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The following is a summary of “Oral semaglutide for the treatment of obesity: a retrospective real-world study,” published in the May 2025 issue of Frontiers in Endocrinology by Krajnc et al. 

Clinical obesity, a prevalent and morbid chronic condition where the long-term effectiveness of diet and exercise is limited, and pharmacotherapy faces challenges like shortages and injection aversion, necessitates exploration of oral semaglutide’s role (currently approved for type 2 diabetes at 14 mg) in treating obesity in individuals without diabetes.  

Researchers conducted a retrospective study to evaluate the efficacy and safety of oral semaglutide 14 mg in managing individuals with obesity and without diabetes.  

They analyzed data from 93 adults without diabetes (57% women; mean age, 52 years) to examine the association between 14 mg oral semaglutide use and changes in clinical measures over 1 year. Body weight, body mass index (BMI), waist circumference, blood pressure, heart rate, and obesity stage based on the Edmonton Obesity Staging System (EOSS) were evaluated before and after treatment.   

The results showed that 82 of 93 participants (88%) remained on 14 mg oral semaglutide after 1 year. Body weight decreased by 5.7% (5.9 kg), and BMI declined by 2 kg/m² in completers. The waist circumference dropped by 5.5 cm, and EOSS score was reduced by 0.1. Clinically significant weight loss occurred in 46% of participants, while a reduction of ≥15% was observed in a few cases. Nausea was reported in 23%, and vomiting or diarrhea in 12%, with most adverse effects being mild.   

Investigators concluded that oral semaglutide 14 mg led to variable weight loss outcomes but showed a favorable safety profile, supporting its use in select cases. 

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1593334/full