Can semaglutide (generic name) be prescribed for weight loss in a patient with a body mass index (BMI) of 25.8, indicating overweight?

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Last updated: March 6, 2025 • View editorial policy

From the Guidelines

Semaglutide can be considered for weight loss in a patient with a BMI of 25.8, but only on a case-by-case basis and under the guidance of a clinician experienced in obesity medicine, as per the most recent guidelines 1.

Key Considerations

  • The patient's BMI of 25.8 falls into the overweight category, which may not typically qualify for medication-assisted weight loss according to some guidelines 2, 3.
  • However, the most recent consensus on care and management of obesity suggests that pharmacotherapy, including semaglutide, may be considered for adults with a BMI of 25-26.9 kg/m2 on a case-by-case basis to help ameliorate obesity-related complications 1.
  • The decision to prescribe semaglutide should be based on the individual's clinical characteristics, treatment targets, and the presence of weight-related complications.
  • Lifestyle modifications, including dietary changes, increased physical activity, and behavioral interventions, should still be the primary approach for weight loss in patients with a BMI of 25.8.

Important Factors

  • The potential side effects of semaglutide, such as nausea, vomiting, diarrhea, and rare but serious complications, should be carefully considered and weighed against the potential benefits of medication-assisted weight loss.
  • Close monitoring by a clinician experienced in obesity medicine is essential if semaglutide is prescribed for a patient with a BMI of 25.8.
  • The choice of obesity medication should be made with respect to the individual's clinical characteristics and the country-specific approved labeling of the available products 1.

From the Research

Semaglutide for Weight Loss

  • Semaglutide has been shown to be effective in achieving significant weight loss in individuals with overweight or obesity, with mean weight losses of 14.9%-17.4% in clinical trials 4.
  • The medication has been associated with improvements in cardiometabolic risk factors, including high blood pressure and atherogenic lipids, as well as benefits on physical function and quality of life 4.
  • A cohort study found that weekly 1.7-mg and 2.4-mg doses of semaglutide were associated with weight loss similar to that seen in randomized clinical trials, with 87.3% of patients achieving weight loss of 5% or more and 54.9% achieving weight loss of 10% or more after 6 months 5.

Eligibility for Semaglutide Prescription

  • According to the studies, semaglutide can be prescribed for patients with a body mass index (BMI) of 25.8, indicating overweight, as it has been shown to be effective in achieving weight loss in individuals with overweight or obesity 4, 5.
  • The medication has been evaluated in various patient populations, including those with type 2 diabetes, and has been found to be effective in achieving weight loss regardless of age or presence of type 2 diabetes 6, 7.

Safety and Efficacy

  • The safety profile of semaglutide has been consistent across trials, with primarily gastrointestinal adverse events reported 4, 8.
  • The medication has been found to be effective and safe in achieving weight loss in patients with antipsychotic-induced weight gain, with significant reductions in body weight, BMI, and waist circumference observed after 16 weeks of treatment 8.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.