Understanding the Limitations and Risks of Semaglutide for Weight Loss

Recent insights published in JAMA Cardiology shed light on the significant limitations and potential risks associated with semaglutide, a medication often prescribed for weight management. Despite its popularity and ability to induce weight loss, several concerns have been raised regarding its long-term effectiveness and safety.

A key issue is the moderate effectiveness of semaglutide, with many users experiencing weight loss plateaus. Studies such as the SELECT trial reveal that after four years of treatment, only about 12% of participants achieved a normal BMI. The majority remained in the overweight or obese categories, and weight regain was common once the medication was discontinued, as shown by the STEP-1 extension study.

Furthermore, adverse events are prevalent among users, and the long-term safety profile of semaglutide remains uncertain. An observational study linked the drug to an increased risk—more than fourfold to sevenfold—for nonarteritic anterior ischemic optic neuropathy, a serious vision problem.

In contrast, plant-based diets have demonstrated substantial benefits for weight loss and cardiometabolic health. The BROAD study, for example, showed that participants on a low-fat plant-based diet lost an average of 12.1 kg over six months, with greater improvements in cholesterol levels compared to standard care.

Dr. Vanita Rahman emphasizes that while semaglutide offers some weight loss benefits, its limitations and potential risks highlight the importance of exploring safer, sustainable alternatives such as dietary interventions. Public awareness of plant-based diets’ benefits is growing, with many adults recognizing its positive health impacts. However, few healthcare providers actively discuss this option with patients.

In light of these findings, health professionals should consider endorsing nutritious, low-cost, risk-free strategies like plant-based diets to combat obesity and reduce associated health risks effectively.