TOPLINE:

Repetitive transcranial magnetic stimulation (rTMS) produced 12-month weight loss comparable to semaglutide 0.5 mg/wk and greater than that achieved with SGLT2 inhibitors in adults with obesity and type 2 diabetes (T2D).

METHODOLOGY:

• Previous research revealed that rTMS, an emerging neurostimulation technique targeting the prefrontal cortex and insula, reduced food cravings and body weight for up to 1 year in individuals with obesity.
• Researchers conducted a retrospective analysis to compare changes in body weight among patients with obesity and T2D treated with semaglutide, SGLT2 inhibitors, and rTMS.
• Patients receiving rTMS underwent stimulations three times per week for 5 consecutive weeks and were followed for up to 1 year; patients treated with semaglutide or SGLT2 inhibitors had been receiving therapy for at least 1 year.
• All patients received recommendations for a low-calorie Mediterranean diet and regular, moderate-intensity physical activity. Changes in body weight were assessed at 6 and 12 months after treatment initiation.

TAKEAWAY:

• Researchers included 40 patients with T2D treated with SGLT2 inhibitors (mean age, 51.9 years; 19 male), 37 patients with T2D treated with semaglutide 0.5 mg/wk (mean age, 52.5 years; 15 male), and 30 patients with or without T2D treated with rTMS (mean age, 50.5 years; 10 male).
• At 12 months, the mean weight change was -8.2 kg with rTMS, -5.7 kg with semaglutide, and -2.0 kg with SGLT2 inhibitors; both rTMS and semaglutide produced greater weight loss than SGLT2 inhibitors (P < .0001 and P = .01, respectively), with no significant difference between rTMS and semaglutide groups.
• Patients treated with SGLT2 inhibitors experienced initial weight loss at 6 months followed by weight regain at 12 months, whereas both semaglutide and rTMS produced significant weight loss at 6 months with continued reductions through 12 months.
• Weight loss achieved with rTMS was similar in patients with obesity alone and in combination with T2D (P = .82).

IN PRACTICE:

“Repetitive TMS may be an effective initial weight-loss therapy or could be employed in combination with [glucagon-like peptide-1 receptor agonists] to promote and maintain weight loss in individuals with obesity with and without T2D,” the authors of the study wrote.

SOURCE:

The study was led by Anna Ferrulli, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy. It was published online in Obesity.

LIMITATIONS:

The study was retrospective in nature. Semaglutide was administered at 0.5 mg/wk, below the maximally approved dose for the treatment of T2D and obesity. Baseline A1c levels differed between groups because patients with higher A1c levels (≥ 48 mmol/mol) were excluded from the rTMS group.

DISCLOSURES:

The study was supported by the Italian Ministry of Health and Ricerca Corrente, IRCCS MultiMedica. Two authors reported having industry relationships, including grant support, advisory board membership, and participation in speakers bureaus for pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.