Endocrine Abstracts

Background: In 2023, NICE approved Semaglutide for the treatment of obesity in adults with BMI ≥35 kg/m², with at least one weight-related comorbidity, within Tier-3 weight management services. Continuation beyond 6 months requires ≥5% weight loss, with a maximum duration of 2 years.

Objective: To evaluate real-world effectiveness and tolerability of Wegovy in an NHS Tier-3 weight management service.

Method: A retrospective study of adults starting Wegovy between January 2024 and August 2025 in Musgrove Park Hospital, Taunton with data collection of demographics, weight, BMI, treatment duration, and discontinuation through electronic records.

Results: Of 181 patients (mean age 51.3 ± 12.4 years; 66 % female), baseline weight was 142.1 ± 34.9 kg and BMI 50.1 ± 10.5 kg/m². At 6 months, 116/181 (64%) had weight data: mean weight loss 9.5 ± 5.2%. 27/181 (14.9 %) discontinued during the first 6 months (side effects 14/181, 7.7 %; <5 % weight loss 8/181, 4.4 %; poor adherence 5/181, 2.8 %). 38/181 had been on treatment <6 months and, 16/181 (8.8 %) discontinued Wegovy between 6–12 months (bariatric surgery 4/181, 2.2 %; swapped to tirzepatide 5/181, 2.8 %; complications 3/181, 1.7 %; conception planning 2/181, 1.1 %; target weight 1/181, 0.6 %; death 1/181, 0.6 %). At 12 months, 65/181 had follow-up weight data, with mean weight loss of 13.5 ± 6.5%, and 138/181 (76.2%) remained on treatment.

Discussion: In comparison with global studies, weight loss at 12 months is similar (13.5% vs 14.9%)¹. Treatment persistence at 6 months is significant 81% vs 46.3%, ²while discontinuation due to side effect is 7.7%. Despite sporadic availability of semaglutide in NHS, this can be effective management.

References: 1. Wilding, J. P. H., et al. (2021). N Engl J Med, 384, 989–1002. 2. Gleason, P. P., et al. (2024). JMCP, 30(8), 860–867.