The short answer
Several randomized trials found greater weight loss with semaglutide than placebo in Asian populations. Their entry criteria, diabetes status and duration differed, so their averages should not be ranked as if the participants were interchangeable.
Four studies, four different populations
All studies included lifestyle support. The table shows average estimated weight change for weekly semaglutide 2.4 mg and placebo.
STEP 6 also studied semaglutide 1.7 mg, with a −9.6% average change. Its placebo groups were pooled.
Semaglutide / placebo; percent of starting weight
STEP 6: 401 across groups; Japan and South Korea; 68 weeks
−13.2% / −2.1%
STEP 7: 375; predominantly East Asian, including Brazil; 44 weeks
−12.1% / −3.6%
STEP 11: 150; South Korea and Thailand, without diabetes; 44 weeks
−16.0% / −3.1%
STEP 12: 242; mainland China and Taiwan; 44 weeks
−12.1% / −2.2%
Original visual based on the four studies cited below.
| Group or measure | Result |
|---|---|
| STEP 6: 401 across groups; Japan and South Korea; 68 weeks | −13.2% / −2.1% |
| STEP 7: 375; predominantly East Asian, including Brazil; 44 weeks | −12.1% / −3.6% |
| STEP 11: 150; South Korea and Thailand, without diabetes; 44 weeks | −16.0% / −3.1% |
| STEP 12: 242; mainland China and Taiwan; 44 weeks | −12.1% / −2.2% |
Why the entry criteria matter
STEP 11 enrolled people of Asian descent with BMI at least 25. STEP 12 examined a narrower BMI range below 30, using local thresholds: BMI 24–below 28 with a weight-related condition, or 28–below 30. About 19% had type 2 diabetes.
STEP 6 and STEP 7 also allowed participants with type 2 diabetes. These differences help explain why no single headline percentage describes everyone.
What about side effects?
Digestive problems were common. In STEP 6, they occurred in 59% with semaglutide 2.4 mg versus 30% with placebo; in STEP 7, 67% versus 36%.
STEP 11 reported serious adverse events in 13% versus 8%; these reports do not by themselves establish that treatment caused them. STEP 12 reported any adverse event in 87.6% versus 75.3%, with digestive disorders most common.
The useful takeaway
Look for evidence involving people like you, while remembering that a trial average is not a personal forecast. These studies support benefit across additional populations; they do not prove ethnicity explains differences between trials.
Sources
All four trials were funded by Novo Nordisk.
Kadowaki and colleagues: STEP 6, 2022
Mu and colleagues: STEP 7, 2024