Are semaglutide (Wegovy) and liraglutide (Saxenda) effective in the treatment of obesity?

Updated: Jun 09, 2021
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Semaglutide (Wegovy)

In June 2021, the FDA approved the use of the GLP-1 receptor agonist semaglutide for weight loss, in a 2.4-mg/week subcutaneous dose. The drug is indicated as an adjunct to diet and exercise for adults with an initial BMI of 30 kg/m2 or greater (obesity). It also indicated for BMI of 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, dyslipidemia). The approval was based on four phase-3 clinical trials in the Semaglutide Treatment Effect in People With Obesity (STEP) program involving approximately 4500 patients. The STEP 1, 2, and 4 trials reported a 15-18% weight loss over 68 weeks in individuals with overweight or obesity who received the medication. [151, 152, 153]

Liraglutide (Saxenda)

Liraglutide is a GLP-1 analog. It is approved for chronic weight management as an adjunct to diet and exercise in adults with a BMI of 30 kg/m2 or higher (obese) or adults with a BMI of 27 kg/m2 or higher (overweight) who have at least 1 weight-related condition (eg, hypertension, type 2 diabetes, dyslipidemia). The dose for obesity differs from that of liraglutide (Victoza) that is used to treat diabetes. Saxenda is initiated at 0.6 mg SC once daily for 1 week, and is then increased by 0.6 mg/day in weekly intervals until a dose of 3 mg/day is achieved.

Approval was based on data from 3 clinical trials that included about 4800 obese and overweight patients with and without significant weight-related conditions. Results from a clinical trial that enrolled patients without diabetes or with diabetes showed that patients had an average weight loss of 4.5% and 3.7% from baseline respectively compared to treatment with a placebo at 1 year. Of those treated with liraglutide, 62% of persons without diabetes and 49% of persons with diabetes lost at least 5% of their body weight compared with 34% or 16% treated with placebo, respectively. [154]


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