Semaglutide trims down weight in patients with severe obesity

Use of semaglutide 2.4 mg results in substantial weight reduction in patients with severe obesity who had previously undergone bariatric surgery (BS) but failed to achieve satisfactory weight loss, reports a recent study.

“By focusing on individuals with severe obesity (body mass index [BMI] >40 kg/m² and associated comorbidities), it fills a gap in the current literature and highlights the potential of semaglutide 2.4 mg as a treatment option for this specific population,” the investigators said.

Data from 129 patients with severe obesity, including 39 with (BS+) and 90 without (BS‒) a history of BS, were analysed. These patients were treated with semaglutide for 24 weeks, starting at 0.25 mg/wk and gradually increasing to 2.4 mg/wk.

The investigators then evaluated treatment outcomes based on the percentage of weight loss, changes in BMI, and waist circumference (WC).

Use of semaglutide led to a 9.1-percent weight loss among participants, with no significant difference between the BS+ and BS‒ groups. [Obesity 2024;32:50-58]

In the BS+ group, treatment with semaglutide resulted in a 9.8 percent weight loss and a change in WC of 9.2 cm (p<0.01). Seventy-two percent of patients in this cohort had at least a 5-percent reduction in their initial body weight, while 36 percent and 8 percent had at least 10- and 15-percent decrease in weight, respectively.

In the BS‒ group, semaglutide use resulted in an 8.7-percent weight loss (p<0.001) and a change in WC of 7.8 cm (p<0.01). Sixty-two percent of patients achieved at least a 5-percent decrease of their weight, while 31 percent and 8 percent had weight loss of at least 10 percent and 15 percent, respectively.

“There was no significant difference in mean weight loss, excess weight loss, BMI change, or WC change between patients in the BS+ and BS− groups from baseline to 24 weeks,” the investigators said.

“Additionally, our analysis using the mixed-effects linear model did not reveal any significant difference in the dynamics of weight loss between the two groups over the entire treatment period, including baseline, 12 weeks, and 24 weeks,” they noted.

These findings suggest that semaglutide “could be an effective alternative for individuals with a history of BS who require additional support in their weight-loss journey,” the investigators said.

In addition, the similar outcomes between patients in the BS+ and BS‒ groups underscore the promising role of semaglutide as a treatment option for severe obesity, regardless of previous surgical intervention.

“However, further research is warranted to validate and expand upon our findings,” the investigators said. “Randomized controlled trials comparing semaglutide with other treatment modalities, including a second BS, in patients with a history of BS and inadequate weight loss or weight regain would provide valuable insights.”

Studies with longer follow-up are also warranted to assess the durability of the observed weight-loss outcomes, according to the investigators.