The drug semaglutide is used to treat type 2 diabetes by regulating how the pancreas releases insulin.
However, the drug, sold under the brand names Ozempic and Rybelsus, also may have potential as a weight-control aid because it appears to reduce appetite, craving for food, and energy intake.
Novo Nordisk is applying for approval of semaglutide for the treatment of obesity in the United States and Europe. A phase 3 clinical trial for a semaglutide drug delivered orally for the treatment of obesity was announced in April 2021.
Semaglutide is in a class of drugs known as glucagon-like peptide-1 (GLP-1) agonists. In the new study, a research team led by Dr. Dorthe Skovgaard, Novo Nordisk’s senior international medical manager, studied how the drug affected gastric emptying, energy intake, appetite, and control of eating among study subjects with obesity.
“GLP-1s are known to affect body weight by decreasing energy intake, increasing feelings of satiety and fullness, and decreasing hunger,” Skovgaard told Healthline. “So, the mechanism of action of semaglutide held great potential for a treatment of obesity. In addition, several clinical trials with people with type 2 diabetes had demonstrated the weight loss benefits of semaglutide.”
The study, published in the journal Diabetes, Obesity, and Metabolism, reported that while semaglutide did not seem to delay gastric emptying, energy intake among those receiving the drug was reduced 35 percent compared with those receiving a placebo.
Study subjects also reported being less hungry and less interested in eating, as well as feeling fuller and more satiated after eating.
Weight loss of 15-18 percent was reported among the study group taking semaglutide. More significant weight loss was reported among both obese and overweight individuals.
“In subjects with obesity, semaglutide [administered at a dose of 2.4 mg weekly, compared to 1 mg for treatment of diabetes] suppressed appetite and reduced the frequency and strength of food cravings,” the study concluded. “Control of appetite and reduced frequency and strength of food cravings are important for weight management in people living in obesity, especially in a society which promotes unhealthy lifestyles and overeating.”
Skovgaard noted that liraglutide, another GLP-1 drug, also has been shown to affect weight by reducing energy intake and increasing feelings of satiety and fullness as well as decreasing hunger.
Marketed as Saxenda, liraglutide is approved by the Food and Drug Administration (FDA) for weight management.
“However, the reduction in energy intake and the weight loss observed with semaglutide is greater than with liraglutide,” noted Skovgaard.
Dr. Kim Boyd, the chief medical officer at the weight health program Calibrate, told Healthline that the research on semaglutide is “very exciting.”
“Clinical studies have shown that this new dosage leads to an average weight loss of 15 percent (and over 20 percent in a third of participants) that is sustained for over a year,” Boyd said. “This is more effective than any other FDA-approved weight-loss medication on the market.”
“Given that other diabetes drugs can be associated with weight gain, the fact that GLP-1 [agonists] help people lose weight make them especially good medications for the many people who have both diabetes and obesity,” said Dr. Florencia Halperin, the chief medical officer at the weight-loss program FormHealth. “A fascinating aspect of this is that the effect for improving diabetes is related to how the drug interacts with the pancreas (which secretes insulin) and other organ tissues that regulate blood sugar. But weight loss is related to how the drugs affect the networks in our brain that regulate hunger and fullness.
“Semaglutide works as a treatment for obesity because it helps people be less hungry,” Halperin told Healthline. “My patients who use this medicine report they are less interested in food, and they can feel full from much smaller portions. So, they eat less but are not uncomfortably hungry or feeling deprived, as they might have when they were purposefully restricting calories.”
Medications such as semaglutide can help some people with obesity, but others can lose weight by making changes in their diet and other lifestyle habits, experts say.
“Pills are a short-term solution to losing weight,” Morgan Nolte, DPT, a clinical specialist in geriatric physical therapy and owner of Weight Loss for Health, told Healthline. “The best long-term weight-loss solution is learning how to live a low insulin lifestyle. This requires a change in mindset and strategy. A low insulin lifestyle not only facilitates long-term weight loss, but also helps lower insulin resistance, thus reducing a person’s risk for type 2 diabetes, heart disease, dementia, and arthritis.”