GLP-1 Evidence

Not medical advice. A record of published research and our assessments of it. The limits

Once-Weekly Semaglutide in Adults with Overweight or Obesity

Design
Randomized trial · 1961 participants · Intermediate outcome
Match to healthy normal-weight adults aged 55–75
Different populationObesity without diabetes; landmark weight-loss trial; DXA substudy (full text) showed lean mass fell alongside fat mass.
Could weight loss explain it?
Not applicable[Auto] Participants had obesity and/or type 2 diabetes and the abstract does not separate direct drug effects from weight loss or glycaemic improvement.
Study tier
Study tier 1[Auto] Randomized trial of moderate size; outcome type and follow-up limit certainty (auto-provisional).
Assessment
Version 2 · curated · Sep 13, 2026

Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.

Landmark trial: semaglutide 2.4 mg produced 15% weight loss over 68 weeks in adults with obesity. Included for context and for its body-composition substudy showing proportional lean-mass loss.

01Findings

What the study reported

Drugs
Semaglutide
Dose
2.4 mg weekly
Route
subcutaneous
Treatment duration
68 weeks
Comparator
placebo
Primary outcome
Percent change in body weight; >=5% weight loss at week 68
Effect
-14.9% vs -2.4% (difference -12.4 pp)
95% confidence interval
-13.4 to -11.5
P value
<0.001
Follow-up
68 weeks
Adverse events
GI events most common; discontinuation for GI events 4.5% vs 0.8%.
Limitations
Auto-classified from abstract only; effect estimates, adverse events and limitations not extracted. Requires manual review.

Who was studied

Bmi min
30
Obesity status
BMI >= 30 or >= 27 with comorbidity
Diabetes status
excluded
Sample size
1961

Study quality details

Study design
Randomized controlled trial
Sample size
1961
Randomization
yes
Blinding
double-blind
Comparator
placebo
Follow up duration
68 weeks
Outcome type
unknown
Replication
not assessed (auto)
Consistency with other evidence
not assessed (auto)
Population applicability
INDIRECT
Statistical precision
CI reported: 95% confidence interval [CI], -13
Risk of bias
not assessed (auto)
Funding conflicts
yes
Peer review status
yes
02Funding

Funding and conflicts

Funding
Novo Nordisk
Industry funded
Yes
Manufacturer
Novo Nordisk
Sponsor role
Sponsor designed and analysed.
Author conflicts
Authors report Novo Nordisk relationships; sponsor co-authors.
Independent replication
unknown
Notes
Authors declare relationships with the drug's manufacturer: Novo Nordisk

Funding is shown on every study and never used to score it.

04Source

The source, as retrieved

Abstract

[BACKGROUND] Obesity is a global health challenge with few pharmacologic options. Whether adults with obesity can achieve weight loss with once-weekly semaglutide at a dose of 2.4 mg as an adjunct to lifestyle intervention has not been confirmed. [METHODS] In this double-blind trial, we enrolled 1961 adults with a body-mass index (the weight in kilograms divided by the square of the height in meters) of 30 or greater (≥27 in persons with ≥1 weight-related coexisting condition), who did not have diabetes, and randomly assigned them, in a 2:1 ratio, to 68 weeks of treatment with 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 primary estimand (a precise description of the treatment effect reflecting the objective of the clinical trial) assessed effects regardless of treatment discontinuation or rescue interventions. [RESULTS] 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, for an estimated treatment difference of -12.4 percentage points (95% confidence interval [CI], -13.4 to -11.5; P<0.001). More participants in the semaglutide group than in the placebo group achieved weight reductions of 5% or more (1047 participants [86.4%] vs. 182 [31.5%]), 10% or more (838 [69.1%] vs. 69 [12.0%]), and 15% or more (612 [50.5%] vs. 28 [4.9%]) at week 68 (P<0.001 for all three comparisons of odds). 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 (estimated treatment difference, -12.7 kg; 95% CI, -13.7 to -11.7). Participants who received semaglutide had a greater improvement with respect to cardiometabolic risk factors and a greater increase in participant-reported physical functioning from baseline than those who received placebo. Nausea and diarrhea were the most common adverse events with semaglutide; they were typically transient and mild-to-moderate in severity and subsided with time. More participants in the semaglutide group than in the placebo group discontinued treatment owing to gastrointestinal events (59 [4.5%] vs. 5 [0.8%]). [CONCLUSIONS] In participants with overweight or obesity, 2.4 mg of semaglutide once weekly plus lifestyle intervention was associated with sustained, clinically relevant reduction in body weight. (Funded by Novo Nordisk; STEP 1 ClinicalTrials.gov number, NCT03548935).

Where this record came from

SourceRetrievedIdentifier
pubmedSep 13, 202633567185
first ingestion