Lower-dose semaglutide achieves 9.9% weight loss in Chinese adults with obesity over 24 weeks in real-world setting

Obesity is a rapidly escalating global public health crisis, significantly contributing to conditions like type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease (NAFLD). Current standard-of-care often falls short in achieving sustained, clinically meaningful weight loss for many individuals. Glucagon-like peptide-1 receptor (GLP-1R) agonists like semaglutide have demonstrated robust efficacy in clinical trials, but real-world data, particularly with lower doses and in diverse populations such as Chinese adults, remains crucial. This study addresses the gap in understanding semaglutide's effectiveness in routine clinical practice.

Adults with obesity were enrolled from the HARMONY study, a real-world observational cohort in China. Participants received once-weekly subcutaneous semaglutide, titrated to a maintenance dose of either 0.5 mg or 1.0 mg based on clinical response and tolerability. The protocol included lifestyle counseling and periodic metabolic monitoring. The primary endpoint was the percentage change in body weight from baseline at 12 and 24 weeks. Subgroup analyses investigated the impact of baseline type 2 diabetes status and ectopic fat deposition in the liver and pancreas.

Overall, 143 participants were included at week 12, with 113 completing the 24-week assessment. Mean percent weight change was -7.3% at week 12 and -9.9% at week 24, corresponding to mean absolute weight losses of 6.7 kg and 9.1 kg, respectively. By week 24, a significant 76.1% of participants achieved 5% or more weight loss. Notably, participants with type 2 diabetes at baseline experienced a lower weight change compared to those without diabetes (-7.4% vs. -12.4%, p < 0.001). Weight loss also differed by baseline intrapancreatic fat deposition (IPFD) status, with attenuated weight change among patients with baseline IPFD (-9.0% with IPFD vs. -11.6% without IPFD, p = 0.043).