From the Guidelines
A safe rate of weight loss for patients on semaglutide is approximately 1-1.5% of total body weight per month, which translates to 0.5 to 2 pounds per week, as supported by the STEP trials that examined the efficacy of semaglutide 1. This recommendation is based on the most recent and highest quality study available, which prioritizes morbidity, mortality, and quality of life as the outcome. The STEP trials demonstrated that semaglutide can achieve significant weight loss, with a mean weight loss of 14.9% and 16.0% at 68 weeks in the STEP 1 and STEP 3 trials, respectively 1.
Key Considerations for Weight Loss on Semaglutide
- The medication should be initiated at low doses and gradually increased according to the prescribed titration schedule to minimize gastrointestinal side effects 1.
- Patients should maintain adequate protein intake, stay well-hydrated, and engage in regular physical activity, including strength training, to preserve muscle mass during weight loss.
- The mechanism of semaglutide promotes gradual weight loss through decreased appetite, increased satiety, and slowed gastric emptying, which supports a measured approach to weight reduction rather than rapid results 1.
Monitoring and Adjustments
- Patients should be monitored regularly for weight loss, gastrointestinal side effects, and other potential issues, such as inadequate nutrition or muscle loss instead of fat loss.
- Adjustments to the medication dose, diet, or physical activity plan may be necessary to ensure a safe and sustainable rate of weight loss.
- The long-term use of semaglutide is necessary to maintain weight loss, as significant weight regain was observed after cessation of the medication in the STEP trials 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Safe Rate of Weight Loss on Semaglutide
The safe rate of weight loss for patients on semaglutide, a glucagon-like peptide-1 receptor agonist, can be determined by examining the results of various studies.
- A study published in 2024 2 found that after three months of semaglutide administration, the median weight reduction was 7.4 kg (6.6% of the baseline weight).
- Another study from 2023 3 reported that semaglutide demonstrated the largest weight loss of any obesity medication to date, with reductions of approximately 15% of initial weight at 68 weeks.
- A 2018 study 4 compared the efficacy and safety of semaglutide with liraglutide and placebo for weight loss in patients with obesity, and found that estimated mean weight loss was -2.3% for the placebo group versus -6.0% to -13.8% for the semaglutide groups.
- A systematic review published in 2022 5 evaluated the efficacy and safety of liraglutide and semaglutide on weight loss in people with obesity or overweight, and found that semaglutide 2.4mg had the best weight loss, with a mean weight loss of -12.47 kg.
- A review article from 2022 6 discussed the use of semaglutide for weight loss and cardiometabolic risk reduction in overweight/obesity, and noted that semaglutide offers adults with obesity or overweight a new treatment option in conjunction with a weight management program.
Key Findings
- The weight loss achieved with semaglutide varies depending on the dose and duration of treatment, but overall, it appears to be an effective treatment for weight loss in patients with obesity or overweight.
- The safe rate of weight loss on semaglutide is not explicitly stated in the studies, but the results suggest that a weight loss of 5-15% of initial weight over a period of several months is achievable and associated with improvements in cardiovascular risk factors and physical functioning 2, 3, 4, 5, 6.
- The incidence of adverse events, including gastrointestinal symptoms and hypoglycemia, is higher with semaglutide compared to placebo, but the overall safety profile is considered good 2, 4, 5.