Exploring the wider benefits of semaglutide treatment in obesity: insight from the STEP program

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ABSTRACT

Obesity negatively impacts patients’ health-related quality of life (QOL) and is associated with a range of complications such as type 2 diabetes (T2D), cardiovascular disease, and sleep apnea, alongside decreased physical function, mobility, and control of eating. The Semaglutide Treatment Effect in People with obesity (STEP) trials compared once-weekly subcutaneous semaglutide 2.4 mg with placebo in adults with overweight or obesity, with or without T2D. This article reviews the effects of semaglutide 2.4 mg on QOL, control of eating, and body composition. Weight-related QOL was assessed using the Impact of Weight on Quality of Life-Lite Clinical Trials Version (IWQOL-Lite-CT), and health-related QOL was assessed with the 36-item Short Form Health Survey version 2 (SF-36v2®). Control of eating was evaluated using the Control of Eating questionnaire in a subgroup of participants in one trial. Body composition was evaluated via dual-energy x-ray absorptiometry in another trial, in a subgroup of participants with a body mass index of ≤40 kg/m². All IWQOL-Lite-CT scores (Physical Function, Physical, Psychosocial, and Total Score) improved with semaglutide 2.4 mg significantly more than with placebo. Across the trials, changes in SF-36v2 scores were generally in favor of semaglutide versus placebo. There were significant improvements in all Control of Eating questionnaire domains (craving control, craving for savory, craving for sweet, and positive mood) up to week 52 with semaglutide treatment versus placebo, with improvements in craving control and craving for savory remaining significantly different at week 104. Body composition findings showed that reductions in total fat mass were greater with semaglutide versus placebo. These findings highlight the wider benefits that patients can experience with once-weekly subcutaneous semaglutide 2.4 mg, in addition to weight loss, including improvements in patients’ wellbeing and ability to perform daily activities. Taken together, these are important considerations for primary care when incorporating pharmacotherapy for weight management.

KEYWORDS:

• Obesity
• overweight
• weight loss
• quality of life
• semaglutide
• glucagon-like peptide-1 receptor agonist

Abbreviations

BMI, body mass index

CI, confidence interval

DEXA, dual-energy x-ray absorptiometry

ETD, estimated treatment difference

FDA, US Food and Drug Administration

GLP-1RA, glucagon-like peptide-1 receptor agonist

IBT, intensive behavioral therapy

IWQOL-Lite-CT, Impact of Weight on Quality of Life-Lite Clinical Trials Version

OW, once weekly

QOL, quality of life

SF-36v2, 36-item Short Form Health Survey version 2

STEP, Semaglutide Treatment Effect in People with obesity

T2D, type 2 diabetes

Acknowledgments

Medical writing and editorial support were provided by Nicole Cash, PhD, of Axis, a division of Spirit Medical Communications Group Limited, and Emma Marshman, PhD, a contract writer working on behalf of Axis (and were funded by Novo Nordisk Inc.), under direction of the authors. Novo Nordisk Inc. also performed a medical accuracy review.

Declaration of financial/other relationships

Patrick M. O’Neil: research grants to his university – Eli Lilly, Epitomee Medical, Novo Nordisk, and WW International; fees for consulting or advisory board participation – Gedeon Richter and Pfizer; and honoraria for non-promotional talks – Novo Nordisk and Robard.

Domenica M. Rubino: investigator, consultant, and speaker – Novo Nordisk; investigator – Boehringer Ingelheim and Epitomee Medical; and honoraria for CME talks – Endocrine Society, PeerView, and WebMD.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by Novo Nordisk Inc.