Semaglutide in Obesity and Exercise Medicine: A Review of Clinical Evidence, Performance Implications, and Implementation Challenges

Background. Obesity is a growing global public health issue. Semaglutide (Ozempic), a glucagon-like peptide-1 receptor agonist (GLP-1 RA), represents a breakthrough in obesity pharmacotherapy, with documented benefits in weight reduction, metabolic control, and cardiovascular risk reduction. Aim. To review key clinical evidence on semaglutide in obesity treatment, explain its mechanism of action, and discuss practical aspects of implementing semaglutide therapy in Poland, including accessibility and long-term use, with particular emphasis on integration with physical activity and rehabilitation. Material and methods. The article is based on a narrative synthesis of existing sources, including key clinical trials, meta-analyses, international recommendations, and Polish regulatory and reimbursement documents concerning semaglutide use in obesity. Conclusions. Semaglutide is an effective and innovative pharmacological option in obesity management, with additional potential benefits for physical activity tolerance and weight-related rehabilitation in both recreationally active and sedentary individuals. Optimal long-term outcomes require combining semaglutide therapy with comprehensive lifestyle interventions, particularly structured exercise programs, while addressing challenges of accessibility and long-term treatment in Poland.