Semaglutide can produce clinically meaningful weight loss and reduce waist size for at least four years in overweight or obese adults, according to research presented at the European Congress on Obesity.

The SELECT study, sponsored by Novo Nordisk, enrolled 17,604 overweight or obese (BMI of 27kg/m² or higher) adults aged 45 years or older from 41 countries. The patients, 72.3 per cent of whom were male, did not have type 1 or type 2 diabetes when enrolled, but had a history of heart attacks, strokes or peripheral artery disease. Participants received semaglutide (2.4mg) or placebo once-weekly for, on average, 40 months. 

With semaglutide, weight loss continued to week 65 and was sustained for four years. Participants lost, on average, 10.2 per cent of their body weight and 7.7cm from their waistline, compared with 1.5 per cent and 1.3cm respectively with placebo. Average waist circumference-to-height ratio fell by 6.9 and 1.0 per cent with semaglutide and placebo respectively.

After two years, 52.4 per cent of adults taking semaglutide and 15.7 per cent receiving placebo moved down at least one BMI category with 12.0 per cent of semaglutide users reaching a healthy BMI (25kg/m² or less) compared with 1.2 per cent with placebo. Improvements emerged across sexes, races and age, and irrespective of baseline glycaemia, renal function or adiposity. 

No unexpected safety issues emerged. Gallbladder-related disorders, such as cholelithiasis (1.4 and 1.1 per cent respectively), were more common with semaglutide than placebo (2.8 and 2.3 per cent respectively). More patients receiving semaglutide discontinued because of GI symptoms, including nausea, diarrhoea and vomiting.