the quality of weight loss, the findings add mechanistic context, although all 3 analyses were presented as late-breaking abstracts.¹

Brain Responses to Food Cues

In a 52-week study using functional magnetic resonance imaging (fMRI), a noninvasive technique that measures brain activity during specific tasks, CagriSema modified brain responses to high-calorie food cues in regions linked to cravings, reward, sensory processing, and behavioral control. Participants also reported improved eating behavior, including reduced food noise, cravings, hunger, appetite, and food-related thoughts, as well as improved craving control, at both 22 and 52 weeks. These changes were accompanied by an estimated treatment difference in body weight of 22.4% versus placebo at 52 weeks (P < .0001).¹

Ectopic Fat in Early Type 2 Diabetes

An MRI substudy of the phase 3a REIMAGINE 1 trial, a 40-week study of 189 adults with type 2 diabetes inadequately controlled on diet and exercise, evaluated whole-body metabolic effects. CagriSema 2.4 mg/2.4 mg produced significant reductions in abdominal fat and in fat around the liver and pancreas vs placebo, alongside a 14.3% reduction in body weight at week 40. According to Novo Nordisk, ectopic fat stored in the liver, pancreas, and around abdominal organs is a key contributor to insulin resistance and type 2 diabetes progression. ¹

Bone Markers With Substantial Weight Loss

A post hoc analysis of bone markers from the phase 3 REIMAGINE 2 trial (NCT06065540), a 68-week study of 2713 adults with type 2 diabetes inadequately controlled on metformin with or without a sodium-glucose cotransporter 2 (SGLT2) inhibitor, showed signs of a healthy balance in bone maintenance with CagriSema 2.4 mg/2.4 mg alongside a 14.2% body weight reduction at week 68. The study authors described the findings as "preliminary reassurance regarding bone changes with CagriSema in type 2 diabetes." Because the analysis relied on circulating biomarkers rather than bone mineral density or fracture outcomes, it should be viewed as hypothesis-generating.¹

Where CagriSema Stands

The new analyses build on published phase 3 data. In REDEFINE 2 (NCT05394519), which enrolled 1206 adults with overweight or obesity and type 2 diabetes, CagriSema 2.4 mg/2.4 mg reduced body weight by 13.7% at 68 weeks vs 3.4% with placebo; gastrointestinal adverse events occurred in 72.5% and 34.4% of patients, respectively, and were mostly transient and mild or moderate. In REIMAGINE 3, CagriSema added to basal insulin lowered HbA1c by 2.33% with the 2.4 mg/2.4 mg dose vs 0.66% with placebo at 40 weeks, with no severe hypoglycemia reported, a relevant finding for pharmacists managing insulin-treated patients. 2,3

Novo Nordisk submitted a new drug application for CagriSema for weight management to the FDA in December 2025, with a decision expected in the fourth quarter of 2026. REDEFINE 2 and REIMAGINE 3 were funded by Novo Nordisk, which also announced the EASD data. 1-3

REFERENCES

1. Novo's investigational obesity and diabetes drug CagriSema reduces 'food noise' and shows benefits in organ and bone health—EASD 2026. News release. Novo Nordisk. September 30, 2026. Accessed September 30, 2026. https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=917138

2. Davies MJ, Bajaj HS, Broholm C, et al. Cagrilintide-semaglutide in adults with overweight or obesity and type 2 diabetes. N Engl J Med. 2025;393(7):648-659. doi:10.1056/NEJMoa2502082

3. Rosenstock J, Billings LK, Gajria R, et al. Cagrilintide-semaglutide (CagriSema) as an add-on to basal insulin in adults with type 2 diabetes (REIMAGINE 3): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study. Lancet. 2026;408(10549):38-51. doi:10.1016/S0140-6736(26)01022-6