In conjunction with lifestyle management, once-weekly semaglutide helped people with obesity lose a significant amount of weight, the Semaglutide Treatment Effect in People with Obesity (STEP) 1 study found.

In a double-blind trial of 1,961 adults with a body mass index (BMI) of 30 or higher, adults on 2.4 mg of weekly semaglutide lost an average 14.9% of baseline body weight after 68 weeks of treatment versus only 2.4% for a group on placebo and lifestyle intervention alone (treatment difference -12.4%, 95% CI -13.4 to -11.5, P<0.001), reported Robert Kushner, MD, of Northwestern University Feinberg School of Medicine in Chicago, and colleagues.

A total of 86.4% of adults on semaglutide were able to cut at least 5% of their baseline body weight during the trial compared with only 31.5% of those adhering to lifestyle intervention alone, the researchers wrote in the study online in the New England Journal of Medicine.

Beyond that, almost 70% of those on semaglutide plus lifestyle intervention achieved a 10% or more weight loss, and more than half were able to lose 15% of their baseline body weight.

In total, adults on semaglutide treatment lost an average 33.7 lb (15.3 kg) by week 68, while those in the placebo/lifestyle intervention group saw only a modest 5.7 lb (2.6 kg) weight loss (estimated treatment difference -30 lb [-12.7 kg], 95% CI -13.7 to -11.7).

Within only the first 4 weeks of treatment initiation, those on semaglutide had more than a 2% reduction in body weight, and continued to lose weight throughout the 68-week trial.

In addition to weight loss, semaglutide also improved cardiovascular risk factors including greater reductions in waist circumference, BMI, systolic and diastolic blood pressures, HbA1c, fasting plasma glucose, C-reactive protein, and fasting lipid levels, as well as physical functioning scores and quality of life.

"I was surprised and gratified to see the unprecedented results from the medication," Kushner told MedPage Today. "The fact that 50% of participants were able to lose at least 15% of initial body weight and one-third lost at least 20% body weight is a game changer."

"Semaglutide is by far the most effective drug intervention we have seen for weight management," he continued. "We know that a lot of the health concerns we see in people who struggle with their weight, such as type 2 diabetes, hypertension, GERD [gastroesophageal reflux disease], and arthritis of the weight-bearing joints, are improved by losing at least 10% of their body weight. In this study, nearly 70% of participants were able to achieve this 10% weight loss threshold by taking semaglutide."

https://www.medpagetoday.com/primarycare/obesity/91146