Real-world Evidence of Injection Semaglutide 2.4 mg in Indian Adults with Obesity: Effects on Weight Loss and Metabolic Outcomes

Introduction: Obesity, a serious chronic disease, is rapidly rising in India and is strongly linked to diabetes and cardiovascular complications, often at lower body mass index (BMI) levels in Asian Indians. Real-world evidence on injection semaglutide 2.4 mg in the Indian population remains limited following its recent approval, underscoring the need for clinical practice-based data. Materials and Methods: This real-world, multicenter, retrospective, observational study conducted in India included 50 obese adults who were treated with injection semaglutide 2.4 mg. After 6 months of treatment, changes in anthropometric, body composition, and glycemic index were extracted from a structured clinical database. Changes from baseline to follow-up were evaluated using paired statistical tests, and responder rates (≥5% and ≥10% weight loss) were calculated, with analyses conducted on available-case data. Results: Treatment with injection of semaglutide 2.4 mg resulted in significant reductions in weight, BMI, and body fat percentage. Mean body weight decreased by 13.39 ± 6.04 kg (estimated treatment difference), corresponding to a 14.7% relative reduction from baseline (P < 0.001). After around 6-month of treatment, BMI declined significantly by 5.02 ± 2.42 kg/m2 (P < 0.001) and body fat percentage decreased by 5.27 ± 5.89 percentage points (P < 0.001), representing a 14.5% relative reduction with preservation of muscle mass. Fat loss constituted approximately one-third of total body weight reduction. Around 94% and 80% of patients achieved ≥5% and ≥10% weight loss, respectively. The glycated hemoglobin level decreased by 1.11% (P < 0.001), indicating improved glycemic control. Weight loss was consistent across dose groups and follow-up durations, with predominantly mild gastrointestinal adverse events and high patient-reported satisfaction (82%). Conclusion: Injection of semaglutide 2.4 mg was found to be more efficacious and had a favorable safety profile in Indian adults with obesity, producing significant weight and fat loss, while preserving lean mass and supporting improvements in muscle function and metabolic parameters.