Study summary · research use only
Efficacy and Safety of Semaglutide for Weight Loss in Obesity Without Diabetes: A Systematic Review and Meta-Analysis
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
This systematic review and meta-analysis examined subcutaneous semaglutide in humans with obesity but without diabetes, pooling 4 randomized controlled trials totaling 3,613 individuals. The mean difference in weight reduction was -11.85% favoring semaglutide (95% CI -12.81 to -10.90, p<0.00001). Gastrointestinal adverse events were 1.59 times as likely with semaglutide (RR 1.59, 95% CI 1.34-1.88), treatment discontinuation due to adverse events was 2.19 times as likely (95% CI 1.36-3.55), and serious adverse events were 1.60 times as likely (95% CI 1.24-2.07), mostly gastrointestinal and hepatobiliary, including acute pancreatitis and cholelithiasis. The authors describe semaglutide as associated with an 11.85% weight reduction from baseline versus placebo, alongside higher rates of gastrointestinal adverse events, discontinuation, and serious adverse events.
Abstract
The weight loss benefit of semaglutide in patients with diabetes is well-documented, but its clinical utility in treating obesity among patients without diabetes is less described. We therefore assessed the efficacy and safety of subcutaneous semaglutide as treatment for obesity in patients without diabetes. A comprehensive search of PubMed/MEDLINE, Cochrane and Google scholar was performed to identify trials on the efficacy and safety of subcutaneous semaglutide on patients with obesity without diabetes. Primary outcome was expressed as percent mean weight difference. Secondary outcomes including risk for gastrointestinal adverse events, discontinuation of treatment and serious adverse events were expressed as risk ratios. These were calculated using the random effects model. The study included 4 randomized controlled trials having a total of 3,613 individuals with obesity without diabetes. The mean difference for weight reduction was -11.85%, favoring semaglutide [95% confidence interval (CI) (-12.81,-10.90), p<0.00001]. Secondary outcomes showed that the risk of developing gastrointestinal adverse events was 1.59 times more likely with semaglutide (RR 1.59, 95%CI [1.34, 1.88], p<0.00001). Risk for discontinuation due to adverse events was twice as likely in the semaglutide group (RR 2.19, 95%CI [1.36,3.55], p=0.001) and the risk for serious adverse events was 1.6 times more likely for semaglutide (RR1.60, 95%CI [1.24, 2.07], p=0.0003). Serious events were mostly of gastrointestinal and hepatobiliary disorders such as acute pancreatitis and cholelithiasis. Among individuals with obesity without type 2 diabetes, subcutaneous semaglutide is effective for weight loss with an 11.85% reduction from baseline compared to placebo. This supports the use of semaglutide for weight management in obesity. However, risk of gastrointestinal adverse events, discontinuation of treatment and serious adverse events were higher in the semaglutide group versus placebo.
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