Obesity is a complex condition, one with serious social and psychological dimensions, that affects virtually all age and socioeconomic groups and threatens to overwhelm both developed and developing countries.
In 1995, there were an estimated 200 million obese adults worldwide and another 18 million under-five children classified as overweight. As of 2000, the number of obese adults has increased to over 300 million.
In a recently published study, researchers evaluated whether adults with obesity can achieve weight loss with one-weekly semaglutide at a dose of 2.4 mg. The study appears in the New England Journal of Medicine.
Semaglutide is a medication used in the treatment of type 2 diabetes mellitus, its mechanism of action is as a glucagon-like peptide-1 (GLP-1) agonist, which stimulates insulin secretion. They also have the added benefits of delaying gastric emptying and inhibiting the production of glucagon from pancreatic alpha cells if blood sugar levels are high, and they can also decrease pancreatic beta-cell apoptosis (programmed cell death).
The study was double-blinded and included 1,961 adults with a body-mass index of 30 or greater, who did not have diabetes, and that were randomly assigned in a 2:1 ratio, to 68 weeks of treatment with once-weekly subcutaneous semaglutide or placebo, plus lifestyle intervention.
The mean change in body weight from baseline to week 68 was −14.9% in the semaglutide group as compared with −2.4% with placebo. More participants in the semaglutide group than in the placebo group achieved weight reductions of 5% or more.
The change in body weight from baseline to week 68 was −15.3 kg in the semaglutide group as compared with −2.6 kg in the placebo group. Also, the participants in the semaglutide group had a better improvement in cardiometabolic risk factors.
The researchers found that adults with obesity or overweight with one or more coexisting conditions and without diabetes had a mean weight loss of 14.9% from baseline with semaglutide combined with lifestyle interventions. The weight loss exceeded the one in the placebo group, which was only 2.4%. No major adverse events were reported.
John P.H. Wilding, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021. DOI: 10.1056/NEJMoa2032183.
Collins L, Costello RA. Glucagon-like Peptide-1 Receptor Agonists. [Updated 2021 Jun 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551568/.