Effects of Once-Weekly Semaglutide on Appetite, Energy Intake, Control of Eating, Food Preference and Body Weight in Subjects With Obesity

Diabetes Obes Metab. 2017 Sep;19(9):1242-1251. doi: 10.1111/dom.12932. Epub 2017 May 5.

Abstract

Aim: The aim of this trial was to investigate the mechanism of action for body weight loss with semaglutide.

Materials and methods: This randomised, double-blind, placebo-controlled, two-period crossover trial investigated the effects of 12 weeks of treatment with once-weekly subcutaneous semaglutide, dose-escalated to 1.0 mg, in 30 subjects with obesity. Ad libitum energy intake, ratings of appetite, thirst, nausea and well-being, control of eating, food preference, resting metabolic rate, body weight and body composition were assessed.

Results: After a standardised breakfast, semaglutide, compared with placebo, led to a lower ad libitum energy intake during lunch (-1255 kJ; P < .0001) and during the subsequent evening meal ( P = .0401) and snacks ( P = .0034), resulting in a 24% reduction in total energy intake across all ad libitum meals throughout the day (-3036 kJ; P < .0001). Fasting overall appetite suppression scores were improved with semaglutide vs placebo, while nausea ratings were similar. Semaglutide was associated with less hunger and food cravings, better control of eating and a lower preference for high-fat foods. Resting metabolic rate, adjusted for lean body mass, did not differ between treatments. Semaglutide led to a reduction from baseline in mean body weight of 5.0 kg, predominantly from body fat mass.

Conclusion: After 12 weeks of treatment, ad libitum energy intake was substantially lower with semaglutide vs placebo with a corresponding loss of body weight observed with semaglutide. In addition to reduced energy intake, likely mechanisms for semaglutide-induced weight loss included less appetite and food cravings, better control of eating and lower relative preference for fatty, energy-dense foods.

Keywords: Body composition; Energy regulation; GLP-1 analogue; Glucagon-like peptide-1; Randomised trial; Semaglutide; Type 2 diabetes; Visual analogue scale.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity / drug effects*
  • Adult
  • Appetite Depressants / administration & dosage
  • Appetite Depressants / adverse effects
  • Appetite Depressants / therapeutic use*
  • Appetite Regulation / drug effects*
  • Basal Metabolism / drug effects
  • Body Mass Index
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Energy Intake / drug effects*
  • Feeding Behavior / drug effects
  • Female
  • Food Preferences / drug effects
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Glucagon-Like Peptide-1 Receptor / metabolism
  • Glucagon-Like Peptides / administration & dosage
  • Glucagon-Like Peptides / adverse effects
  • Glucagon-Like Peptides / therapeutic use*
  • Humans
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Obesity / drug therapy*
  • Obesity / metabolism
  • Self Report
  • Weight Loss / drug effects

Substances

  • Appetite Depressants
  • GLP1R protein, human
  • Glucagon-Like Peptide-1 Receptor
  • semaglutide
  • Glucagon-Like Peptides