Ozempic and Wegovy Show Major Weight Loss Benefits for Adults Over 65, New Study Confirms

A comprehensive new analysis of clinical trial data reveals that semaglutide—the active ingredient in blockbuster drugs Ozempic and Wegovy—produces substantial weight loss and health improvements in adults aged 65 and older with obesity. The findings, presented by researchers from the University of Padova in Italy and Novo Nordisk, suggest that older adults can achieve results comparable to younger populations, though with some important safety considerations.

Why This Matters for Older Adults

Obesity is not just a concern for younger generations. In fact, experts point out that in many high-income countries, the majority of excess weight cases occur in people aged 65 and over. This is a significant public health issue because carrying extra weight in later life is linked to a higher risk of heart disease, type 2 diabetes, joint problems, and reduced mobility. It can also seriously impact quality of life and contribute to disability.

Dr. Luca Busetto, the study’s lead author, emphasized that older adults with obesity are often medically vulnerable. They frequently have multiple chronic conditions, take several medications, and may experience frailty. These factors can make treating obesity more complicated. Until now, there has been limited information about how GLP-1 receptor agonists like semaglutide perform specifically in this age group.

How the Study Was Conducted

To better understand the drug’s effects in older adults, researchers analyzed data from six major clinical trials known as the STEP program (STEP 1, 3, 4, 5, 8, and 9). These trials are some of the most well-known studies examining semaglutide for weight management.

The analysis focused specifically on participants aged 65 years and older who had obesity (a body mass index of 30 or higher) or were overweight (BMI of 27 or higher) with at least one obesity-related complication. Importantly, the study excluded people with diabetes because weight loss results in obesity drug trials tend to be lower in those with diabetes, which would make direct comparisons less clear.

Participants were randomly assigned to receive either a weekly injection of semaglutide 2.4 mg or a placebo. Everyone in the study also received lifestyle counseling, including diet and exercise advice. Those in one specific trial (STEP 3) received additional intensive behavioral therapy.

The study tracked participants for 68 weeks—roughly 16 months. Researchers measured changes in body weight, waist circumference, waist-to-height ratio, BMI category, and several cardiometabolic risk factors. These included blood pressure, cholesterol levels, blood fats (triglycerides), blood sugar measures, and a marker of inflammation called hs-CRP. Adverse events were also carefully recorded.

Key Results: Weight Loss and Health Improvements

Out of the total 4,523 participants across all the trials, 358 were aged 65 or older and included in this analysis. Of those, 248 received semaglutide and 110 received placebo. The majority (90%) were between 65 and 74 years old, with the remaining 10% aged 75 and older.

At the start of the study, the average participant was 69 years old, weighed about 99 kilograms (roughly 218 pounds), had a BMI of 36.6 (classified as class II obesity), and a waist circumference of 115 centimeters (about 45 inches). Women made up 72% of the group.

By the end of the 68-week period, the results were striking:

– Weight loss: Participants taking semaglutide lost an average of 15.4% of their body weight, compared to just 5.1% in the placebo group.

• Waist circumference: The semaglutide group saw an average reduction of 14.3 centimeters (about 5.6 inches), versus 6.0 centimeters (about 2.4 inches) with placebo.
• Major weight loss milestones:
• At least 10% weight loss: 66.5% of semaglutide users achieved this, compared to 15.5% on placebo.
• At least 15% weight loss: 46.8% versus 6.4%.
• At least 20% weight loss: 28.6% versus 2.7%.

Researchers also observed significant improvements in waist-to-height ratio and BMI categories. For example, 27% of semaglutide users reached a BMI below 27 (classified as overweight or healthy weight), compared to only 5.5% in the placebo group. Additionally, 11.3% of those on semaglutide achieved a waist-to-height ratio below 0.53, a marker associated with lower health risk, compared to 4.5% on placebo.

Improvements in Heart Health Markers

Beyond weight loss, the semaglutide group showed better results across several cardiometabolic risk factors. These included reductions in blood pressure, improvements in cholesterol and blood fat levels, and better blood sugar control as measured by glycated hemoglobin (HbA1c). These are all important indicators for reducing the risk of heart disease and diabetes, conditions that become more common with age.

Safety and Side Effects: What to Know

No medication is without risks, and semaglutide is no exception. Overall, the rate of any adverse event was similar between groups—89.1% in the semaglutide group and 84.5% in the placebo group. However, serious adverse events were reported more frequently in the semaglutide group (19.0%) compared to the placebo group (12.7%).

Specific side effects that were more common with semaglutide included constipation and dizziness. These are known issues with GLP-1 medications, which work by slowing digestion and affecting appetite signals in the brain. Rates of fractures and dangerously low blood sugar (hypoglycemia) were low in both groups, affecting less than 1% of participants.

It is important to note that the study was sponsored by Novo Nordisk, the manufacturer of semaglutide. Independent experts often recommend reviewing such findings with this context in mind.

Practical Takeaways for Older Adults and Their Doctors

For older adults struggling with obesity, these findings offer a potential new option, but they also come with important considerations.

– Talk to your doctor: Weight loss medications are not a one-size-fits-all solution. A healthcare provider can help determine if semaglutide is appropriate based on your overall health, other medications, and medical history.

• Lifestyle changes are still key: All participants in the study received lifestyle counseling. Medication works best when combined with healthy eating and regular physical activity.
• Monitor side effects: Older adults may be more sensitive to side effects like dizziness, which can increase fall risk. Constipation is also a common concern that should be managed with diet, hydration, and sometimes medication adjustments.
• Consider the bigger picture: Weight loss in older adults can improve mobility, reduce joint pain, and lower the risk of chronic disease. However, rapid or significant weight loss can also lead to muscle loss, which is already a concern with aging. Discussing strategies to preserve muscle mass, such as strength training and adequate protein intake, is essential.

Dr. Busetto concluded that these results support the use of semaglutide in patients aged 65 and older, noting that the safety and effectiveness profile is consistent with what has been seen in the broader STEP program. For many older adults, managing obesity could mean not just a longer life, but a healthier and more active one.

Source: ScienceDaily