A large Cochrane review of 18 randomized trials involving nearly 28,000 adults evaluated the effectiveness of semaglutide for obesity management. The analysis showed that semaglutide led to clinically meaningful weight loss in both medium-term and long-term follow-up, with participants achieving significantly greater reductions in body weight and higher rates of ≥5% weight loss compared with placebo. While non-serious adverse events were more common, effects on serious adverse events, quality of life, major cardiovascular events, and mortality were small or uncertain, particularly due to imprecision and inconsistency across trials.
Long-term data further confirmed sustained weight reduction while treatment continued, alongside an increased likelihood of treatment withdrawal due to adverse events. Most trials were manufacturer-funded, highlighting concerns regarding potential conflicts of interest, and several outcomes showed limited certainty. The authors concluded that although semaglutide is effective for weight loss, higher-quality independent studies are needed to better understand its broader clinical impact, especially in underrepresented populations.
Keywords: semaglutide, obesity treatment, GLP-1 receptor agonist, weight loss therapy