Semaglutide in Obesity and Type 2 Diabetes Management: A Systematic Review of Clinical Outcomes

Semaglutide, a glucagon-like peptide-1 receptor agonist, has emerged as a promising pharmacological intervention in obesity management. This systematic review aimed to evaluate the efficacy and safety of semaglutide in promoting weight loss in adults with obesity. A comprehensive literature search was conducted in the PubMed, Scopus, and Web of Science databases, and nine studies met the inclusion criteria. The studies included randomized controlled trials and case-control studies involving participants aged 18-65 years with BMI > 30 kg/m². Semaglutide administered once a week, particularly at a dosage of 2.4 mg, led to a significant mean weight loss of 14.9% compared to 2.4% in the group receiving a placebo (mean difference: -12.4 percentage points; 95% CI: -13.4 to -11.5; P < 0.001). Research has indicated weight reductions between 3 and 15 kg, with greater doses and longer treatment durations, resulting in more substantial decreases. Additionally, semaglutide considerably improved glycemic control, with 57-74% of participants receiving 1.0 mg achieving HbA1c levels below 7.0% (P < 0.0001). The observed improvements in weight and metabolic parameters were consistent across the diverse racial and demographic groups. The most common adverse effects observed were mild-to-moderate gastrointestinal issues, primarily nausea and vomiting. These symptoms were dose-dependent and typically transient, although they caused some participants to discontinue the treatment. Assessment of potential bias using the Cochrane Risk of Bias Tool revealed that most studies had a low overall risk, with some exhibiting moderate risks in areas of performance, detection, and reporting biases. In conclusion, semaglutide is effective as a pharmacological intervention for obesity management, resulting in significant weight loss and improved glycemic control. However, long-term safety data remain scarce, and gastrointestinal side effects may negatively affect patient compliance. Further research is required to optimize dosing strategies, assess cost-effectiveness, and evaluate long-term safety, thus enhancing the clinical utility and accessibility of the drug.