Semaglutide helps control food cravings in addition to weight loss in overweight adults

"We showed that over a longer duration of 104 weeks, semaglutide 2.4 mg improved the ability of participants to control their eating, making it easier to resist food cravings compared to placebo, the researchers wrote.

The findings obtained from the data analysis from the STEP 5 trial imply that semaglutide 2.4 mg could be an effective longer-term treatment for obese/overweight adults by improving the control of eating and food cravings, enabling patients to achieve and maintain substantial weight loss.

Once-weekly, subcutaneously injected glucagon-like peptide-1 receptor agonist semaglutide 2.4 mg is approved as an adjunctive therapy to lifestyle recommendations to maintain and achieve weight loss in overweight/obese people. In previous studies,semaglutide has been demonstrated to be effective in reducing body weight and having short-term favorable effects on the control of eating aspects such as fullness and hunger, food cravings, and mood in overweight/obese people.

Against the above background, Sean Wharton from McMaster University and Wharton Weight Management Clinic in Burlington, Ontario, Canada, and colleagues aimed to evaluate the effect of once-weekly semaglutide 2.4 mg on 2-year control of eating.

The STEP 5 trial comprised overweight/obese adults randomized in the ratio of 1:1 to receive semaglutide 2.4 mg or placebo, plus lifestyle modification for 104 weeks. A 19-item Control of Eating Questionnaire was administered in a subgroup of patients at weeks 0, 20, 52, and 10.

The study led to the following findings:

• In patients completing the Control of Eating Questionnaire (semaglutide, n = 88; placebo, n = 86), mean body weight changes were −14.8% (semaglutide) and −2.4% (placebo).
• With semaglutide, scores were significantly improved compared to placebo for Craving Control and Craving for Savory domains at weeks 20, 52, and 104; for Positive Mood and Craving for Sweet parts at weeks 20 and 52; and for hunger and fullness at week 20.
• Improvements in craving domain scores positively correlated with body weight reductions from baseline to week 104 with semaglutide.
• At 104 weeks, scores for the desire to eat spicy and salty food, cravings for dairy and starchy foods, difficulty in resisting cravings, and control of eating were significantly reduced with semaglutide versus placebo.

"Semaglutide improves short- and longer-term control of eating, with patients reporting reduced hunger, fewer cravings, and increased feelings of fullness," the researchers wrote. "Additionally, semaglutide prevents the compensatory appetite increases that would otherwise be expected following substantial weight loss."

"Together, these changes most likely underlie the marked and sustained effects of weight loss seen with once-weekly semaglutide 2.4 mg," they conclude.

Reference:

Wharton S, Batterham RL, Bhatta M, Buscemi S, Christensen LN, Frias JP, Jódar E, Kandler K, Rigas G, Wadden TA, Garvey WT. Two-year effect of semaglutide 2.4 mg on control of eating in adults with overweight/Obesity: STEP 5. Obesity (Silver Spring). 2023 Jan 18. doi: 10.1002/oby.23673. Epub ahead of print. PMID: 36655300.