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doi: 10.1159/000443828 59 StanMNSalviM

STEP 1 (N = 1,961 adults with obesity, no diabetes): Semaglutide 2.4 mg weekly vs placebo 68-week treatment duration Mean weight loss: 14.9% of baseline body weight (semaglutide) vs 2.4% (placebo) 86% of semaglutide patients lost at least 5% of body weight 69% lost at least 10% 50% lost at least 15% Published in New England Journal of Medicine, 2021 (Wilding et al.) STEP 2 (N = 1,210 adults with obesity and type 2 diabetes): Semaglutide 2.4 mg vs 1 mg vs placebo 68-week duration Mean weight loss: 9.6% (2.4 mg dose) vs 7.0% (1 mg dose) vs 3.4% (placebo) Diabetes patients lose less weight than non-diabetic patients on the same dose, likely due to baseline insulin resistance Published in Lancet, 2021 (Davies et al.) STEP 3 (N = 611, semaglutide plus intensive behavioral therapy): Mean weight loss: 16.0% at 68 weeks Adding structured diet and exercise counseling improved outcomes by approximately 1% absolute weight loss vs medication alone STEP 4 (withdrawal study, N = 803): Patients who achieved weight loss on semaglutide were randomized to continue semaglutide vs switch to placebo Patients who continued semaglutide lost an additional 7.9% of body weight over 48 weeks Patients switched to placebo regained 6.9% of body weight This demonstrates that semaglutide requires ongoing treatment