Overview

• In two Phase 3 STEP UP trials published in The Lancet Diabetes & Endocrinology, weekly semaglutide 7.2 mg produced greater average weight loss than 2.4 mg over 72 weeks—about 18.7–19% vs roughly 16% in adults without diabetes and 13.2% vs 10.4% in those with type 2 diabetes.
• Common adverse events such as nausea, vomiting, diarrhoea and tingling were more frequent at 7.2 mg, but trials reported no increase in serious adverse events or severe hypoglycaemia and few treatment discontinuations.
• A nationwide Danish registry analysis of 77,310 first-time semaglutide users without diabetes found 18% stopped by three months, 31% by six months, 42% by nine months and about 52% within a year.
• Discontinuation was more likely in younger adults aged 18–29 (+48% vs ages 45–59), residents of low-income areas (+14%), prior users of gastrointestinal (+9%) or psychiatric (+12%) medicines, people with chronic cardiovascular disease (around +10%) and men (+12%); researchers highlighted high out-of-pocket costs (about €2,000 per year for the lowest dose in Denmark) as a key barrier.
• Experts note weight-loss benefits wane after stopping GLP-1 therapy, raising concerns that early drop-off could blunt public-health gains, and they caution that the registry lacks individual BMI, income and on-treatment weight-change data and undercaptures milder side effects.