Online clinic obesity reaches weight loss at the clinical level at lower semaglutide doses

New studies presented at this year’s European Congress of Obesity (Eco 2025) showed that patients from the online obesity clinic achieved a similar weight loss as reported in clinical trials – but with less than half of the drug. The study is to be published in the journal

Patients who followed the program had an average weight loss of 16.7 (16.8 kg/2 9 pounds) after 64 weeks, which is equally visible in randomized controlled studies of the same drug, SemglutideAND glucagon-Donal agonist Peptid-1 (GLP-1) receptor.

Achieving the same weight loss in everyday life as in strictly controlled conditions of clinical examination, although also the use of lower doses of drugs, has many potential benefits, from lower costs and lower side effects for patients, to ensure that the reserves of the drug go further. “

Dr. Henrik Gudbergsen, Main Researcher and Medical Director of EMBLA, Internet Slimming Service

Semaglutide and other GLP-1 agonists have impressive results in clinical trials for weight loss. However, research in the real world has shown less weight loss and there is a lack of details about whether patients also introduce lifestyle changes that will increase the likelihood of achieving optimal weight loss.

The actual test results also suggest that few patients follow the standard dosage schedule, and most of which remain in lower doses.

In the first study of this kind, Dr. Gudbergsen and colleagues from the University of Copenhagen assessed the actual effects of the online weight loss program, which provides intensive behavioral therapy and tips on diet and exercise, as well as the doses of semaglutide that are adapted to individual patients.

2694 people in Denmark (78% of women, average age 47, average BMI 34.3, average body weight 100.5 kg/15st 12 pounds) took part in the cohort study, which were enrolled in the weight management program led by the EMBLA application, available in Denmark and Great Britain.

The program included advice on healthy eating, increasing exercises and the use of cognitive behavioral therapy (CBT) and other therapies to overcome psychological barriers in slimming, access to doctors, nurses and psychologists through the AI ​​powered application and the course of drug semaglutrid for slimming (Wegova).

The standard dosage schedule in which the low initial dose of 0.25 mg after a week is increased every four weeks for 16 weeks to a maximum dose of 2.4 mg (which the patient remains until the end of treatment) was adapted to individual patients.

Patients received the lowest effective dose, and increases were considered only if they stopped making progress. If they maintained a weekly weight reduction> 0.5% of their body weight and experienced possible levels of side effects and hunger, they remained in the existing dose. The treatment lasted in this way until they reached the desired weight or BMI of 25 – the approach known as “Tread is a goal”.

After 26, 64 and 76 weeks, 1580, 712 and 465 patients, respectively, continued to participate in the program.

The average weight loss among people who still take part in the program amounted to 12.2% (12.2 kg/1st 13lb) in week 26, 16.2% (16.3 kg/2 8 pounds) in the week 52 and 16.7% (16.8 kg, 2 9LB) at week 64.

Scientists note that this is similar to 15-16% weight loss after 64 weeks achieved by patients who took part in clinical trials, in which semaglutide was combined with lifestyle interventions, such as calorie controlled diets and behavioral therapy.^1-3

However, this was achieved less than half of the drug used in clinical trials. The average dose of semaglutide in this study was about 1 mg/week, and only 28.8% of patients achieved doses higher than that.

However, about 90% of patients in clinical trials reached a dose of 2.4 mg/week.

Dr. Gubdergsen, who is also an associate professor at the University of Copenhagen, says: “Combining diet tips and exercises with psychological coaching and personalization of semaglutide doses, it was possible to achieve the same weight loss at lower doses of the drug.”

About 98% out of 515 patients with weight in the week 52-64 reached at least 5% weight loss, and 82%, 51% and 23% reached 10%, 15% and 20% of weight loss, respectively.

Women had a higher weight loss than men (17.6 % vs 13.4 %) and patients who used online applications, lost more weight than those who used it less.

The analysis also showed that the loss of patient mass was similar, regardless of their initial BMI, age or the amount of semaglutide used. In other words, the lower doses of semaglutide were as effective as higher.

Side effects, such as nausea, vomiting and stomach pain, were generally mild and temporary.

Research restrictions include the use of data reported by you and the lack of a control group.

Dr. Gudbergsen sums up: “Our results show that by giving personalized doses of semaglutide together with diet, exercises and psychological support, patients can achieve weight loss at the clinical level in everyday life.

“Our approach” target treatment “, in which the number of drugs was adapted to the purposes of each patient, allowed us to keep the doses as low as possible, which should mean lower costs and less side effects for patients.

“This approach was effective in all age groups and all initial weights and in both sexes.”