Semaglutide is a traditional type 2 diabetes treatment that may help obese individuals lose weight, especially if given at a higher dose.
At 3 and 6 months, high doses of semaglutide are suggested to be as clinically effective for weight loss in overweight and obese patients, which supports previous findings from randomized control trials (RCTs). After 6 months, participants experienced a mean weight loss of 12.3 kg (10.9% increase from baseline), and a small portion of participants lost nearly double this percentage.
“To our knowledge, this study is the first retrospective study to evaluate weight loss outcomes associated with treatment with subcutaneous semaglutide, including the highest doses approved for weight loss (>1.0 mg) for patients with overweight or obesity, with or without type 2 diabetes,” said the authors of the study published in JAMA Network Open.
During the trial, the study authors noted all patients lost an average of 6.7 kg (5.9%). Class 3 obese patients had similar outcomes to class 1 and 2 obese patients, with a mean weight loss of 7.1 kg. However, those with type 2 diabetes had a lower mean percentage weight loss (3.9%).
Semaglutide is a glucagon-like peptide-1 receptor agonist that is approved to treat type 2 diabetes at lower doses of 0.25 mg, 0.5 mg, or 1 mg once weekly and via subcutaneous injection. Previous randomized clinical trials show that it can also lead to weight loss in patients.
Based on this, researchers wanted to see if different doses of semaglutide could treat obesity. They compared weight loss between obese and type 2 diabetes patients.
The researchers evaluated 175 patients who were on semaglutide prescriptions. Among participants, 82 (50.9%) were identified as having class 3 obesity—this describes a body mass index (BMI) of 40 or more—and almost half of all participants had hypertension (the most common comorbidity [49.1%]). Further, 18 participants had type 2 diabetes.
Researchers administered the highest doses of subcutaneous semaglutide (1.7 and 2.4 mg) to 77 patients, and 98 received lower doses at 0.25, 0.5, and 1 mg. At 3 months, those who received the highest doses had a mean weightless of 6.9%, while the group at lower doses achieved 5.1%.
Only 102 participants made it to the 6-month follow-up, at which time the high-dose participants experienced a mean weight loss of 12.1%, with a 2.9% increase from the lower dose group. The highest class of obese individuals also lost a similar percent of weight to the lower classes of obese participants at 9.2%. Among diabetics, mean weight loss was 7.2% at 6 months.
The authors noted that due to the study being observational, it could not determine causation between the drug and associated weight loss. Additionally, the results might have been skewed by excluding patients who did not make the 3- or 6-month follow-up. Other limitations include the cohort, which was mostly White females, the possibility that there was recall bias, and the electronic medical record database, which may have errors in its coding system.
By 2030, almost half of the entire US population is estimated to be obese. Common comorbidities include type 2 diabetes, hypertension, dyslipidemia, coronary heart disease, among other types of cancer.
Ghusn, Wissam, De la Rosa, Alan, Sacoto, Daniel, et al. Weight Loss Outcomes Associated With Semaglutide Treatment for Patients With Overweight or Obesity. September 19, 2022. JAMA Netw Open. 2022;5(9):e2231982. doi:10.1001/jamanetworkopen.2022.31982