Effect of semaglutide 2.4 mg on physical functioning and weight‐ and health‐related quality of life in adults with overweight or obesity: Patient‐reported outcomes from the STEP 1–4 trials
Open accessAbstract
Aims: To summarize the effects of semaglutide 2.4 mg on weight‐related quality of life (WRQOL) and health‐related quality of life (HRQOL), focusing on the confirmatory secondary endpoint of physical functioning. Materials and Methods: The STEP 1–4 Phase 3a, 68‐week, double‐blind, randomized controlled trials assessed the efficacy and safety of semaglutide 2.4 mg versus placebo in individuals with overweight/obesity. WRQOL and HRQOL were assessed by change from baseline to Week 68 in two different but complementary measures, the Impact of Weight on Quality of Life‐Lite Clinical Trials Version (IWQOL‐Lite‐CT; STEP 1 and 2) and the SF‐36v2 Health Survey Acute (SF‐36v2; STEP 1–4). Results: Superiority for semaglutide 2.4 mg over placebo based on IWQOL‐Lite‐CT and SF‐36v2 physical functioning scores was confirmed in STEP 1 and 2 and in STEP 1, 2 and 4, respectively. At Week 68, a greater proportion of participants treated with semaglutide 2.4 mg than with placebo reached meaningful within‐person change (MWPC) thresholds for IWQOL‐Lite‐CT Physical Function scores in STEP 1 (51.8% vs. 28.3%; p < 0.0001) and STEP 2 (39.6% vs. 29.5%; p = 0.0083) and the MWPC threshold for SF‐36v2 Physical Functioning in STEP 1 (39.8% vs. 24.1%; p < 0.0001), STEP 2 (41.0% vs. 27.3%; p = 0.0005) and STEP 4 (18.0% vs. 6.6%; p < 0.0001). All other IWQOL‐Lite‐CT and SF‐36v2 scale scores in STEP 1–4 were numerically improved with semaglutide 2.4 mg versus placebo, except for SF‐36v2 Role Emotional in STEP 2. Conclusions: Semaglutide 2.4 mg significantly improved physical functioning, with greater proportions of participants achieving MWPC compared with placebo, and showed beneficial effects on WRQOL and HRQOL beyond physical functioning.
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The reduced mechanical load resulting from GLP-1RA-associated weight loss may improve aspects of physical function, as shown in the STEP 1-4 trials involving semaglutide.
“the reduced mechanical load resulting from GLP-1RA–associated weight loss may improve aspects of physical function, as shown in the STEP 1–4 trials involving semaglutide (123).”
From The science of safety: adverse effects of GLP-1 receptor agonists as glucose-lowering and obesity medications (2026) · cites this paper as [123]
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Tirzepatide as Compared with Semaglutide for the Treatment of Obesity
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- Authors
- Rubino, D., Bjorner, J. B., Rathor, N., Sharma, A. M., von Huth Smith, L., Wharton, S., Wadden, T., Zeuthen, N., & Kolotkin, R. L.
- Affiliations
- Washington Center for Weight Management and Research (US)
- QualityMetric Inc., LLC Johnston Rhode Island USA
- Novo Nordisk (Denmark) (DK)
- University of Alberta (CA)
- Novo Nordisk A/S Søborg Denmark
- York University (CA)
- University of Pennsylvania (US)
- Duke University (US)
- Corresponding author
- Kolotkin, Ronette L.
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2024-05-02
- Volume
- 26
- Issue
- 7
- Pages
- 2945-2955
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W4396619388
- Cited by
- 56
- References
- 7
- Citations by year
- 2026: 34 · 2025: 18 · 2024: 4
- FWCI
- 16.00
- Type
- journal article
- Language
- en
- Update notices
- correction (2025-01-14)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- Novo Nordisk (GPP2022)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- semaglutide, obesity, overweight, weight-related quality of life, health-related quality of life, physical function, SF-36v2, GLP-1 receptor agonists, weight loss, patient-reported outcomes, adverse events, serious adverse events, drug safety
- MeSH terms
- Patient Reported Outcome Measures, Semaglutide, Adult, Double-Blind Method, Glucagon-Like Peptides, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Obesity, Quality of Life, Weight Loss, Overweight
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