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Semaglutide, initially hailed for its efficacy in managing type 2 diabetes, has grow increasingly prominent as a weight-loss drug, prompting both excitement and caution among medical professionals. A recent analysis of the SELECT trial, published in The Lancet, revealed that the benefits of semaglutide for cardiovascular health extend beyond weight reduction, even in patients without diabetes.
The growing adoption of semaglutide and similar GLP-1 receptor agonists (GLP-1RAs) is driven by substantial results. The Step-1 trial demonstrated an average 15% reduction in body weight over 68 weeks in individuals without diabetes receiving weekly semaglutide injections. The 2023 SELECT trial further solidified its benefits, showing a reduced risk of heart attacks and strokes in overweight patients with existing cardiovascular disease.
Beyond weight loss and cardiovascular protection, research indicates broader metabolic advantages. A 2024 study co-authored by Dr. Chun-Su Yuan of the University of Chicago, compared various GLP-1 receptor agonists and found they consistently lowered blood glucose, aided weight loss, and reduced cholesterol levels.
Yet, experts are sounding a note of caution regarding the rapid increase in demand and apply of these medications. Dr. Yuan warned that the current enthusiasm surrounding GLP-1RAs, particularly for weight reduction, could lead to overuse. He emphasized the need for individualized treatment plans based on a patient’s specific conditions.
Concerns also extend to the need for further research within diverse populations. Sabina Semiz, a professor at Khalifa University in Abu Dhabi, highlighted the lack of data on the effects of GLP-1 therapies in Arab populations, noting that treatment choices are currently guided by the cause of obesity, co-existing conditions, severity, and individual risk-benefit assessments. Semiz also pointed to financial barriers, with the high cost of these therapies limiting access for lower-income groups in the UAE and the wider Middle East and North Africa (MENA) region.
The potential for complications and the importance of medical supervision are also under scrutiny. There is currently no comprehensive regional registry tracking complications among patients using these drugs, according to some medical professionals. Accessing GLP-1s without proper clinical evaluation is described as a gamble, potentially leading to serious health consequences.
Sustainability of treatment is another challenge. A 2025 study revealed that 54% of patients discontinue GLP-1 treatment prematurely, citing high costs, supply issues, or side effects like nausea. Potential issues extend beyond typical side effects to include incorrect patient selection, improper dosage, overlooked contraindications, and the emergence of counterfeit drugs.
Reported side effects include headaches, acid reflux, constipation, and injection site irritation. Some patients experience dizziness or fatigue, though Karim suggests these symptoms are often linked to significantly reduced food intake rather than the medication itself. Careful dosing and gradual escalation are recommended to minimize risks like gallstones, and pancreatitis.