Does More Semaglutide Mean More Weight Loss?
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Semaglutide is a medication that helps people with type 2 diabetes manage their blood sugar and lose weight. It's usually taken once a week by injection. While the approved dose goes up to 2 mg per week, researchers wanted to know if higher doses—up to 16 mg—could help even more.
What the Study Looked At
A clinical trial tested semaglutide at 2 mg, 8 mg, and 16 mg per week in people with type 2 diabetes who were also overweight or obese. Everyone in the study was already taking metformin. The trial lasted 40 weeks and compared changes in blood sugar levels and body weight.
Blood Sugar Control: Limited Extra Effect
All doses of semaglutide helped lower blood sugar levels, but the benefit of increasing the dose was small. For example, the difference in HbA1c (a long-term measure of blood sugar) between 2 mg and 16 mg was only about 0.5%. This small change might not matter much in real-world diabetes management.
Weight Loss: Higher Dose, Bigger Drop
Where higher doses did make a difference was in weight loss. Here’s what the study found:
- 2 mg: about 7–8% body weight loss
- 8 mg: about 9% weight loss
- 16 mg: nearly 13% weight loss
This means people on the highest dose lost more weight—up to 4.5 kg (about 10 pounds) more than those on 2 mg. For those struggling with obesity, this is a meaningful difference.
Side Effects: A Bigger Issue at Higher Doses
The downside? More side effects. People taking 8 mg or 16 mg had more problems like nausea, vomiting, and diarrhea. Some had to stop the treatment altogether. A few also experienced unusual nerve sensations in the skin, like tingling or numbness.
This makes the higher doses harder to stick with, especially if the goal is just better blood sugar control.
Bottom Line
Higher doses of semaglutide can help with more weight loss—but the improvement in blood sugar is only slightly better. More importantly, the chance of side effects goes up at higher doses. For most people, the approved 2 mg dose offers a good balance of benefits and tolerability. Future studies may show if higher doses can be used more safely in people who mainly want to lose weight.