How much weight loss does semaglutide produce in adults with overweight or obesity?
STEP 1 randomised 1,961 adults with a BMI of 30 or above (or 27 or above with a weight-related comorbidity) and without diabetes to once-weekly subcutaneous semaglutide 2.4 mg or placebo, both alongside lifestyle intervention. At 68 weeks, mean body-weight change was -14.9% with semaglutide versus -2.4% with placebo [1].
The proportions reaching clinically meaningful thresholds were substantially higher on treatment: 86% lost at least 5% of body weight, 69% at least 10%, and 51% at least 15%, compared with 32%, 12%, and 5% respectively on placebo [1]. Cardiometabolic risk factors including waist circumference, blood pressure, and lipids improved alongside weight.
Gastrointestinal adverse events, chiefly nausea and diarrhoea, were the most common problem and were typically transient and mild to moderate, though they led more participants to discontinue treatment than placebo [1].
- Participants received intensive lifestyle support in both arms, so results may not transfer directly to routine care without that support.
- The trial excluded people with diabetes and ran for 68 weeks, leaving long-term weight maintenance after discontinuation outside its scope.
Once-Weekly Semaglutide in Adults with Overweight or Obesity
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