Sustained weight reduction with once-weekly semaglutide: results from a real-world retrospective cohort study in the United States (SCOPE 24 months).
Ruseva. Aleksandrina A; Michalak. Wojciech W; Fabricatore. Anthony A; Hartaigh. Bríain Ó BÓ; Zhao. Zhenxiang Z; Wang. Julia J; Umashanker. Devika D
Key Findings
- Average weight loss of 17.9 kg (‑16.6%) after 24 months on semaglutide.
- BMI dropped by about 6 kg/m² over the same period.
- All measured cardiometabolic risk factors (BP, HbA1c, cholesterol, triglycerides) improved significantly.
Practical Outcomes
- For biohackers aiming at long‑term weight control, staying on the maintenance dose of semaglutide (1.7 mg or 2.4 mg weekly) can deliver sustained, clinically meaningful fat loss and better metabolic health. The data support using semaglutide as a chronic weight‑management tool rather than a short‑term fix.
Summary
In a real‑world US study, people who stayed on the weekly 1.7 mg or 2.4 mg dose of semaglutide for two years lost about 18 kg (roughly 17% of their body weight) and saw big improvements in blood pressure, blood sugar, cholesterol and triglycerides.
Abstract
To evaluate the real-world effectiveness of once-weekly semaglutide for weight reduction and change in cardiometabolic risk factors at 24 months in patients with obesity or overweight. This real-world retrospective, cohort study used the US Komodo Health database, which included adults with obesity or overweight with ≥1 obesity-related condition (ORC) who started semaglutide after June 15, 2021. Eligible patients escalated to and remained on the 1.7-mg or 2.4-mg maintenance dose for the duration of the 24-month follow-up. Change in weight (primary objective) and change in cardiometabolic risk factors (BMI, blood pressure, glycated hemoglobin, cholesterol, and triglycerides; secondary objective) were assessed from index date to the end of 24-month follow-up. Paired <i>t</i> tests were used to compare means at baseline and 24 months. Of 2592 eligible patients, 630 had 24-month follow-up data for weight, BMI, or cardiometabolic risk factors. The mean (SD) age was 48.6 (9.8) years, 77.8% of patients were female, and musculoskeletal pain and dyslipidemia were the most common baseline ORCs. At 24 months, mean (%) change in body weight was -17.9 kg (-16.6%; <i>p</i> < 0.0001; <i>n</i> = 175) and mean change in BMI was -6.0 kg/m<sup>2</sup> (<i>p</i> < 0.0001; <i>n</i> = 361). Statistically significant improvements in mean values for all cardiometabolic risk factors were observed at 24 months. Real-world use of semaglutide was associated with reductions in weight and BMI and improvement in cardiometabolic risk factors at 24 months among patients with obesity or overweight. These findings support the use of semaglutide in clinical practice as an effective treatment for chronic weight management.
Study Information
pubmed
2025
2025-12-06T00:00:00.000Z
10.1080/03007995.2025.2591464
17