Hormonal
In real-world clinical practice, semaglutide produces attenuated weight loss (average 4.44%) compared to clinical trials, with diabetes mellitus diagnosis significantly reducing efficacy while linaclotide use and prediabetes are associated with enhanced weight loss.
If you are taking semaglutide in a standard clinical setting, expect an average weight loss of around 4-5% over a year, which is less than the 10-15% often cited from clinical trials. This difference is largely due to the lack of intensive lifestyle counseling provided in routine care. If you have diabetes, your weight loss may be further reduced, whereas having prediabetes or taking linaclotide might actually help you lose more weight.
On average, individuals lost 4.44% (male individuals, 3.66%; female individuals, 5.08%) of their initial weight. History of diabetes mellitus diagnosis was associated with less weight loss, whereas prediabetes and linaclotide use were associated with more pronounced weight loss.
Why this rating
Large real-world observational study (n=3555) with robust machine learning feature analysis, though not a randomized controlled trial.
Source
Medications and conditions associated with weight loss in patients prescribed semaglutide based on real‐world data
William C. Powell et al. · Obesity · 2023
DOI 10.1002/oby.23859
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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