TOPLINE:

Once-weekly semaglutide 2.4 mg led to significant decreases in body weight and fat mass over 12 months while preserving lean mass and improved muscle function in adults with obesity. Weight and fat loss were more pronounced in women and in patients with prior bariatric surgery.

METHODOLOGY:

• Once-weekly semaglutide 2.4 mg often produces > 15% weight loss, though evidence on its effects on body composition and muscle function is limited.
• Researchers conducted a prospective, longitudinal trial to investigate changes in lean mass and muscle function in adults with obesity treated with semaglutide over 1 year.
• Patients with grade 3 obesity, at least one obesity-related comorbidity, and prior unsuccessful lifestyle interventions initiated weekly semaglutide, starting at 0.25 mg and gradually increasing every 4 weeks to a final target dose of 2.4 mg by week 16.
• Body weight, body composition using DEXA, muscle function using handgrip strength, and resting energy expenditure were assessed at baseline and after 7 and 12 months of semaglutide.

TAKEAWAY:

• A total of 106 participants were included (68.9% women; mean age, 52 years).
• The mean body weight significantly declined by 9.8% at 7 months and 12.7% at 12 months, and 59% of patients achieved ≥ 10% weight loss.
• Total fat mass decreased by 14.3% at 7 months and 18.9% at 12 months. Lean mass declined initially (-3 kg at 7 months) but stabilized by month 12.
• Handgrip strength improved significantly by 4.1 kg at 12 months; the prevalence of sarcopenic obesity decreased from 49% at baseline to 33% at 12 months; and resting energy expenditure, normalized to lean mass, increased significantly from 7 to 12 months.
• Women and patients with prior bariatric surgery experienced greater reductions in body weight and fat mass, whereas those with type 2 diabetes or prior GLP-1 use had attenuated responses.

IN PRACTICE:

“These findings emphasize the importance of a comprehensive approach to obesity treatment that goes beyond weight loss alone,” the authors wrote.

SOURCE:

This study was led by Mathieu Alissou, MD, and Thomas Demangeat, MD, Department of Nutrition and CIC-CRB 1404, CSO Rouen Normandie, CHU Rouen, in Rouen, France. It was published online in Diabetes, Obesity and Metabolism.

LIMITATIONS:

The relatively small sample sizes in subgroups, exclusion of patients who discontinued treatment, 12-month follow-up, and the absence of a control group may have limited the generalizability and long-term interpretation.

DISCLOSURES:

No sources of funding were declared. One author reported being employed by Novo Nordisk.

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