Semaglutide May Induce Weight Loss in Type 2 Diabetes Despite BMI

A woman weighing herself on a scale
A woman weighing herself on a scale
Researchers assessed whether semaglutide-induced weight loss was related to gastrointestinal adverse events.

Semaglutide, a once-weekly peptide 1 analog for the treatment of type 2 diabetes (T2D), produced clinically relevant and significantly greater weight loss compared with comparison groups regardless of baseline body mass index (BMI), according to a study published in Diabetes, Obesity and Metabolism.

The SUSTAIN clinical trials 1-5 evaluated the efficacy of semaglutide, a glucagon-like peptide 1 analog from Novo Nordisk, Denmark.

It was compared with both placebo and the active comparators dulaglutide, exenatide extended release, insulin glargine, and sitagliptin for the treatment of inadequately controlled T2D. Semaglutide was found to demonstrate superior reductions in baseline body weight and glycated hemoglobin than the active comparators and placebo in 3899 adults across 33 countries.

By conducting a post hoc analysis of the SUSTAIN trials, study investigators aimed to evaluate weight loss induced by semaglutide across BMI subgroups, as well as the possible associations between weight loss and the side effects of nausea and vomiting.

Semaglutide-induced weight reductions were consistent and significant across all BMI subgroups in the studies (2.5-5.7 kg with semaglutide 0.5 mg, and 2.0-7.9 kg with semaglutide 1.0 mg, compared with the 1.5 kg gain to 3.7 kg loss demonstrated within comparator groups).

The semaglutide groups did experience a higher rate of nausea and vomiting side effects than did the comparator groups (15.2-24.0% for 0.5 mg semaglutide and 21.5-27.2% for 1.0 mg semaglutide vs 6.0-14.1% for comparators), but these events were usually transient and between 1 and 8 days in duration. Only a small proportion of sumaglutide-induced weight loss could be associated with nausea and vomiting (0.07-0.5 kg).

Related Articles

Study investigators conclude, “[in] SUSTAIN 1–5, semaglutide-induced weight loss was consistently greater versus comparators, regardless of baseline BMI. The contribution of nausea or vomiting to this weight loss was minor.”

This study and the associated trials were supported by Novo Nordisk A/S, Denmark.


Ahrén B, Atkin SL, Charpentier G, et al. Semaglutide induces weight loss in subjects with type 2 diabetes regardless of baseline BMI or gastrointestinal adverse events in SUSTAIN 1–5 trials [published online May 15, 2018]. Diabetes Obes Metab. doi: 10.1111/dom.13353