Real-World Use of Semaglutide & Weight Loss

Educational Objectives

Summary

Real-World Usage of Semaglutide Leads to Substantial Weight Loss

Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist initially used to treat type 2 diabetes, caused substantial weight loss in randomized trials. In a retrospective study online in JAMA Network Open (https://doi.org/10.1001/jamanetworkopen.2022.31982), Mayo Clinic researchers examined semaglutide’s effectiveness in treating obesity in less-controlled settings. Investigators identified 408 patients with prescriptions for semaglutide (weekly subcutaneous injections), primarily for weight loss; more than half of these patients were excluded from the study because of insurance denial, medication shortages, prior bariatric surgery, use of other antiobesity medications, or active malignancy.

Of the remaining 175 patients (mean age, 49; 16% with type 2 diabetes; mean body-mass index, 41 kg/m²), only one quarter received dietary counseling, and 10% received some type of psychological support. By 3 months, half achieved >5% weight loss, and 15% lost more than 10% of their body weight. Of 102 patients who were followed for 6 months, almost all achieved 5% weight loss, half lost >10%, and a quarter lost >15% of their body weight. Visiting a dietician or psychologist was not associated with greater weight loss. Nearly half of patients reached the highest doses (1.7 mg or 2.4 mg weekly); weight loss was significantly greater in those who reached these doses (compared with lower doses), although the clinical difference was modest.

These real-world results compare favorably to those seen in randomized trials, even with minimal dietary and psychological support. Although some practices require patients to participate in lifestyle interventions in order to receive weight-loss medications, this study suggests that semaglutide is effective even without such support. Of note, more than one third of patients with semaglutide prescriptions were excluded from the study due to insurance denial or drug shortages — two major barriers to prescribing this and other weight-loss medications.

Thomas L. Schwenk, MD & Molly S. Brett, MD

Readings

Disclosures

Acknowledgements

CME/CE INFO

Accreditation:

The Audio- Digest Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Audio- Digest Foundation designates this enduring material for a maximum of 0.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Lecture ID:

JW332111

Expiration:

This CME course qualifies for AMA PRA Category 1 Credits™ for 3 years from the date of publication.

Instructions:

To earn CME/CE credit for this course, you must complete all the following components in the order recommended: (1) Review introductory course content, including Educational Objectives and Faculty/Planner Disclosures; (2) Listen to the audio program and review accompanying learning materials; (3) Complete posttest (only after completing Step 2) and earn a passing score of at least 80%. Taking the course Pretest and completing the Evaluation Survey are strongly recommended (but not mandatory) components of completing this CME/CE course.

Estimated time to complete this CME/CE course:

Approximately 2x the length of the recorded lecture to account for time spent studying accompanying learning materials and completing tests.

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