Weight Changes With Lower Doses of Semaglutide in Clinical Practice: Findings From the Chinese HARMONY Cohort.
Level 4 - case-series / case-control
Uncontrolled observational cohort study without a comparison group
PubMed 42297751 · doi:10.1111/dom.71004
What was done
Adults with obesity in China were enrolled from the HARMONY real-world observational cohort to assess 24-week weight change on lower-dose once-weekly subcutaneous semaglutide (titrated to 0.5 or 1.0 mg) alongside lifestyle counseling and periodic metabolic monitoring. Primary endpoints were percentage change in body weight at weeks 12 and 24, with subgroup analyses evaluating baseline type 2 diabetes status and ectopic fat deposition in the liver and pancreas.
What was found
A total of 143 participants were evaluated at week 12 and 113 at week 24. Mean weight loss was -7.3% (6.7 kg) at week 12 and -9.9% (9.1 kg) at week 24, with 76.1% achieving at least 5% weight loss by week 24. Weight loss was significantly lower in participants with type 2 diabetes compared to those without (-7.4% vs. -12.4%, p < 0.001) and in participants with baseline intrapancreatic fat deposition compared to those without (-9.0% vs. -11.6%, p = 0.043).
Why it matters
This study shows that lower maintenance doses of semaglutide can produce clinically meaningful short-term weight loss in routine Chinese clinical practice, while identifying baseline diabetes and intrapancreatic fat as potential modifiers of treatment response.
Limits
The study lacked a control or placebo comparator group. Sample size was modest with notable attrition by week 24 (declining from 143 to 113 participants). Follow-up was limited to 24 weeks, and specific liver fat outcomes were not reported in the abstract.
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