New analysis being introduced at this yr’s European Congress on Weight problems (ECO 2025) has discovered that sufferers of an internet weight problems clinic achieved related weight reduction to that reported in scientific trials – however with lower than half the treatment. The examine is to be printed within the journal The Lancet Digital Well being.
Sufferers who adopted the programme had a mean weight lack of 16.7% (16.8kg/2st 9lb) after 64 weeks, which is on par with that seen in randomised managed trials of the identical drug, semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
Reaching the identical weight reduction in day-to-day life as within the tightly managed situations of a scientific trial, whereas additionally utilizing decrease doses of medication, has many potential advantages, from decrease prices and fewer side-effects for sufferers, to making sure that shares of the drug go additional.”
Dr. Henrik Gudbergsen, lead researcher and Chief Medical Officer of Embla, an internet weight reduction service
Semaglutide and different GLP-1 agonists for weight reduction have had spectacular ends in scientific trials. Nevertheless, real-world trials have reported smaller weight losses and lack particulars about whether or not sufferers are additionally making life-style modifications that can enhance the chance of their attaining optimum weight reduction.
Actual-world trial outcomes additionally counsel that few sufferers observe the usual dosing schedule, with most staying on decrease doses.
Within the first examine of its form, Dr Gudbergsen and colleagues on the College of Copenhagen evaluated the real-world results of an internet weight reduction programme that gives intensive behavioural remedy and recommendation on eating regimen and train, in addition to doses of semaglutide which are tailor-made to particular person sufferers.
The cohort examine concerned 2,694 people in Denmark (78% feminine, common age 47 years, common BMI 34.3, common physique weight 100.5kg/15st 12lb) who had been enrolled in a weight administration programme run via the Embla app, out there in Denmark and within the UK.
The programme included recommendation on wholesome consuming, rising train and on how you can use cognitive behavioural remedy (CBT) and different therapies to beat the psychological obstacles to weight reduction, entry to docs, nurses and psychologists via the AI-powered app and a course of the weight- loss drug semaglutide (Wegovy).
The usual dosing schedule, through which a low preliminary dose of 0.25 mg as soon as weekly is elevated each 4 weeks for 16 weeks to a most dose of two.4mg (which the affected person stays on till therapy ends), was tailor-made to particular person sufferers.
Sufferers acquired the bottom efficient dose, and will increase had been solely thought-about if they’d stopped making progress. In the event that they maintained a weekly weight discount >0.5% of their physique weight and skilled manageable ranges of side-effects and starvation, they remained on the prevailing dose. Remedy continued on this means till they reached their desired weight or a BMI of 25 – an strategy generally known as “deal with to focus on”.
After 26, 64 and 76 weeks, 1,580, 712 and 465 sufferers, respectively, had been nonetheless collaborating within the programme.
Common weight reduction amongst those that had been nonetheless collaborating within the programme was 12.2% (12.2kg/1st 13lb) at week 26, 16.2% (16.3kg/2st 8lb) at week 52 and 16.7% (16.8kg, 2st 9lb) at week 64.
The researchers notice that that is much like the 15-16% weight reduction at 64 weeks achieved by sufferers who took half in scientific trials through which semaglutide was mixed with life-style interventions resembling calorie-controlled diets and behavioural remedy.1-3
Nevertheless, it was achieved with lower than half the treatment used within the scientific trials. The common dose of semaglutide on this examine was about 1mg/week and solely 28.8% of sufferers reached doses larger than this.
In distinction, about 90% of the sufferers within the scientific trials reached doses of two.4mg/week.
Dr Gubdergsen, who can be an affiliate professor on the College of Copenhagen, says: “By combining eating regimen and train recommendation with psychological teaching and personalising sufferers’ doses of semaglutide it was potential to attain the identical quantity of weight reduction with decrease doses of the drug.”
Some 98% of the 515 sufferers with a reported weight at weeks 52-64 achieved at the least 5% weight reduction and 82%, 51%, and 23% achieved 10%, 15% and 20% weight reduction, respectively.
Females had a better weight reduction than males (17·6% vs 13·4 %) and sufferers who used the web app extra misplaced extra weight than those that used it much less.
The evaluation additionally discovered that sufferers’ weight reduction was related, no matter their preliminary BMI, age or the quantity of semaglutide used. In different phrases, decrease doses of semaglutide had been simply as efficient as larger ones.
Aspect-effects, resembling nausea, vomiting, and abdomen ache had been typically delicate and transient.
The examine’s limitations embrace using self-reported knowledge and the dearth of a management group.
Dr Gudbergsen concludes: “Our outcomes present that by giving personalised doses of semaglutide together with eating regimen, train and psychological help, it’s potential for sufferers to attain scientific trial-level weight reduction of their day-to-day lives.
“Our ‘treat-to-target’ strategy, through which quantity of treatment was tailor-made to every affected person’s targets, allowed us to maintain doses as little as potential, which ought to imply decrease prices and fewer side-effects for sufferers.
“This strategy was efficient throughout all age teams and all beginning weights and in each sexes.”
