Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial.

Ryan DH, Lingvay I, Deanfield J, Kahn SE, Barros E, Burguera B, Colhoun HM, Cercato C, Dicker D, Horn DB, Hovingh GK, Jeppesen OK and 8 more

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Kokkinos A, Lincoff AM, Meyhöfer SM, Oral TK, Plutzky J, van Beek AP, Wilding JPH, Kushner RF

Nature medicine13 May 2024Cited by 275 (Europe PMC)

PMID38740993PMCIDPMC11271387DOI10.1038/s41591-024-02996-7PepBankPUB-38740993

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Summary

In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes. Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI). In patients treated with semaglutide, weight loss continued over 65 weeks and was sustained for up to 4 years. At 208 weeks, semaglutide was associated with mean reduction in weight (-10.2%), waist circumference (-7.7 cm) and waist-to-height ratio (-6.9%) versus placebo (-1.5%, -1.3 cm and -1.0%, respectively; P < 0.0001 for all comparisons versus placebo). Clinically meaningful weight loss occurred in both sexes and all races, body sizes and regions. Semaglutide was associated with fewer serious adverse events. For each BMI category (-²) there were lower rates (events per 100 years of observation) of serious adverse events with semaglutide (43.23, 43.54, 51.07 and 47.06 for semaglutide and 50.48, 49.66, 52.73 and 60.85 for placebo). Semaglutide was associated with increased rates of trial product discontinuation. Discontinuations increased as BMI class decreased. In SELECT, at 208 weeks, semaglutide produced clinically significant weight loss and improvements in anthropometric measurements versus placebo. Weight loss was sustained over 4 years. ClinicalTrials.gov identifier: NCT03574597 .

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study12

12 results from studies that gave the peptide. 12 results from people.

01HumanRandomized controlled trialEfficacy outcome
In adults with cardiovascular disease and overweight or obesity without diabetes, weight loss with semaglutide continued over 65 weeks and was sustained for up to 4 years.
In plain wordsIn adults with heart disease and excess weight, weight loss on semaglutide continued for 65 weeks and held for up to 4 years.
Peptide
Semaglutide
Outcome
DecreaseWeight loss over time
Study
n = 17,604
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated · up to 4 yearsAs given in this study (human).
Source sentences
Summary
In patients treated with semaglutide, weight loss continued over 65 weeks and was sustained for up to 4 years.
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099301
02HumanRandomized controlled trialEfficacy outcome
At 208 weeks, semaglutide reduced body weight by 10.2% versus 1.5% with placebo (P < 0.0001).
In plain wordsAfter 208 weeks, people on semaglutide lost more body weight than people on placebo.
Peptide
Semaglutide
Outcome
DecreaseBody weight change at 208 weeks
Study
n = 17,604
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated · 208 weeksAs given in this study (human).
Measurements
Weight change
−10.2%
semaglutide
Weight change
−1.5%
placebo
Source sentences
Summary
At 208 weeks, semaglutide was associated with mean reduction in weight (-10.2%), waist circumference (-7.7 cm) and waist-to-height ratio (-6.9%) versus placebo (-1.5%, -1.3 cm and -1.0%, respectively; P < 0.0001 for all comparisons versus placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099302
03HumanRandomized controlled trialEfficacy outcome
At 208 weeks, semaglutide reduced waist circumference by 7.7 cm versus 1.3 cm with placebo (P < 0.0001).
In plain wordsAfter 208 weeks, waist size fell more with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
DecreaseWaist circumference change at 208 weeks
Study
n = 17,604
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated · 208 weeksAs given in this study (human).
Measurements
Waist circumference change
−7.7 cm
semaglutide
Waist circumference change
−1.3 cm
placebo
Source sentences
Summary
At 208 weeks, semaglutide was associated with mean reduction in weight (-10.2%), waist circumference (-7.7 cm) and waist-to-height ratio (-6.9%) versus placebo (-1.5%, -1.3 cm and -1.0%, respectively; P < 0.0001 for all comparisons versus placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099303
04HumanRandomized controlled trialEfficacy outcome
At 208 weeks, semaglutide reduced the waist-to-height ratio by 6.9% versus 1.0% with placebo (P < 0.0001).
In plain wordsAfter 208 weeks, the waist-to-height ratio fell more with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
DecreaseWaist-to-height ratio change at 208 weeks
Study
n = 17,604
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated · 208 weeksAs given in this study (human).
Measurements
Waist-to-height ratio change
−6.9%
semaglutide
Waist-to-height ratio change
−1%
placebo
Source sentences
Summary
At 208 weeks, semaglutide was associated with mean reduction in weight (-10.2%), waist circumference (-7.7 cm) and waist-to-height ratio (-6.9%) versus placebo (-1.5%, -1.3 cm and -1.0%, respectively; P < 0.0001 for all comparisons versus placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099304
05HumanRandomized controlled trialEfficacy outcome
Clinically meaningful weight loss with semaglutide occurred in both sexes and all races, body sizes and regions.
In plain wordsSemaglutide led to meaningful weight loss in men and women, in all races, body sizes and regions studied.
Peptide
Semaglutide
Outcome
DecreaseWeight loss across sexes, races, body sizes and regions
Study
n = 17,604
Comparator
Placebo
Outcome group
Body weight · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Clinically meaningful weight loss occurred in both sexes and all races, body sizes and regions.
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099305
06HumanRandomized controlled trialSafety outcome
Semaglutide was associated with fewer serious adverse events than placebo.
In plain wordsPeople on semaglutide had fewer serious side effects than people on placebo.
Peptide
Semaglutide
Outcome
DecreaseSerious adverse events
Study
n = 17,604
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
Semaglutide was associated with fewer serious adverse events.
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099306
07HumanRandomized controlled trialSafety outcome
Semaglutide was associated with increased rates of trial product discontinuation compared with placebo.
In plain wordsMore people stopped taking semaglutide during the trial than stopped taking placebo.
Peptide
Semaglutide
Outcome
IncreaseTrial product discontinuation
Study
n = 17,604
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
Semaglutide was associated with increased rates of trial product discontinuation.
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099311
08HumanRandomized controlled trialSafety outcome
Discontinuations with semaglutide increased as BMI class decreased.
In plain wordsPeople with lower BMI were more likely to stop semaglutide than people with higher BMI.
Peptide
Semaglutide
Outcome
MixedDiscontinuation by BMI class
Study
n = 17,604
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Source sentences
Summary
Discontinuations increased as BMI class decreased.
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099312
09HumanRandomized controlled trialSafety outcome
In the BMI <30 category, serious adverse events were 43.23 per 100 years of observation with semaglutide versus 50.48 with placebo.
In plain wordsIn people with BMI below 30, serious side effects were less frequent with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
DecreaseSerious adverse event rate, BMI <30
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Measurements
Serious adverse event rate
43.23 events per 100 years
semaglutide, BMI <30
Serious adverse event rate
50.48 events per 100 years
placebo, BMI <30
Source sentences
Summary
For each BMI category (-²) there were lower rates (events per 100 years of observation) of serious adverse events with semaglutide (43.23, 43.54, 51.07 and 47.06 for semaglutide and 50.48, 49.66, 52.73 and 60.85 for placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099307
10HumanRandomized controlled trialSafety outcome
In the BMI 30 to <35 category, serious adverse events were 43.54 per 100 years of observation with semaglutide versus 49.66 with placebo.
In plain wordsIn people with BMI 30 to under 35, serious side effects were less frequent with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
DecreaseSerious adverse event rate, BMI 30 to <35
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Measurements
Serious adverse event rate
43.54 events per 100 years
semaglutide, BMI 30 to <35
Serious adverse event rate
49.66 events per 100 years
placebo, BMI 30 to <35
Source sentences
Summary
For each BMI category (-²) there were lower rates (events per 100 years of observation) of serious adverse events with semaglutide (43.23, 43.54, 51.07 and 47.06 for semaglutide and 50.48, 49.66, 52.73 and 60.85 for placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099308
11HumanRandomized controlled trialSafety outcome
In the BMI 35 to <40 category, serious adverse events were 51.07 per 100 years of observation with semaglutide versus 52.73 with placebo.
In plain wordsIn people with BMI 35 to under 40, serious side effects were slightly less frequent with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
DecreaseSerious adverse event rate, BMI 35 to <40
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Measurements
Serious adverse event rate
51.07 events per 100 years
semaglutide, BMI 35 to <40
Serious adverse event rate
52.73 events per 100 years
placebo, BMI 35 to <40
Source sentences
Summary
For each BMI category (-²) there were lower rates (events per 100 years of observation) of serious adverse events with semaglutide (43.23, 43.54, 51.07 and 47.06 for semaglutide and 50.48, 49.66, 52.73 and 60.85 for placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099309
12HumanRandomized controlled trialSafety outcome
In the BMI 40 or higher category, serious adverse events were 47.06 per 100 years of observation with semaglutide versus 60.85 with placebo.
In plain wordsIn people with BMI 40 or more, serious side effects were less frequent with semaglutide than with placebo.
Peptide
Semaglutide
Outcome
DecreaseSerious adverse event rate, BMI >=40
Study
n: not reported in source
Comparator
Placebo
Outcome group
Adverse events · Whole body
Studied dose
Dose not stated
Measurements
Serious adverse event rate
47.06 events per 100 years
semaglutide, BMI >=40
Serious adverse event rate
60.85 events per 100 years
placebo, BMI >=40
Source sentences
Summary
For each BMI category (-²) there were lower rates (events per 100 years of observation) of serious adverse events with semaglutide (43.23, 43.54, 51.07 and 47.06 for semaglutide and 50.48, 49.66, 52.73 and 60.85 for placebo).
2 context sentences(design, population, supporting numbers)
Summary · context
In the SELECT cardiovascular outcomes trial, semaglutide showed a 20% reduction in major adverse cardiovascular events in 17,604 adults with preexisting cardiovascular disease, overweight or obesity, without diabetes.
Summary · context
Here in this prespecified analysis, we examined effects of semaglutide on weight and anthropometric outcomes, safety and tolerability by baseline body mass index (BMI).
Show in the study text Report a problemFND-3874099310

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Registered trials2

Trials this study reports on, or that list this study as a reference. Registry data from ClinicalTrials.gov.

2 trials · 1 ongoing · 1 completed · 1 with posted results · source ClinicalTrials.gov (opens in a new tab)

RecruitingPhase 4NCT07513168

Low-Dose Semaglutide for Weight Loss in Obese Non-Diabetic Pakistani Adults

Asian Institute Of Medical Sciencesn = 601 Aug 2025 to est. 1 Dec 2026

Obesity · Weight Reduction · Cardiometabolic Risk Factors

Trial page ClinicalTrials.govUpdated 6 Apr 2026

CompletedPhase 3Results postedNCT03574597

Semaglutide Effects on Heart Disease and Stroke in Patients With Overweight or Obesity

Novo Nordisk A/Sn = 17,60424 Oct 2018 to 29 Jun 2023

Overweight · Obesity

Trial page ClinicalTrials.govUpdated 30 Aug 2024

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

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