Higher semaglutide dose boosts weight loss in obesity trials
Two phase 3 clinical trials show that a 7.2 mg weekly dose of semaglutide leads to greater weight loss than the approved 2.4 mg dose in adults with obesity, including those with type 2 diabetes. Nearly half of participants on the higher dose lost 20% or more of their body weight over 72 weeks. The results, published in The Lancet Diabetes & Endocrinology, suggest improved metabolic health with a favorable safety profile.
The STEP UP and STEP UP T2D trials, the first to test escalating semaglutide from 2.4 mg to 7.2 mg, involved randomized participants receiving the higher dose, standard dose, or placebo alongside lifestyle interventions like dietary counseling and physical activity over 72 weeks.
In adults without diabetes, the 7.2 mg dose resulted in an average weight loss of nearly 19%, compared to 16% with 2.4 mg and 4% with placebo. Nearly half of those on the higher dose achieved 20% or more body weight loss, while about one-third lost at least 25%. Participants saw reductions in waist circumference, blood pressure, blood sugar, and cholesterol levels, addressing key obesity-related risks.
For adults with obesity and type 2 diabetes, the higher dose yielded 13% average weight loss versus 10% with 2.4 mg and 3.9% with placebo, plus significant improvements in blood sugar and waist size.
The trials reported the 7.2 mg dose as safe and well-tolerated. Common side effects included gastrointestinal issues like nausea and diarrhea, and sensory symptoms like tingling, which were mostly mild, temporary, and manageable without increasing dropout rates. No rise in serious adverse events or severe hypoglycemia occurred.
Researchers note that this dose could enhance obesity treatment by delivering greater weight reduction and metabolic benefits, potentially reducing global complications from obesity. However, they emphasize the need for longer-term studies to confirm sustained benefits and risks.