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Review
. 2022 Jun;18(1):35-42.
doi: 10.17925/EE.2022.18.1.35. Epub 2022 Jun 15.

Once-weekly 2.4 mg Semaglutide for Weight Management in Obesity: A Game Changer?

Ides M Colin  1 , Katherine M Gérard  1   2
Affiliations
Review

Once-weekly 2.4 mg Semaglutide for Weight Management in Obesity: A Game Changer?

Ides M Colin et al. touchREV Endocrinol. 2022 Jun.

Abstract

The treatment of obesity can no longer be reduced to a simplistic view of weight loss. Metabolic adaptation leads to systematic weight regain following weight-loss efforts, and new obesity treatments should therefore aim to induce long-standing double-digit weight loss, and thus improve and even reverse obesity-associated comorbidities such as type 2 diabetes. Until now, only metabolic surgery has been able to achieve such a goal, but this invasive procedure cannot be offered on a large scale. Among the alternatives, lifestyle interventions and drug therapies have often been disappointing. The recent availability of once-weekly subcutaneous 2.4 mg semaglutide (a glucagon-like peptide-1 receptor agonist; Wegovy™ Novo Nordisk A/S, Bagsværd, Denmark) has changed the scene, and semaglutide is considered a 'game changer' in the treatment of obesity. The results from the phase III STEP (Semaglutide treatment effect in people with obesity) clinical programme have shown that semaglutide provides clinically meaningful and sustained weight loss in ranges much higher than those achieved with previously available pharmacotherapies. These results led to the approval of semaglutide by regulatory authorities as an adjunct to a reduced-calorie diet and increased physical activity in people with obesity or overweight, with at least one weight-related comorbidity. With data from phase II and III clinical trials showing that newer drugs (i.e. the glucagon-like peptide-1 and gastric inhibitory polypeptide dual receptor agonist tirzepatide and the amylin agonist cagrilintide, either alone or combined) produce a greater sustained weight loss than semaglutide, an upstream 'weight-centric' strategy has emerged as a new standard for the treatment of type 2 diabetes.

Keywords: Obesity; STEP clinical programme; semaglutide; treatment of obesity; weight loss; weight-centric approach.

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Conflict of interest statement

Disclosures: Ides M Colin has served on advisory boards and received honoraria for lectures for Novo Nordisk, Boehringer Ingelheim, Sanofi, Abbott, Eli Lilly, Astra Zeneca and Novartis. He has acted as principal investigator in various clinical trials for Novo Nordisk and Sanofi. Anne-Catherine Gérard has no financial or non-financial relationships or activities to declare in relation to this article.

Figures

Figure 1:
Figure 1:. Treatments for obesity and their impact on weight loss
Figure 2:
Figure 2:. An upstream weight-centric approach versus more downstream, glucose-centric and cardiometabolic approaches. Incretin-based therapies are already active at the most upstream step
See this image and copyright information in PMC

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