Effects of once-weekly semaglutide on regional body composition in overweight or obese adults

Abstract

Aim: To explore the impact of once-weekly semaglutide-induced weight loss on regional body composition in overweight or obese adults.

Methods: This retrospective cohort study enrolled 47 overweight or obese adults (body mass index ≥ 30 kg/m², or ≥ 27 kg/m² with ≥ 1 weight-related comorbidity). Participants received once-weekly semaglutide (initiated at 0.25 mg and gradually escalated to 2.0 mg) for 12 weeks, along with lifestyle intervention. The primary outcome was the change in regional body composition from baseline to week 12, which was measured using dual-energy X-ray absorptiometry.

Results: Semaglutide combined with lifestyle intervention resulted in a significant reduction in body weight (-6.77 ± 4.85 kg, P < 0.001), comprising a 4.75 kg (70.16%) loss of fat mass and a 2.02 kg (29.84%) reduction in muscle mass. The rate of visceral fat reduction was 5.16 percentage points greater than that of subcutaneous fat (21.25% vs. 16.09%; P = 0.009). With the exception of muscle mass in the right arm, both fat mass and muscle mass decreased in all other regions (all P < 0.008). The absolute reductions in fat mass, listed in descending order, were as follows: left leg (-0.74 kg), right leg (-0.71 kg), gynoid (-0.72 kg), android (-0.63 kg), left arm (-0.26 kg), and right arm (-0.19 kg). Similarly, the absolute reductions in muscle mass, in descending order, were: left leg (-0.54 kg), right leg (-0.48 kg), gynoid (-0.43 kg), android (-0.19 kg), left arm (-0.19 kg), and right arm (-0.08 kg). The muscle-to-fat ratio increased in all regions (all P < 0.008). Furthermore, multiple metabolic parameters improved concurrently.

Conclusion: Semaglutide, combined with lifestyle intervention, significantly reduces body weight, improves body composition, and enhances metabolic profiles. Future studies will further validate these findings by increasing the sample size, including parallel control groups, and extending the treatment and follow-up periods.

Keywords

Body composition / semaglutide / overweight / obese / body fat percentage / muscle-to-fat ratio

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