Adults with Prior Antiobesity Medication Use Before Semaglutide Use Lose More Weight: Daily Dose

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On April 25, 2024, we reported on findings from a study published in Diabetes, Obesity and Metabolism that compared weight loss outcomes between patients starting semaglutide who had previously been on another antiobesity medication (AOM) compared to those who were AOM-naïve.

The study

Researchers conducted a retrospective cohort study using data from Mayo Clinic Hospital centers and affiliated hospitals between January 2021 and 2023.

Participants included adults with a body mass index (BMI) of at least 27 kg/m² who received weekly subcutaneous semaglutide injections for the primary purpose of weight loss. The primary endpoint was 12-month total body weight loss (TBWL) in AOM-naïve compared to non-AOM-naïve participants. The secondary outcome was a comparison of the proportion of participants achieving ≥5%, ≥10%, ≥15%, and ≥20% TBWL between the groups.

A total of 305 patients (mean age, 49 years; 73% women) were included in the analysis, of whom 231 (75%) were AOM-naïve and 74 (24%) were non-AOM-naïve. Mean baseline BMI was 41 kg/m².

The findings

Results showed that TBWL was greater among AOM-naïve participants compared with non-AOM-naïve participants at:

• 3 months (mean, 6.3% vs 3.8%; P < .001)

• 6 months (mean, 10.6% vs 6.7%; P < .001)

• 9 months (mean, 14.0% vs 9.1%; P < .001)

• 12 months (mean, 14.3% vs 10.6%; P = .01)

Investigators also found that compared with non-AOM-naïve participants, a greater proportion of AOM-naïve participants achieved TBWL at 12 months of ≥15% (48.0% vs 21.0%; P < .05) and ≥20% (27.0% vs 4.0%; P < .01).

Authors' comment

"[I]n this study, the use of semaglutide in patients with previous intake of other AOMs was associated with inferior weight loss outcomes in comparison to AOM-naïve patients...These data are crucial for physicians and patients to manage expectations and guide therapy based on targeted weight loss goals."

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