Semaglutide reduces appetite and energy intake, improves control of eating and provides weight loss in subjects with obesity

Introduction: Glucagon-like peptide-1 (GLP-1) therapy has thepotential to decrease body weight. Semaglutide is a human GLP-1analogue.Methods: This 12 week double-blind, crossover study examinedthe mechanisms of weight loss with once-weekly subcutaneoussemaglutide (dose-escalated to 1.0mg) vs placebo in 30 subjectswith obesity and without Type 2 diabetes (mean body weight101.3kg). Primary endpoint: ad libitum energy intake during lunch(5h after standardised breakfast) after 12 weeks’ treatment.Results: Ad libitum energy intake at lunch and subsequent meals(evening meal, snacks) was lower with semaglutide vs placebo, aswas resting metabolic rate, but to a lesser extent. Fasting overallappetite score (visual analogue scale) indicated reduced appetitewith semaglutide vs placebo (p = 0.0023), while nausea ratings were similar. For semaglutide vs placebo, the Control Of EatingQuestionnaire indicated less hunger and food cravings and bettercontrol of eating; the Leeds Food Preference Task indicated arelatively lower preference for high-fat vs low-fat foods. Semaglu-tide treatment led to a mean  SD weight loss of 5.0  2.4kg vsan increase of 1.0  2.4kg with placebo, and proportionally morefat than lean body mass was lost.Summary: Semaglutide-induced weight loss was confirmed. Pos-sible mechanisms are: reduced energy intake, appetite and foodcravings; better control of eating; and lower relative preference forfatty, energy-dense foods.