The short answer
A dose-finding study found additional weight loss at 16 mg weekly, alongside more side effects and treatment stops.
What was tested?
Researchers randomized 245 adults with type 2 diabetes and overweight or obesity to weekly semaglutide 2, 8 or 16 mg, or placebo, for 40 weeks. These were study doses, not instructions for changing treatment.
40 weeks; 245 adults randomized; secondary weight outcome
16 mg versus 2 mg weekly
Additional weight reduction in the main analysis
Treatment stopping
More adverse-event stops in higher-dose groups
Dose adjustments
Reductions or pauses were not allowed
Original visual based on the study.
| Group or measure | Result |
|---|---|
| 16 mg versus 2 mg weekly | Additional weight reduction in the main analysis |
| Treatment stopping | More adverse-event stops in higher-dose groups |
| Dose adjustments | Reductions or pauses were not allowed |
What changed?
The treatment-policy analysis of a secondary outcome estimated 3.4 kg more weight loss with 16 mg than with 2 mg. That is an additional loss, not total loss. The main blood-sugar comparison did not show a clear advantage for 16 mg. Comparisons were not adjusted for multiple testing.
What was the trade-off?
Adverse events led to stopping treatment in 7%, 23% and 18% of people taking 2, 8 and 16 mg, respectively (4 of 60, 14 of 60 and 11 of 62), versus 2% (1 of 59) with placebo. Digestive problems were prominent; unusual skin sensations also occurred more often at higher doses.
The trial did not allow dose reductions or pauses, which may have affected tolerability.
What does this mean?
A larger dose can add benefit while making treatment harder to continue. This small study cannot settle everyone’s best dose.
Novo Nordisk funded and helped conduct the study.