Hormonal
Once-weekly subcutaneous semaglutide 2.4 mg produces clinically significant, sustained weight loss (mean -10.2% at 208 weeks) in adults with preexisting cardiovascular disease and obesity/overweight without diabetes, compared to placebo.
If you have heart disease and are overweight or obese (even without diabetes), once-weekly semaglutide 2.4 mg can help you lose about 10% of your body weight over 4 years, which is significantly more than placebo. This benefit is seen across different sexes, races, and BMI categories, though those with lower starting BMI might stop the medication more often due to side effects or lack of motivation. The key is that it works sustainably for cardiovascular health.
In SELECT, at 208 weeks, semaglutide produced clinically significant weight loss and improvements in anthropometric measurements versus placebo. Weight loss was sustained over 4 years.
Why this rating
Large-scale, randomized, placebo-controlled clinical trial (SELECT) with 17,604 participants and long-term follow-up (4 years).
Source
Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial
Donna H. Ryan et al. · Nature Medicine · 2024
DOI 10.1038/s41591-024-02996-7
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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