Oral semaglutide, marketed as Wegovy pills, appears to be as effective as its injectable counterpart for weight loss, but may not offer the same cardiovascular benefits, according to a new analysis of existing data. The study, published in The BMJ, suggests that while most obesity drugs lead to weight loss, they do not significantly improve patients' quality of life.
Researchers reviewed 262 studies involving nearly 100,000 participants, examining 19 available and emerging obesity drugs over periods ranging from 12 to 172 weeks. When compared to lifestyle changes alone, drugs like Mounjaro (tirzepatide) and CagriSema demonstrated the largest weight loss after one year, with participants losing 14.9% and 14.8% of their body weight, respectively. Oral semaglutide (Wegovy pills) resulted in a 10.9% weight loss, while the injectable form of semaglutide (Wegovy injections) led to a 9.8% loss.
Notable findings indicate that Mounjaro led to the greatest reduction in body fat (25.7%) but also the largest loss of lean body mass, such as muscle (8.3%).
However, the analysis highlighted that Wegovy injections were the only medication linked to a reduced risk of death from any cause (19%), heart attack (28%), and heart failure (57%). Mounjaro also showed a significant reduction in heart failure risk by 51%.
No drug included in the review conclusively reduced the risk of kidney failure or demonstrated clinically significant improvements in quality of life, the researchers noted. The study's authors emphasized that most clinical trials had relatively short follow-up periods, limiting conclusions about long-term safety, quality of life, and effects on heart and kidney health.
In accompanying commentary, medical experts from the Cleveland Clinic in Ohio stated that the increasing number of new obesity drugs is a positive development for clinicians and the more than one billion individuals worldwide living with obesity or overweight. They described the study as an important step in providing comparative information to aid patient-clinician discussions in the rapidly evolving landscape of obesity treatment options.
The review's authors advised that treatment decisions for obesity should be individualized, considering expected benefits, potential harms, treatment burden, costs, availability, and patient preferences.