Semaglutide in obesity and type 2 diabetes: A review of clinical trial evidence from 1 to 5 semaglutide treatment effect in people with obesity program.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing previously published clinical trials without systematic review methodology
PubMed 42060800 · doi:10.4103/ijp.ijp_686_25
What was done
This narrative review synthesized findings from the STEP 1 through STEP 5 clinical trials evaluating once-weekly semaglutide 2.4 mg for weight management in adults with overweight or obesity, with or without type 2 diabetes mellitus (T2DM). The review examined trials assessing standard treatment, combination with intensive behavioral therapy (STEP 3), treatment withdrawal (STEP 4), and 2-year maintenance (STEP 5).
What was found
In participants without diabetes (STEP 1, 3, and 4), semaglutide led to average weight reductions between 10% and 17%, whereas patients with T2DM (STEP 2) achieved approximately 10% weight loss. STEP 4 showed notable weight regain following treatment withdrawal. STEP 5 demonstrated maintained weight loss of approximately 15% over 2 years. Gastrointestinal adverse events were the most common side effects and were generally manageable and nonsevere.
Why it matters
The review reinforces semaglutide 2.4 mg as an effective pharmacological intervention for substantial weight reduction up to 2 years, while emphasizing that obesity is a chronic condition requiring continuous management to avoid weight regain.
Limits
As a narrative review, it lacks systematic search methodology, risk of bias assessment, or quantitative meta-analytic pooling. Aggregate participant counts, exact confidence intervals, and specific adverse event rates were not reported in the abstract.
Cited by
- context In clinical trials, diabetic patients on GLP-1 drugs only lose 3 to 4 pounds on average, whereas non-diabetic individuals with obesity lose 40 to 80 pounds.