Krajnc Mitja, Kuhar Neža, Koceva Andrijana
Department of Endocrinology and Diabetology, Clinic of Internal Medicine, University Medical Centre Maribor, Maribor, Slovenia.
Faculty of Medicine, University of Maribor, Maribor, Slovenia.
Front Endocrinol (Lausanne). 2025 May 29;16:1593334. doi: 10.3389/fendo.2025.1593334. eCollection 2025.
Clinical obesity is a prevalent chronic disease, significantly increasing morbidity and mortality while impairing quality of life. As diet and physical activity interventions often prove ineffective in the long term, with increasing use of pharmacotherapy, drug shortages and injection aversion present a challenge. The role of oral semaglutide at a dose of 14 mg (registered for type 2 diabetes) as a treatment for obesity in patients without diabetes remains undefined.
In the retrospective real-world study, which included 93 adults without diabetes (57% women, average age 52 years), we assessed whether treatment with 14 mg oral semaglutide over one year is associated with lower body weight, body mass index (BMI), waist circumference, blood pressure, heart rate, and obesity staging according to EOSS.
Of the 93 subjects recruited, 82 (88%) were receiving oral semaglutide at a dose of 14 mg after one year. After one year of treatment body weight was significantly lower by 5.7% (5.9 kg) in completers, and BMI decreased significantly by an average of 2 kg/m². There was also a significant reduction in waist circumference by 5.5 cm and a decrease in EOSS score by 0.1. Clinically significant weight loss was achieved in 46% of all participants, with rare individuals experiencing a decrease of ≥ 15%. Adverse effects were mostly mild, with nausea reported by 23% and vomiting and diarrhoea by 12% of participants.
Obesity treatment with oral semaglutide at a dose of 14 mg showed marked interindividual variability, with approximately half achieving clinically significant reductions - mostly under 10%. Although less effective than injectable therapy, oral semaglutide at a dose of 14 mg had a favorable safety profile and may be suitable in selected clinical scenarios.
临床肥胖是一种常见的慢性疾病，在损害生活质量的同时，显著增加发病率和死亡率。由于饮食和体育活动干预措施长期来看往往效果不佳，随着药物治疗的使用增加，药物短缺和注射厌恶带来了挑战。14毫克口服司美格鲁肽（已注册用于2型糖尿病）在无糖尿病患者中作为肥胖治疗药物的作用尚不明确。
在这项回顾性真实世界研究中，纳入了93名无糖尿病的成年人（57%为女性，平均年龄52岁），我们评估了一年使用14毫克口服司美格鲁肽治疗是否与更低的体重、体重指数（BMI）、腰围、血压、心率以及根据EOSS的肥胖分期相关。
在招募的93名受试者中，82名（88%）在一年后接受了14毫克的口服司美格鲁肽治疗。治疗一年后，完成治疗者的体重显著降低了5.7%（5.9千克），BMI平均显著降低了2千克/平方米。腰围也显著减少了5.5厘米，EOSS评分降低了0.1。所有参与者中有46%实现了具有临床意义的体重减轻，极少有人体重下降≥15%。不良反应大多轻微，23%的参与者报告有恶心，12%报告有呕吐和腹泻。
14毫克口服司美格鲁肽治疗肥胖显示出明显的个体差异，约一半人实现了具有临床意义的体重减轻——大多低于10%。虽然不如注射疗法有效，但14毫克口服司美格鲁肽具有良好的安全性，可能适用于某些特定临床情况。
