For example, any information (eg, on adverse effects) that was not reported by the patient or entered into the EMR portal by the health care professional could potentially be missed. Also, there is a possibility of recall bias because the dates of medication initiation and termination were reported by patients during patients’ visits or communications with their physicians and therefore may not be exact. In addition, we had mostly White female patients, which limits the generalizability of the study. This study has some strengths, including an adequate sample size at 3 and 6 months of follow-up. Observation periods included the in-trial period (that is, while in the trial, regardless of treatment discontinuation or rescue intervention) and the on-treatment period (with trial product). Comparison of change from baseline by week for selected cardiometabolic endpoints… Cumulative distribution plot of change from baseline to week 104 in… Comparison of body weight parameters… Flow chart of trial participants in the STEP 5 clinical trial. The intensive behavioral therapy (IBT) intervention succeeded at week 28 in inducing a mean loss of approximately 8% of baseline weight in placebo-treated participants, a loss that declined to 5.7% at week 68, most likely because of the decreased number of counseling visits during the second part of the intervention. Effect of semaglutide treatment or placebo on mean percentage change in body weight… Another serious limitation is the exclusion of patients who did not reach 3 months of follow-up, which might have resulted in an overestimation of the association of semaglutide with body weight. Considering the observational nature of this study, we could not compare weight loss outcomes between patients receiving semaglutide and controls. Practicing Eating Habits for Weight Loss On average, it’s recommended to lose 1 to 2 pounds per week, according to the Centers for Disease Control and Prevention (CDC). Served as site principal investigator for the clinical trial (he received no financial compensation, nor was there a financial relationship) and reports advisory/consulting fees and/or other support from Boehringer Ingelheim, Eli Lilly & Company, Guidotti Laboratories, Menarini Diagnostics, Novo Nordisk and Therascience Lignaform. Access request proposals can be found at novonordisk-trials.com. Individual participant data will be shared in datasets in a de-identified and anonymized format. Data will be shared with bona fide researchers submitting a research proposal approved by the independent review board. CI, confidence interval; EDT, estimated treatment difference; HDL, high-density lipoprotein; LDL, low-density lipoprotein; OR, odds ratio; VLDL, very-low-density lipoprotein. EExploratory endpoints were assessed with descriptive statistics based on observed data. BThe difference is the estimated treatment difference, odds ratio or estimated relative percentage difference between groups, as indicated. At week 68, a larger proportion of participants in the semaglutide 2.4 mg and semaglutide 1.7 mg group than the placebo group had achieved a ≥5% (83 vs 72 vs 21%), ≥10% (61 vs 42 vs 5%), and ≥15% or higher reductions (41 vs 24 vs 3%) in baseline bodyweight.Excess abnormal body fat, especially visceral adiposity and ectopic fat, is a driver of cardiovascular (CV) disease (CVD)3,4,5, and contributes to the global chronic disease burden of diabetes, chronic kidney disease, cancer and other chronic conditions6,7.Regular physical activity is another cornerstone of a successful weight loss plan with Ozempic.6 for corresponding data for the trial product estimand (which assesses treatment effect assuming all participants adhered to treatment and did not receive rescue intervention).Additionally, semaglutide increases glucose-dependent insulin secretion, suppresses glucagon, and may contribute to metabolic improvements beyond weight loss alone.‘This can help you maintain after the six weeks is up as well – so you really can have your cake and eat it.’ Which leads us on too… However, everyone’s journey is different and tracking your weight isn’t the only way to measure success in the early stages of Wegovy treatment. You can enhance your progress with our 5 ways to increase weight loss with Wegovy guide. Although any significant weight loss is still unlikely, you may start to notice changes in your appetite. During week two, it is essential to continue monitoring any side effects you experience and report them to your clinician if they are severe or if you are concerned. Proportion (%) of in-trial patients… Variation in weight loss response… For each BMI category (-2) there were lower rates (events per 100 years of observation) of serious adverse events with semaglutide (43.23, 43.54, 51.07 and 47.06 for semaglutide and 50.48, 49.66, 52.73 and 60.85 for placebo). 3 Steps A 2021 systematic literature review showed that 14% to 58.6% of patients achieved weight loss of 5% or more within 3 to 6 months when using orlistat, phentermine-topiramate, naltrexone-bupropion, phentermine, and liraglutide.22 However, in our study, 53.7% of patients at 3 months and 87.3% at 6 months had at least 5% weight loss. In 12 weeks, weight loss of approximately 4% was achieved among patients taking the 1-mg dose, and weight loss of approximately 5% was achieved among those taking the 2.4-mg dose.21 In addition, weight loss at 28 weeks approached approximately 7% for patients taking the 1-mg dose and 9.6% for those taking the 2.4-mg dose. Hence, this study may be a stepping stone to demonstrating the effectiveness of semaglutide for patients aiming to lose weight. Semaglutide versus other weight loss medications ‘One of the easiest things you can do to improve weight loss from a nutritional perspective, is to replace excess carbs with good quality protein and healthy fats,’ says Lawrance. ‘This will be a little different for everybody, but start with a 10% deficit, and adjust things from there, depending on how you’re responding and progressing over the 6 weeks. If, however, you are keen to get to a healthy bodyweight, don’t fixate on the scales and live miserably. Or, you might feel inspired to use all this time sans distraction to really hone in on your health and dedicate a few weeks to feeling your best self. The safety and effectiveness of combining semaglutide with other weight loss products have not yet been confirmed. Fuel groundbreaking medical research! The mean age in the final cohort was 48 years and mean body mass index was 37 kg/m2. To determine whether patients had undergone a bariatric procedure, we used the ICD-10-CM and CPT-4 codes described in Table S2. Obesity was defined as an ICD-9-CM or ICD-10-CM diagnostic code of obesity or a calculated BMI ≥30 kg/m2. Non-pregnant adults (aged 18 years and older) who were first dispensed a GLP-1 agonist (liraglutide, dulaglutide, exenatide ER, semaglutide, exenatide, and albiglutide) between 2011 and 2018 were eligible (see Table S1). The research challenges long-held beliefs about cardio vs weights A cost-effectiveness analysis of Wegovy will help clinicians decide if it should be preferred compared with other weight loss drugs. Another significant benefit of semaglutide is that it can be used for long-term management of weight. A future study comparing these two agents would be a beneficial addition to the literature on the efficacy of semaglutide. The three trials from the SUSTAIN clinical trial program—SUSTAIN China multiregional clinical trial, SUSTAIN (Japan), and SUSTAIN (Japan, sitagliptin)—were also excluded due to redundancies in the comparators.17–19 This review also includes superficial comparisons of the findings from the SUSTAIN, PIONEER, and STEP trials, as no studies to date have compared the efficacy of subcutaneous and oral semaglutide. The only apparent difference between oral semaglutide and subcutaneous semaglutide, besides slight differences in their efficacy in weight reduction, is the route of administration. Clinical trials have substantiated the anecdotal successes, demonstrating Ozempic's role in significantly reducing abdominal fat. The 6-week program led to a noticeable flattening of his abdominal region and a renewed sense of vitality and self-esteem. While the journey doesn't end here, the six-week mark is a milestone that highlights the potential of Ozempic as a tool for transformation when combined with lifestyle changes. It's a time to reflect on progress, celebrate achievements, and consider the next steps. What the SELECT trial of semaglutide means for clinicians Some recommend specific products, supplements, or detox kits, which may put you at risk for potentially harmful side effects. But these diets typically eliminate entire food groups, have strict menus, and say nothing about exercise or lifestyle changes, according to the American Academy of Family Physicians. If you have special dietary considerations or need more support in choosing an eating plan, consider working with a registered dietitian. The key is to get creative in the kitchen and recreate your favorite recipes using healthy alternatives. News & World Report’s annual list of the best diets, is touted for its manageable approach that emphasizes whole foods without over-restricting. To minimize gastrointestinal side effects, it is titrated up starting at 0.25 mg once a week with dose increases every 4 weeks until the full dose of 2.4 mg is reached. The United States Food and Drug Administration (FDA) has approved five medications, as adjuncts to a reduced-calorie diet and increased physical activity, for chronic weight management. Weight loss goals are typically considered a loss of ≥5% of initial body weight at three to six months. In fact, a 2021 study led by Rubino found that people on semaglutide regain weight when the drug is stopped. It was approved in June 2021 for treating people with a body mass index in the obese range or just under that range but with weight-related health issues. Many patients have medical problems related to severe obesity, including diabetes, fatty liver disease, hypertension, polycystic ovary syndrome, sleep apnea and painful arthritic joints. You’ve heard this before, but that doesn't make it any less true; eating a healthy, natural food diet and getting moderate exercise almost every day is the best way to lose weight. The 6-week weight loss plan to lose 15 pounds is designed to help you achieve your weight loss goals in a safe and sustainable way. With an effective weight loss plan, you can not only lose weight but also improve your overall health and quality of life. An effective weight loss plan provides structure and guidance, helping you to make healthier food choices, incorporate exercise into your routine, and manage stress and sleep. We’ll provide you with tips on how to make healthier food choices, incorporate exercise into your daily routine, and manage stress and sleep to support your weight loss goals. Each patient’s percentage change in body weight is plotted as a single bar.Full size imageWC change from baseline to 104 weeks has been reported previously in the primary outcome paper21. Bars depict the proportion (%) of patients receiving semaglutide or placebo who achieved ≥5%, ≥10%, ≥15%, ≥20% and ≥25% weight loss. The SELECT trial (Semaglutide Effects on Heart Disease and Stroke in Patients with Overweight or Obesity) studied patients with established CVD and overweight or obesity but without diabetes. Once-weekly subcutaneous semaglutide 2.4 mg, a glucagon-like peptide-1 receptor agonist, is approved for chronic weight management14,15,16 and at doses of up to 2.0 mg is approved for type 2 diabetes treatment17,18,19. The STEP 5 trial assessed the efficacy and safety of once-weekly subcutaneous semaglutide 2.4 mg versus placebo (both plus behavioral intervention) for long-term treatment of adults with obesity, or overweight with at least one weight-related comorbidity, without diabetes. Comparing the results presented in both trials, we observe that in the primary placebo-controlled trial from the PIONEER program and SUSTAIN 1, around 40% of participants on semaglutide achieved a weight loss of 5% or more.21 31 Thus, these results could suggest that semaglutide is outperformed by phentermine-topiramate and liraglutide as antiobesity medications. A lower energy intake was considered the key factor responsible for bodyweight reduction.8 The Semaglutide Treatment Effect in People with Obesity (STEP) program is a phase III clinical trial program focused on the approval of semaglutide as a weight loss medication in patients with obesity. STEP 2 was a 68-week trial of 1210 adults with type 2 diabetes (ie, glycated hemoglobin of 7–10%) and overweight/obesity who were assigned in equal numbers to once-weekly semaglutide 2.4 mg, semaglutide 1.0 mg, or matching placebo.39 Study eligibility included taking up to three oral glucose-lowering medications (ie, metformin, sulfonylureas, SGLT2 inhibitors, or thiazolidinediones) but not insulin. This means incorporating plenty of fruits, vegetables, whole grains, lean protein, and healthy fats into your meals.We went over the potential benefits and risks of treatment.With this 6-week weight loss plan, you can not only lose 15 pounds but also develop healthy habits that will benefit you in the long run.There were no reports of pancreatitis in either treatment group.Participants in all three groups received the same program of diet and activity counseling provided in STEP 1.In short, losing weight can be as simple as eating less than your body is burning to survive each day.Effect of semaglutide treatment or placebo on waist circumference from baseline… The changes Dr Wuth has made in his eating and exercise habits have done more than reverse his overall weight. "I knew I needed to "walk the walk" and show what is possible with a preventative approach to health and disease prevention." Even better, he has taken his visceral fat rating from a 'high level' of 10.5 to a healthier level of 9. Our pharmacies are based in UK and only dispatch UK medications. Figure 2. Percentage Weight Loss and Categorical Percentage Weight Loss at 3 and 6 Months. Nearly 50% of American adults try to lose weight every year.Ready-to-eat meals based around a 1,500 calorie plan were sent to Dr Wuth each week.Your healthcare team will need to make sure that it's safe for you to have a general anaesthetic or medicine to relax you (sedation).If you are tolerating Wegovy well, the start of month three should see your dose increase to 1mg per week, which should be accompanied by more significant and noticeable weight loss.The use of orlistat in children is only recommended in exceptional circumstances, such as if a child is severely obese and has an obesity-related complication.It offers new options for people seeking effective and sustainable weight management solutions. In STEP 1, discontinuation of study medication due to adverse events was reported in 7.0% of participants on semaglutide and 3.1% of participants on placebo. In a weight loss maintenance trial with liraglutide 3.0 mg/day, the effect of the medication on increasing heart rate was attenuated when liraglutide was combined with a moderate-to-vigorous-intensity exercise program.77 Encouraging moderate-to-vigorous-intensity exercise combined with semaglutide may help to mitigate increases in heart rate and improve cardiorespiratory fitness, but studies are needed to examine the efficacy of this strategy. The average decrease in body weight at week 68 was 13.2% in the semaglutide 2.4 mg group and 9.6% in the semaglutide 1.7 mg group versus 2.1% in the placebo group. Participants who received IBT combined with semaglutide 2.4 mg lost 16.0% of body weight at week 68 and achieved significantly greater improvements in multiple measures of cardiometabolic risk than the placebo-treated group. Before starting Ozempic, she struggled with weight management despite various attempts at dieting and exercising. The journey with Ozempic is not just a narrative of weight loss but also one of personal transformation and scientific validation. Significant reductions in abdominal fat and improvements in overall health are common outcomes, providing a solid foundation for continued weight management. This visible progress is a powerful motivator to continue the weight loss plan, reinforcing the decision to embark on this journey. For the trial product estimand, the estimated mean (s.e.) change in body weight from baseline to week 104 was –16.7% (0.9) with semaglutide and –0.6% (0.9) for placebo (ETD –16.0 percentage points, 95% CI –18.6 to –13.5). B, Observed proportions of participants and OR for achieving weight loss of at least 5% from baseline at week 104 in the full analysis set during the in-trial observation period, based on the treatment policy estimand. Based on the treatment policy estimand, the estimated mean (standard error (s.e.)) change in body weight from baseline to week 104 was –15.2% (0.9) with semaglutide and –2.6% (1.1) with placebo (co-primary endpoint; estimated treatment difference (ETD) –12.6 percentage points, 95% confidence interval (CI) –15.3 to –9.8, P P 2 and Fig. A multiple imputation approach was used to handle missing data31, with imputation based on available data from participants in the same treatment arm with the same treatment status (on-treatment or discontinued).Asian individuals would probably benefit from weight loss and medication approaches undertaken at lower BMI levels in the secondary prevention of CVD.Percentage changes in glycated hemoglobin (HBA1C) were also calculated from baseline in both subject groups of treatment.Evidence from the trial suggests that along with weight loss come reductions in blood pressure, blood glucose and unhealthy lipids, as well as C-reactive protein (a measure of inflammation).During data abstraction, we confirmed the medication start date from physicians’ EMR notes or physician-patient communications because there might be a delay between the day of prescription and the start of medication (eg, insurance approval delay and drug availability). Research indicates that these metabolic adaptations can persist for years after weight loss, making weight maintenance particularly challenging without continued intervention. When you achieve your target weight, your body has undergone substantial metabolic adaptations. If doses are missed for more than 2 weeks, re-titration is recommended per FDA labeling. This gradual titration helps minimize gastrointestinal side effects such as nausea, vomiting, and diarrhea, which are the most commonly reported adverse effects during the initial treatment phase. While originally developed for type 2 diabetes management under the brand name Ozempic, a higher-dose formulation marketed as Wegovy received FDA approval specifically for weight management in 2021. The most recent clinical trial program to investigate the efficacy of subcutaneous semaglutide was the STEP program. Along with the evidence obtained during the SUSTAIN clinical trial program, a second clinical trial program was run to test the safety and efficacy of oral semaglutide (Rybelsus) as an antidiabetic drug. Presently, most animal and human studies exploring these mechanisms have been conducted using liraglutide.1 3 With the approval of Wegovy, further studies could be conducted focusing on the mechanisms of GLP-1 RAs in weight loss and studies on combinatorial pharmacotherapeutics in weight loss. This could provide an option with higher prospects of regimen compliance for patients with obesity. A linear mixed model was used to estimate percent weight change, with follow-up time as a discrete fixed effect (i.e., 8-week intervals from baseline to 72 weeks). For patients who underwent a bariatric procedure during the 72-week follow-up period, we censored all body weight and BMI measurements that occurred following the bariatric procedure. Baseline demographic and clinical variables were measured during the 52 weeks prior to the first GLP1-a dispense date and extracted from the electronic health record portion of the dataset. We conducted a retrospective cohort study of non-pregnant adults first dispensed a GLP-1a between 2011 and 2018 using electronic health record data from patients receiving care at a large health system. Here are six tips to help you start your weight-loss journey. But the best way to lose weight and keep it off is to make lasting lifestyle changes. "It all depends on how much weight someone has to lose. If you have 100 pounds you lose, it will come off faster initially. If you only have 15 pounds to lose, the weight will come off more slowly. The basic math of calories in vs calories out is caloric deficit which is necessary to lose weight, Collingwood agrees. However, "if she is doing this in the morning and not getting any calories until 2 PM (and that is very few with the green juice and fruit and no protein) she is leaving her body susceptible to poor recovery, injury risk, dehydration, and low energy," she points out. For a safe and sustainable weight loss plan over six weeks, aim to lose 6 to 12 pounds. Rather than figuring out how to drop, say, 20 to 30 pounds in six weeks, stick with the expert-recommended pace of 1 to 2 pounds of weight loss per week, or between 6 and 12 pounds in six weeks. There's no quick fix when it comes to weight loss, but understanding how much weight you can lose in six weeks can help you safely and sustainably work toward your ultimate goal. The trial product estimand addressed the average treatment effect in all randomly assigned participants, assuming that the drug or placebo was taken as intended (participants on treatment). This estimand was used to assess the superiority of semaglutide versus placebo for the co-primary and confirmatory secondary endpoints in a predefined hierarchical order.For the treatment policy estimand, continuous endpoint analyses were conducted with the use of the analysis-of-covariance method, with randomized treatment as a factor and baseline endpoint value as a covariate. Collectively, these results indicate a beneficial effect of treatment on overall patient health. Consistent with these findings, in STEP 5 semaglutide treatment improved a range of cardiometabolic risk parameters, including waist circumference, systolic and diastolic blood pressure, HbA1c levels, total cholesterol, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol and triglycerides. With all nonsurgical interventions and to some extent with bariatric surgery, weight regain after initial weight loss is common10–14,18–22. One death was reported in the semaglutide group and was considered by the independent external event adjudication committee to be unrelated to the trial product (Table 3). After 6 months of therapy HBA1C was 6.4 ± 0.6%, with a mean reduction of − 1.5 ± 1.6%. In the OS group at baseline mean HBA1C was 7.6 ± 1.6%. IS and OS therapy were well tolerated, and no patients in both groups experienced severe adverse events like nausea or vomiting. Without a plan in place, it’s easy to get overwhelmed and discouraged, leading to giving up on your weight loss journey altogether. Having an effective weight loss plan is crucial to achieving your weight loss goals in a safe and sustainable manner. We believe that sustainable weight loss is achievable for anyone who is committed to making positive changes in their life. Developing an effective six-week weight loss plan is an individualized process. Eating too few calories can endanger your health by depriving you of necessary nutrients, and it can also make weight loss more difficult in the long run. To achieve steady weight loss, it’s suggested to cut approximately 500 calories from your daily diet, according to the Mayo Clinic. Finally, managing stress and sleep can help prevent overeating and emotional eating, and can improve your overall health and well-being. It’s also important to create a relaxing bedtime routine, such as taking a warm bath or reading a book, to help signal to your body that it’s time to sleep. Stress and poor sleep can have a significant impact on weight gain, as they can lead to overeating, poor food choices, and a lack of motivation to exercise. Exercise not only helps to burn calories, but also builds muscle mass, improves cardiovascular health, and can have a positive impact on your mental health and overall well-being. Orlistat will usually only be recommended if you've made a significant effort to lose weight through diet, exercise or changing your lifestyle. You'll need to start eating a balanced diet and exercising regularly before starting treatment with orlistat, and continue this during treatment and after you stop taking the medicine. All medicines for supporting weight management should be used alongside a reduced-calorie diet and increased physical activity. They will look at your individual health needs to decide if the medicine is safe and right for you, taking into account the benefits and any possible side effects. You may need to exercise for longer each day to prevent obesity or to avoid regaining weight if you've been obese. Clinical evidence shows that discontinuing semaglutide after weight loss leads to significant weight regain (approximately 7% within one year). Successful long-term weight maintenance with semaglutide requires not only appropriate dosing but also continued attention to nutrition, physical activity, sleep, and stress management as part of a comprehensive approach to metabolic health. If doses are missed for more than 2 weeks, re-titration according to the FDA-approved schedule is recommended to minimize side effects. Continuing semaglutide is not a sign of failure but rather an evidence-based approach to managing a chronic disease, similar to ongoing treatment for hypertension or diabetes. Patients should be informed that it is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma in humans. Many of the contraindications and adverse events of semaglutide are shared among other GLP-1RAs, including liraglutide; however, there are differences in occurrence and severity as further detailed below. Within the broader GLP-1RA medication class, differences exist in drug structure, efficacy, and adverse events. Moreover, the 104-week losses (for both groups) were within 0.5 percentage points of those observed at week 68 in STEP 1. Placebo-treated participants, by contrast, gained 6.1 kg after randomization, resulting in only a net 5.0% loss from the start of the run-in. Recently, a medication called semaglutide has been featured in many news outlets after the manufacturer reported an impressive percentage of weight loss from clinical trials. It's important to remember that as you lose weight your body needs less food (calories), so after a few months, weight loss slows and levels off, even if you continue to follow a diet. Over a few weeks, though, your weight loss should level out to a healthy pace. Test your body’s IgG antibody reactivity to 96 foods Measure 11 key biomarkers known to play important roles in women’s overall health Test your body’s IgG antibody reactivity to 204 foods You should avoid semaglutide if you have a personal or family history of certain types of thyroid cancers. Supplementary Tables 1 and 2 Semaglutide is widely seen as a breakthrough—“a new paradigm for the hormonal treatment of obesity,” as Kushner puts it. “We want to be sure our patients are getting healthier, not just thinner,” he says. Such results are about double what older weight-loss drugs achieve, says Robert Kushner of Northwestern University, one of the study’s principal investigators. “We are finally able to help people lose weight in the ranges that help the complications of obesity,” Rubino says. However, semaglutide is not for everyone and is only one of many ways to achieve healthy, lasting weight loss. In fact, our results demonstrated the effectiveness and safety over 24 months of semaglutide treatment in T2DM obese subjects on loss of weight and HBA1C improvement. This allowed us to report data only at 12 months for oral semaglutide from baseline. In the treatment of overweight T2DM patients, therapy should continue throughout life (at least in patients without disease remission) and long-term studies in this population can help us understand whether maintaining weight after weight loss is an achievable goal. In this study we verified in real-world the efficacy of semaglutide both subcutaneously and orally in T2DM subjects with obesity or overweight. Eventually, I was carrying around less weight and I was keeping it off. Wegovy® should not be used with other semaglutide-containing products, other GLP-1 medicines, or in children under 12 years of age. I was excited to start treatment with Wegovy®. My doctor said, I would need to take Wegovy® with a reduced calorie diet and increased physical activity. When taken regularly, semaglutide has been shown to have a significant impact on weight loss. Unlock the full potential of semaglutide and take the first step towards a healthier, happier you. With its convenient once-weekly dosing and impressive weight loss efficacy, Ozempic is an attractive option for those seeking a comprehensive weight loss solution. Ozempic, with its active ingredient semaglutide, has revolutionized the weight loss landscape. By incorporating this medication into a comprehensive weight loss plan, individuals can achieve sustainable, long-term results. These remarkable success stories are a testament to the potent weight loss effects of Ozempic. It is administered via injection once weekly, making it a convenient and manageable option for those seeking to lose weight and improve their overall health. We excluded patients with a history of bariatric procedures (ie, surgical or endoscopic), taking other FDA-approved AOMs, or with an active malignant neoplasm or pregnancy.This guide aims to convert six weeks of uncertainty into a period of measurable progress.In STEP 5, once-weekly treatment with semaglutide 2.4 mg as an adjunct to behavioral intervention in adults with overweight (with at least one weight-related comorbidity) or obesity led to a substantial initial reduction in weight, which plateaued after approximately week 60 and was maintained for the remainder of the study.Gastrointestinal disorders were the most common adverse events with semaglutide, typically transient, of mild-to-moderate severity, occurring during dose escalation, and infrequently leading to treatment discontinuation.On average, it’s recommended to lose 1 to 2 pounds per week, according to the Centers for Disease Control and Prevention (CDC).Yes, Wegovy can interact with certain medications, which is why it is essential to inform your clinician about any other treatments you may be taking.Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist, a type of medication that mimics the action of a natural hormone in the body.This may include adopting a healthy diet, increasing physical activity, and managing stress.Although our trial focused on CV events, many chronic diseases would benefit from effective weight management28.In fact, the World Health Organization defines clinical obesity as ‘abnormal or excessive fat accumulation that may impair health’1. Continuous endpoints were analyzed using an analysis of covariance model with treatment as a fixed factor and baseline value of the endpoint as a covariate. Body weight was measured without shoes and only wearing light clothing; it was measured on a digital scale and recorded in kilograms or pounds (one decimal with a precision of 0.1 kg or lb), with preference for using the same scale throughout the trial. The lifestyle counseling was not targeted at weight loss. In SELECT, at 208 weeks, semaglutide produced clinically significant weight loss and improvements in anthropometric measurements versus placebo. In patients treated with semaglutide, weight loss continued over 65 weeks and was sustained for up to 4 years. The findings of this cohort study suggest that semaglutide is clinically effective for weight loss at 3 and 6 months for people with overweight or obesity. During the study, 30.6% of those assigned to semaglutide did not complete drug treatment, compared with 27.0% for placebo. First, SELECT was not a primary prevention trial, and the data should not be extrapolated to all individuals with overweight and obesity to prevent major adverse CV events. By 104 weeks, approximately 77% of SELECT patients on dose were receiving the target semaglutide 2.4 mg weekly dose, which is lower than the corresponding proportion of patients in STEP 1 (89.6% were receiving the target dose at week 68)14,21. The co-primary endpoints were the percentage change in body weight and achievement of weight loss of ≥5% at week 104. The co-primary endpoints were the percentage change in body weight and achievement of weight loss of ≥5% at week 104. As we described before, the most commonly reported adverse effects of semaglutide during the SUSTAIN clinical trial were GI side effects, including nausea and vomiting.1 Patients taking semaglutide experienced these side effects more frequently than comparators (in the SUSTAIN, PIONEER, and STEP trials), but most episodes were transient.4 Higher nausea and vomiting rates were experienced at higher doses of semaglutide and lower baseline BMI.4 There are also concerns for increased pancreatic lipase and pancreatitis, similar to other GLP-1 RAs. We will not include lorcaserin (Belviq, Belviq ER), a previously marketed weight loss medication, because the FDA revoked its approval due to the increased risk of malignancies reported in a recent safety clinical trial.6 In a recent study, most patients reported preferring taking oral tablets to subcutaneous injections, supported by the ease of administration and the lack of pain.40 From these results, most patients would possibly prefer to take an oral tablet of semaglutide than a once-weekly subcutaneous injection. B,c, Percentage change in body weight for individual patients from baseline to week 104 for semaglutide (b) and placebo (c). Data derived from the SELECT trial offer the opportunity to evaluate the weight loss efficacy, in a geographically and racially diverse population, of semaglutide compared with placebo over 208 weeks when both are given in addition to standard-of-care recommendations for secondary CVD prevention (but without a focus on targeting weight loss). To understand body weight changes at 72 weeks after index dispense date, we used descriptive statistics to compare participants with and without weight data in the 72-week time window. Markedly elevated body weight is a well described risk factor for major adverse cardiovascular events and all-cause mortality among patients with type 2 diabetes.1–3 Achieving and maintaining weight loss in this group of patients may result in improved glycemic control and help patients reduce the dosage or number of glucose lowering medications.4,5 In some cases, more substantial weight loss (i.e. ≥10% to 15%) may result in disease remission.6,7 Real-world effectiveness of Semaglutide treatment on weight loss maintenance after weight loss in patients with obesity or overweight and diabetes. Interestingly, at 2 years, a significant proportion of the semaglutide-treated group fell below the sex- and race-specific WC cutoff points, especially in those with BMI −2, and a notable proportion (12.0%) fell below the BMI cutoff point of 25 kg m−2, which is deemed a healthy BMI in those without unintentional weight loss. The weight-loss trajectory with semaglutide occurred over 65 weeks and was sustained up to 4 years. The proportion of patients with obesity (BMI ≥30 kg m−2) fell from 71.0% to 43.3% in the semaglutide group versus 71.9% to 67.9% in the placebo group. 4, which depicts in-trial patients receiving semaglutide and placebo. Moreover, we reported few moderate and severe adverse events (eg, nausea and constipation) that resulted in continuing to receive the same dose of medication or even discontinuing semaglutide. In our study, adverse effects were reported in approximately 50% of our cohort during follow-up. Mild adverse effects did not affect dose escalation; moderate adverse effects prevented dose escalation; and severe adverse effects resulted in medication termination. Data are for on-treatment adverse events, occurring during which any dose of semaglutide or placebo given within the previous 49 days (after excluding any temporary interruptions in taking trial intervention), unless indicated otherwise.However, a long list of insurance and prescription benefit plans can make it impossible to determine if the medication is covered, which can be another barrier.First, SELECT was designed as a CV outcomes trial and not a weight-loss trial, and weight loss was only a supportive secondary endpoint in the trial design.However, there were only 3 patients and we censored all weight data following bariatric procedures for the 5 patients who underwent a bariatric procedure during the 72 weeks of follow-up.I was playing basketball four to five times a week.The treatment policy estimand assesses treatment effect regardless of treatment discontinuation or rescue intervention; see Extended Data Fig.The Mayo Clinic Diet helps you achieve lasting weight loss with custom meal plans and proven strategies.Rather than figuring out how to drop, say, 20 to 30 pounds in six weeks, stick with the expert-recommended pace of 1 to 2 pounds of weight loss per week, or between 6 and 12 pounds in six weeks.Only a healthcare professional can determine whether Wegovy® (semaglutide) is the appropriate option for you.Moreover, we reported few moderate and severe adverse events (eg, nausea and constipation) that resulted in continuing to receive the same dose of medication or even discontinuing semaglutide. If you are one of them, one of the most important things to consider is setting realistic weight loss goals. Treating children living with obesity usually involves improvements to diet and increasing physical activity using behaviour change strategies. If you're due to have surgery or a medical procedure, tell your healthcare team that you're taking weight management injections. Try to avoid foods containing high levels of salt because they can raise your blood pressure, which can be dangerous for people who are already living with obesity. The best way to achieve this is to swap unhealthy and high-energy food choices – such as fast food, processed food and sugary drinks (including alcohol) – for healthier choices. If you need help managing your weight, you might be able to refer yourself directly to services that can help you, without seeing a GP. Reach your goals and continue to set new ones for a happier, healthier you! Board-certified obesity medicine specialist in Elmhurst, Illinois Losing weight too quickly can also lead to gallstones. The FDA-approved maintenance dose is 2.4 mg weekly, with 1.7 mg weekly as an alternative if the higher dose isn't tolerated.The changes Dr Wuth has made in his eating and exercise habits have done more than reverse his overall weight.For patients who underwent a bariatric procedure during the 72-week follow-up period, we censored all body weight and BMI measurements that occurred following the bariatric procedure.In this paper, we summarize the weight loss efficacy of semaglutide and discuss the criteria to be considered in the selection of patients who are candidates for semaglutide and special considerations related to its use in different patient populations.Future landscape of obesity pharmacotherapy.…While the journey doesn't end here, the six-week mark is a milestone that highlights the potential of Ozempic as a tool for transformation when combined with lifestyle changes.As in the SUSTAIN trials, oral semaglutide also showed no increased risk of hypoglycemia.30 GI adverse effects (table 4), namely mild to moderate nausea and vomiting, were again the most commonly reported.30–35 37 Finally, a significant increase in lipase was noted.31 These results may support the applicability of semaglutide in a less controlled environment, as previously proven in RCTs.18,19,20 Other adverse effects included dizziness, depression, bloating, dry mouth, and taste change. Nausea and vomiting were the most encountered adverse events (64 patients 36.6%), followed by diarrhea (15 patients 8.6%) and fatigue (11 patients 6.3%). Gastrointestinal symptoms were the most reported adverse effects. In those with diabetes, taking Wegovy® with insulin or a sulfonylurea can increase the risk of low blood sugar. It was just mind blowing to see like the weight starting to drop and wow, this is actually, you know, making a difference. It was the coolest experience because not once throughout my struggles of trying to lose weight, did I have someone actually holding me accountable. I got assigned a wonderful health coach and I'm still in touch with her today. Wegovy® should not be used with other semaglutide-containing products, other GLP-1 medicines or in children under 12 years of age. The doctor’s supervision gives me confidence in the treatment plan. Semaglutide Scripts™ has been a pivotal part of my health regimen. The convenience of getting my medication shipped directly to my door every month is a game-changer. The material on this website is provided for educational purposes only and is not to be used for medical advice, diagnosis or treatment. These methods synergistically produce transformative results that individuals can maintain long after medication stops. More gradual titration of semaglutide or down-titrating insulin could help mitigate rapid decreases in glucose concentrations and reduce the risk of diabetic retinopathy worsening, though further research is needed. Adverse events are primarily derived from randomized clinical trials that occur under a wide variety of conditions and with different inclusion and exclusion criteria. Patients should be monitored for depression, suicidal thoughts and behavior, and mood changes, and those who experience suicidal thoughts or behavior should discontinue semaglutide. Our results show a comparable effectiveness of IS and OS in T2DM patients with obesity or overweight. At baseline, mean weight (mW) was 101.8 ± 24.6 kg and 95.2 ± 15.0 kg; mean body mass index (mBMI) was 36.7 ± 8.7 kg/m2 and 34.3 ± 5.3 kg/m2. With determination and persistence, you can achieve your weight loss goals and enjoy a healthier, happier life. It's also a period when the body adapts more fully to Ozempic, potentially leading to more significant weight loss. This boost can be attributed to weight loss, improved diet, and regular physical activity. Most private insurers and Medicare typically cover Ozempic for the treatment of diabetes rather than for weight reduction purposes. Results from semaglutide can vary from person to person, but most people start to see significant weight loss within weeks of starting treatment. SELECT evaluated once-weekly subcutaneous semaglutide 2.4 mg versus placebo to reduce the risk of major adverse cardiac events (a composite endpoint comprising CV death, nonfatal myocardial infarction or nonfatal stroke) in individuals with established CVD and overweight or obesity, without diabetes. In conclusion, this analysis of the SELECT study supports the broad use of once-weekly subcutaneous semaglutide 2.4 mg as an aid to CV event reduction in individuals with overweight or obesity without diabetes but with preexisting CVD. At the first visit, mean weight m(W) was 101.8 ± 24.6 and kg 95.2 ± 15.0 kg; mBMI was 36.7 ± 8.7 kg/m2 and 34.3 ± 5.3 kg/m2 respectively for IS and OS group of subjects. Patient consents were not required due to the retrospective nature of this study. The diet regime included approximately 50% carbohydrates, 30% lipids and 20% proteins. Other serious side effects can include pancreatitis, gall bladder disease, kidney damage, increased heart rate, as well as low blood glucose levels and eye disorder in type 2 diabetics. Sometimes, more severe side effects may occur. Semaglutide is a manufactured form of the naturally occurring GLP1 in the human body.4,5 GLP1s are incretin hormones produced in the gastrointestinal tract after food intake to help regulate insulin release. Food and Drug Administration (FDA) approved for long-term use in people who are obese and overweight. Semaglutide belongs to a class of medications known as GLP-1s, or glucagon-like peptide 1 drugs. Second, the respective study populations were quite different, with STEP 1 including a younger, healthier population with more women (73.1% of the semaglutide arm in STEP 1 versus 27.7% in SELECT) and higher mean BMI (37.8 kg m−2 versus 33.3 kg m−2, respectively)14,21. First, SELECT was designed as a CV outcomes trial and not a weight-loss trial, and weight loss was only a supportive secondary endpoint in the trial design. As more robust weight loss is possible with newer medications, achieving and maintaining these cutoff point targets may become important benchmarks for tracking responses. I would try to diet and exercise, but I couldn’t go anywhere. I didn’t think about weight that much. Some side effects may lead to dehydration, which may worsen kidney problems. Tell all your healthcare providers that you are taking Wegovy® before you are scheduled to have surgery or other procedures. For tips from our Medical reviewer on how to track your weight loss, scroll down! You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. We’re here to show you that you can lose weight just by eating healthy, portioned meals and doing exercises that burn calories and tone your muscles. These findings suggest that GLP-1 agonists be used in patients who would benefit from weight loss in real-world settings. This suggests that GLP-1 agonists may be used in patients who would benefit from weight loss in real-world settings. However, this means that our weight loss results may be more modest than what can be expected in patients who are fully adherent to GLP-1 agonist therapy. We thank the study participants, and the investigators and study site staff who conducted the study. For the treatment policy estimand, continuous endpoint analyses were conducted with the use of the analysis-of-covariance method, with randomized treatment as a factor and baseline endpoint value as a covariate. This estimand was used to assess the superiority of semaglutide versus placebo for the co-primary and confirmatory secondary endpoints in a predefined hierarchical order. Two estimands were employed to assess treatment efficacy from different perspectives and accounted for intercurrent events and missing data differently, as described in a previous publication31. These studies provide a clinical perspective that complements the personal anecdotes, offering a holistic view of Ozempic's potential as a transformative agent in weight loss. The physical changes were accompanied by a boost in self-confidence, showcasing the profound impact of Ozempic beyond mere weight loss. Within six weeks of incorporating Ozempic into her regimen, Emma noticed a significant reduction in her waistline. However, a long list of insurance and prescription benefit plans can make it impossible to determine if the medication is covered, which can be another barrier. The high cost of Wegovy can make it unaffordable for many patients unless it is covered by insurance. Gall bladder-related issues, including cholelithiasis, ranged between 0.2% and 4.9%, and cardiovascular issues, including tachycardia and arrhythmias, ranged between 1.5% and 9.8% in STEP trials 1–4. It should also be noted that, as an incretin-based therapy, semaglutide (like other GLP-1 analogs) has a low risk of hypoglycemia. Essential differences in safety between these medications should also be considered. Dr. Chao reports grants from WW International Co and Eli Lilly and Co, outside the submitted work. Patients should be asked about barriers to adherence to giving a weekly injection. However, the use of an injectable can be a barrier to initiation and adherence due to concerns about self-administering a medication, convenience, and social acceptance. Important attributes driving patient preferences for particular medications include dose frequency, efficacy, adverse event profiles, and if the medication is provided as an injection, injection preparation, type of device, and needle size.90 Semaglutide is provided as a prefilled, single-dose pen with an integrated needle. We sought to describe the percent change in body weight 72 weeks after starting a GLP-1a. Expert-recommended weight loss hovers around 500g – 1kg per week (anymore and you risk upsetting your metabolism), so some women could potentially lose around 2kg of fat in six weeks, while others will be just shy of 6kg. Dr. Richard Koffler specializes in weight loss management, focusing on effective, non-invasive solutions for individuals struggling with obesity or weight-related health issues. If you're considering using semaglutide for weight loss, it's important to consult a healthcare provider. The size of the calorie deficit will dictate how much and how fast you lose, but doctors and health organizations advise that weight loss be gradual and steady. Here's what you need to know about a six-week weight loss plan, including how much weight is safe to lose and tips to help you develop a sustainable program. Here's how much weight you can lose in six weeks and how to do it safely. W.T.G. reports a grant from Novo Nordisk; serving as site principal investigator for the current clinical trial, which was sponsored by his university during the conduct of the study; and receiving grants to serve as site principal investigator for other university-sponsored clinical trials funded by Eli Lilly & Company, Lexicon, Epitomee and Pfizer outside the submitted work. All authors had full access to aggregated study data and to unaggregated data on request from the sponsor; participated in the data interpretation, presentation and manuscript drafting (assisted by a sponsor-funded medical writer); approved its submission, and vouched for data accuracy and fidelity to the protocol. Can you lose 6kg in 6 weeks? The category ‘Other’ for CV inclusion criteria includes patients where it is unknown if the patient fulfilled only one or several criteria and patients who were randomized in error and did not fulfill any criteria. Data are represented as number and percentage of patients. The dots show estimated treatment differences and the error bars show 95% confidence intervals. Increasing physical activity to up to 60 minutes a day and continuing to watch what you eat may help you keep the weight off. If you go back to your previous calorie intake once you've lost weight, it's very likely you'll put the weight back on. Getting psychological support from a trained healthcare professional may also help you change the way you think about food and eating. Yes, the average Wegovy weight loss of 15% is achieved with the highest weekly dose of 2.4 mg. It's possible that Wegovy isn’t the right weight loss medication for you, and an alternative, such as Mounjaro or Nevolat, may be more effective. Wegovy is a long-term medication which is intended to support gradual, consistent, and safe weight loss. Other medications are in development that combine two or three hormones involved in appetite. That changed with the recent advent of medications directly targeting the brain-gut axis that regulates appetite. The people who seek out endocrinologist Domenica Rubino have tried again and again to lose weight. Injectable weight-loss medicines reduce appetite but raise questions of long-term safety and affordability You can eat platefuls of steamed broccoli, spinach, tomatoes, and cauliflower and STILL lose weight! As you increase the strength, you may notice your side effects temporarily return or worsen. You’ve completed your first month of Wegovy treatment, and it’s time to celebrate. Don’t be too hard on yourself if you find them challenging, as it can take 66 days for a lifestyle change to become a healthy habit, but doing it daily will make it easier. You may even notice that you have lost a few pounds by now, even if you cannot physically see any changes in your weight. The STEP trial examined the effects of 2.4 mg, once-weekly, subcutaneous semaglutide on patients with obesity. In conclusion, semaglutide is efficacious for sustained weight loss in patients with overweight/obesity and without diabetes. Our objective was to examine the long-term efficacy and safety of semaglutide use for weight loss in patients with overweight/obesity and without diabetes. The medication’s efficacy in improving self-reported appetite and in reducing objectively-measured energy intake may reduce the need for traditional behavioral counseling to support changes in these behaviors. Further research is needed to determine the optimal frequency of lifestyle counseling required with semaglutide 2.4 mg. Participants in all three groups received the same program of diet and activity counseling provided in STEP 1. The SUSTAIN program included nine Phase 3a clinical trials (SUSTAIN 1–6,25–30 two trials conducted in Japan,31,32 and one China Multi-Regional Clinical Trial33), and four phase 3b clinical trials (SUSTAIN 7–1034–37). In other RCTs following up with patients treated with semaglutide, 2.4 mg, adverse effects were reported in 90% of patients over 68 weeks.18 Some possible explanations for the lower reported adverse effects in our study include patients not reaching the maximum dose of semaglutide (ie, 1.7 and 2.4 mg) and the shorter duration of follow-up (24 vs 68 weeks). In addition, considering the 16-week semaglutide titration schedule and having only 44.0% of the patients in our cohort reach maximal semaglutide doses (ie, 1.7 or 2.4 mg) compared with more than 94% of patients in RCTs,18 weight loss is expected to increase as more patients achieve the maximal doses of this medication. In one study including 1306 patients taking semaglutide, 2.4 mg, weight loss of approximately 6% was achieved by week 12 and 12% was achieved by week 28.18 Our results reflect similar weight loss outcomes within the same period, particularly for patients taking doses of 1.7 mg and 2.4 mg. This cohort study, conducted at a referral center for weight management, retrospectively collected data on the use of semaglutide for adults with overweight or obesity between January 1, 2021, and March 15, 2022, with a follow-up of up to 6 months. One pivotal study contrasted the effects of different dosages of semaglutide, the active ingredient in Ozempic, on weight loss. Originating as a treatment for diabetes, Ozempic's ability to contribute to weight loss has sparked interest among healthcare professionals and individuals striving for a healthier physique. The statistical analyses for the in-trial period were based on the intention-to-treat principle and included all randomized patients irrespective of adherence to semaglutide or placebo or changes to background medications. Missing data at the landmark visit, for example, week 104, were imputed using a multiple imputation model and done separately for each treatment arm and included baseline value as a covariate and fit to patients having an observed data point (irrespective of adherence to randomized treatment) at week 104. Thus, the study did not include Asian patients who qualify for treatment with obesity medications at lower BMI and WC cutoff points according to guidelines in their countries29. Typically, no, as weight loss that rapid far exceeds the healthy pace recommended by the CDC. If you’re new to exercising or haven’t worked out for a long time, talk to your doctor before you begin your six-week weight loss plan. To support your six-week weight loss goals, the U.S. Fad diets like the cabbage soup diet, the Atkins diet, and even the keto diet promise rapid weight loss and often sound too good to be true. You may lose slightly more than that at first, because your body can quickly shed water weight when you make dramatic changes to your diet and exercise, according to the Mayo Clinic. Our first on-treatment analysis demonstrated that those on-drug lost more weight than those in-trial, confirming the effect of drug exposure. Furthermore, both sexes, all races, all body sizes and those from all geographic regions were able to achieve clinically meaningful weight loss. Proportions of patients in the BMI categories at baseline and week 104 are shown in Fig. Our mission is to harness innovative healthcare solutions, offering Semaglutide as a path to achieving your wellness goals. Sharing your complete medical history with your provider is essential for your safety and treatment plan optimization. The approach is comprehensive, with regular follow-ups to monitor progress and adjust treatment as needed. Semaglutide, a GLP-1 receptor agonist, mimics the body’s natural hormone regulating appetite and metabolic processes. This period also involves setting into motion the diet and exercise plans laid out during the preparation phase. It's not just about burning calories; physical activity also boosts metabolism, improves mood, and enhances overall health. It's not about restricting calories to the extreme but choosing the right foods that satisfy nutritional needs and support weight management. "However, two highly processed protein shakes are not really providing the quality of food we like for overall good health. They do have a lot of vitamins and minerals added to them, which she needs because she is not eating very many calories or a variety of foods." She is happy to see some carbs in the pasta, "but vodka sauce does not really provide much nutritional value," she adds. This content is not a substitute for professional medical advice, diagnosis, or treatment. Lower doses are considered off-label and lack systematic evidence for weight maintenance. However, this approach is considered off-label for weight management and should be approached with caution. These findings suggest that semaglutide addresses an ongoing physiological need rather than providing a temporary fix. You will likely experience a gradual and steady decline in body weight during this period. This activation sets off a cascade of events that influence appetite, digestion, and ultimately contribute to weight loss. Informed consent was obtained from all the participants of the study. However, there were only 3 patients and we censored all weight data following bariatric procedures for the 5 patients who underwent a bariatric procedure during the 72 weeks of follow-up. In addition, our results are also in line with the mean 1.6% to 4.6% differential weight loss demonstrated in placebo-controlled cardiovascular outcome trials for liraglutide 1.8mg (LEADER),17 semaglutide 1.0mg (SUSTAIN-6)18 and dulaglutide 1.5mg (REWIND).19 Observed and modeled percent of participants who lost at least 5% of baseline bodyweight at each 8-week time segment between the index GLP-1 agonist dispensing through week 72. At 72 weeks, nearly half of participants (42.7%) had lost weight (Figure 3) and 10.5% had lost 10% or more of their body weight. We used descriptive statistics to summarize the percent weight change from baseline and percent of participants who lost at least 5% of baseline body weight in each 8-week time window. He incorporates the latest treatments to help patients achieve and maintain a healthier lifestyle. Clinically proven weight loss medication offering dual-action metabolic benefits. Clinically proven weight loss medication that helps control appetite and stimulates weight loss. The swift onset of action, driven by the activation of GLP-1, sets semaglutide apart as an approved weight-loss medication. To lose weight, you need to lower the total calories you take in from food and drinks. You set action goals so that you can make healthy changes. You can list a healthy outcome that you aim to have. Those conditions include heart disease and type 2 diabetes. Losing 5% of your current weight may be a good goal to start with. It’s important to remember that weight loss with semaglutide is most effective when combined with a healthy diet and regular exercise. This is significantly more than other weight loss medications on the market, making semaglutide a promising new option for those struggling with obesity. Remember, the key to achieving long-term weight loss success lies in a multifaceted approach that incorporates healthy diet, regular exercise, and evidence-based medication like Ozempic. Numerous clinical trials have demonstrated the remarkable weight loss effects of semaglutide. This clinical trial, among others, has been instrumental in establishing the medication's role not only in managing diabetes but also in facilitating weight loss. Weekly 1.7-mg or 2.4-mg semaglutide subcutaneous injections for 3 to 6 months. Patients with a history of bariatric procedures, taking other antiobesity medications, and with an active malignant neoplasm were excluded. We’re passionate about simplifying weight loss and wellness through clear, actionable advice. STEP 5 shows that the changes in these parameters were sustained through 104 weeks’ treatment. These findings suggest a potential beneficial effect of semaglutide on glycemic status, but whether semaglutide treatment delays or prevents progression to type 2 diabetes requires confirmation. There is marked variability in weight change in patients on weight management treatments; the reason for this is still unclear and likely involves complex biological and societal influences. This is a retrospective observational study, and no ethical approval is required. Material preparation, data collection and analysis were performed by Michela Del Prete, Fabrizio Muratori and Lidia Gavazzi. All authors contributed to the study concept and design. VLCDs should not usually be followed for longer than 12 weeks at a time, and they should only be used under the supervision of a suitably qualified healthcare professional. VLCDs are usually only recommended if you have an obesity-related complication that would benefit from rapid weight loss. It can take several months of making lifestyle changes and possibly using medicine before you start to see changes in your weight and any related health conditions. Your GP can advise you about losing weight safely by eating a healthy, balanced diet and doing regular physical activity. Key considerations for using once‐weekly… Improvements in cardiometabolic risk factors, including high blood pressure, atherogenic lipids and benefits on physical function and quality of life were seen with semaglutide 2.4 mg. Prevention would undoubtedly be better, Rubino agrees, but many of her patients are already ill. The rush to embrace a lifelong injectable drug makes some obesity researchers nervous. “We’ve been asked to hold off starting new patients,” Kushner says. There were no reports of pancreatitis in either treatment group. One participant in the placebo group reported asymptomatic COVID-19. CI, confidence interval; ETD, estimated treatment difference. Results of analyses of the confirmatory and selected supportive secondary endpoints for the trial product estimand, are provided in Supplementary Table 1. Error bars are standard error of the mean; numbers below the panels are the number of participants contributing to the mean. At week 104, 52.4% of patients treated with semaglutide achieved improvement in BMI category compared with 15.7% of those receiving placebo. At week 208, average reduction in WC was −7.7 cm with semaglutide versus −1.3 cm with placebo, with a treatment difference of −6.4 cm (95% CI −7.18 to −5.61; P 21. These waterfall plots show the variation in weight-loss response that occurs with semaglutide and placebo and show that weight loss is more prominent with semaglutide than placebo. These waterfall plots show the variation in weight-loss response that occurs with semaglutide and placebo and show that weight loss is more prominent with semaglutide than placebo.Fig. Clinical data show an average 1–3 lb of weight loss per week after dose escalation. Aim to lose 1 to 2 pounds (0.5 to 1 kilogram) a week over the long term. Track your diet and exercise in a journal or an app. Think of your goals on days when you don't feel like eating healthy foods or moving more. SELECT also did not include individuals who have excess abnormal body fat but a BMI −2. In SELECT, investigators were allowed to slow, decrease or pause treatment. Third, major differences existed between the respective trial protocols. Several reasons may explain the observation that the mean treatment difference was −12.5% in STEP 1 and −8.7% in SELECT.