Research shows that wegovy can keep weight off for at least four years

PEOPLE

However, the initial weight loss was sustained through 208 weeks (four years) of follow-up.
On average, people taking the drug lost 10.2 percent of their weight, while the placebo group lost just 1.5 percent.
That weight loss is less than what has been seen in other trials of semaglutide.
Researchers behind the SELECT trial, which was funded by Wegovy’s maker, Novo Nordisk, speculate that the trials’ different designs may explain the difference in weight loss.
The earlier trial was designed to study weight loss in people who were specifically trying to lose weight and who also tended to be younger than those in the SELECT trial.
In addition to semaglutide treatment, the older trial included other lifestyle interventions to aid in weight loss.
The SELECT trial participants, on the other hand, weren’t specifically seeking to lose weight and didn’t get any additional lifestyle interventions for weight loss.
Still, researchers saw clinically meaningful weight loss across both sexes and all body sizes and geographic regions.

NEGATIVE

According to a comprehensive, long-term study, individuals taking the weight-loss drug semaglutide, or Wegovy, tended to lose weight for the first 65 weeks of the trial—roughly a year and a half—before reaching a “set point” or plateau. That initial weight loss, however, was typically sustained for a maximum of four years as long as the patients continued receiving the weekly shots.

The results, which were released on Monday in Nature Medicine, are the result of a new examination of information from the SELECT trial, which was created to examine the medication’s effects on cardiovascular health. People with pre-existing cardiovascular disease who were also overweight or obese but did not have diabetes were specifically recruited for the multicenter, double-blind, randomized, placebo-controlled trial. The trial comprised 17,604 participants from 41 different countries. Eighty-four percent were white, seventy-two percent were men, and their average age was roughly sixty-two.

The main trial findings were released by researchers last year, and they demonstrated that semaglutide, over a period of slightly more than three years, lowered participants’ risk of heart attack, stroke, and cardiovascular-related deaths by 20%.

Researchers examined the weight-loss trajectories and endpoints of the same participants in a new analysis that included a longer follow-up. After taking semaglutide for 65 weeks, patients experienced a gradual decrease in weight that eventually reached a plateau. By the end of 208 weeks, or four years, of follow-up, the initial weight loss had persisted. Individuals using the medication lost 10.2% on average of their body weight, compared to a mere 1.5% loss in the placebo group. This translates to a treatment difference of 8 points 7 percent.

There hasn’t been as much weight loss as semaglutide trials have shown. Researchers found that those taking the medication lost 14 percent of their body weight, compared to those taking a placebo, which was a treatment difference of 12 percent. The study was published in The New England Journal of Medicine in 2021.

Sponsored by Novo Nordisk, the company that makes Wegovy, the researchers behind the SELECT trial hypothesize that variations in trial designs could account for variations in weight loss. The goal of the earlier trial was to examine weight loss in participants who were younger than those in the SELECT trial and who were specifically attempting to lose weight. The earlier study used additional lifestyle therapies to promote weight loss in addition to semaglutide treatment. In contrast, neither the SELECT trial participants nor their lifestyle interventions for weight loss were purposefully trying to lose weight.

Despite this, the researchers observed clinically significant weight loss in people of all ages, genders, and geographical locations. During the trial, 52.4% of the semaglutide group and only 15.7% of the placebo group moved into a lower category of body mass index each. In addition, the percentage of obese individuals decreased from 71 percent to 43 percent in the semaglutide group and from 71 percent to 67 percent in the placebo group.

The majority of the study’s participants were older white men, which is one of its main limitations. The results on weight loss may not therefore be generalizable. Nonetheless, the study’s authors draw the conclusion that semaglutide should be widely used in patients with cardiovascular disease who are also obese or overweight. The next big question that needs to be answered by researchers is how long patients will need to take the expensive but effective medication.

Ars Technica published this article first.

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