Complex effect of semaglutide on obesity management goes beyond simple weight reduction

Czech version

Authors: Peter Novodvorský ^1,2,3
Authors‘ workplace: Metabolické Centrum s. r. o., Trenčín ¹; I. interná klinika JLF UK a UNM, Martin ²; Centrum diabetologie IKEM, Praha ³
Published in: Diab Obez 2026; 26(1): 35-41
Category: Reviews

Overview

Obesity represents a major medical and social problem with rising prevalence and a high risk of developing multiple serious comorbidities. Semaglutide, a GLP-1 receptor agonist, achieves a mean body weight reduction of -20.7 % at 72 weeks (trial product estimand), with ≥ 25 % body weight loss achieved in one third of patients (STEP UP trial). A pre-specified MRI analysis of STEP UP showed that nearly 85 % of total weight loss was attributable to a reduction in fat mass, with relative preservation of lean mass, indicating a qualitatively favourable change in body composition. Semaglutide also improves eating control (STEP 5, INFORM), confers documented cardiovascular benefits (SELECT, SCORE, STEER), and positively impacts quality of life in patients with heart failure (STEP-HFpEF) and osteoarthritis (STEP 9) and is safe and effective even in adolescents (STEP TEENS), thereby positioning itself as an early first-line pharmacotherapy as a part of a comprehensive obesity management.

Keywords:

obesity – semaglutide

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