Treatment Reduces Appetite, Weight in Patients With Obesity

Semaglutide suppressed appetite and reduced food cravings when administered once-weekly to patients with obesity, according to findings published in Diabetes, Obesity and Metabolism.

Semaglutide is a glucagon-like peptide-1 receptor agonist that “lowers body weight by reducing appetite and hunger, increasing satiety, reducing food cravings, altering food preferences and reducing energy intake,” authors noted.

In the randomized control trial, researchers administered once-weekly subcutaneous semaglutide 2.4 mg or placebo to 72 adults with obesity over 20 weeks. There was a 16-week dose escalation for both semaglutide and placebo groups: 0.25, 0.5, 1.0, and 1.7 mg once weekly for four weeks each, ending with 2.4 mg for five doses.

Paracetamol absorption testing after a standardized breakfast was used to evaluate gastric emptying. Patients completed Control of Eating Questionnaires (CoEQ) to report appetite ratings, and researchers evaluated energy intake during ad libitum lunch.

Patients receiving semaglutide reported better control of eating and fewer food cravings (P<.05), as well as reduced hunger and increased satiety (P<.02). Energy intake was also 35% lower in the semaglutide group (1736 versus 2676 kJ; estimated treatment difference -940 kJ; P<.0001).

“CoEQ scores suggested an effect in terms of reduced intensity of desire for sweet and savoury foods, and reduced frequency of craving for dairy and savoury foods,” researchers wrote. “These results are consistent with the prior study of once‐weekly [subcutaneous] semaglutide 1.0 mg in participants with obesity, which similarly reported appetite suppression, improved control of eating and reduced food craving.”

Semaglutide was associated with an 8% increase in concentration-time curve for paracetamol 0 to 5 hours (P=.005), but this finding was not significant after adjusting for reduced body weight at 20 weeks (P=.12). Additionally, patients in the semaglutide arm saw a 9.9% reduction in body weight at 20 weeks, compared with 0.4% in the placebo arm.

“Obesity is a growing global health crisis placing substantial burden on healthcare systems, with excess weight contributing to a range of detrimental effects, including increased risk of type 2 diabetes, cardiovascular disease, and mortality,” authors wrote. “Our results demonstrate clinically relevant weight loss with once‐weekly subcutaneous semaglutide 2.4 mg in participants with obesity during a relatively short 20‐week treatment period.”

Reference:
Friedrichsen M, Breitschaft A, Tadayon S, Wizert A, Skovgaard D. The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity. Diabetes Obes Metab. 2021 Mar;23(3):754-762. doi:10.1111/dom.14280