Subcutaneous Semaglutide Use for Weight Management: Practice and Attitudes of Physicians in Israel

Dicker Dror, Tamir Orly, Lieberman Segal Gabriella, Eldor Roy, Accos Carmel Moran, Kolobov Tatyana, Karasik Avraham

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In 2019,1 mg subcutaneous semaglutide was registered for the treatment of diabetes in Israel. Recognition of its effect on weight has led to its use as a treatment for obesity. Objectives: To explore physicians' pre-therapy considerations, therapy practices, and attitudes regarding subcutaneous semaglutide for weight loss.Methods: A 22-item questionnaire was disseminated to physicians who prescribed semaglutide 1-mg for weight loss using an authorized off-label path.Results: In total, 127 physicians completed the questionnaire. As for pretreatment requirements, in the absence of diabetes, 30% requested a minimal body mass index of 30 kg/m2. Additional requirements were documented lifestyle-change effort (67%) and prior weight loss medication use (13%). Half of the physicians regarded calorie restriction, and 23% considered physical activity as necessary for weight loss while on therapy. As for dose, most physicians (78%) started with a 0.25-mg weekly injection, 57% doubled the dose monthly, and all others recommended doubling when side effects subsided. Regarding weight loss goal, 43% of the physicians set a personal goal with each patient while 26% limited the goal to 10% of initial weight. Fewer than 50% of physicians discussed treatment duration with their patients, and 52% of patients discontinued therapy in the first 3 months. The main reasons for discontinuation were price, lack of effect, and fear of long-term side effects. Conclusions: The diverse approaches regarding off-label use of semaglutide for weight reduction highlight the necessity to guide physicians and standardize treatment regimen.

Original languageEnglish
Pages (from-to)664-668
Number of pages5
JournalIsrael Medical Association Journal
Volume25
Issue number10
StatePublished - Oct 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 Israel Medical Association. All rights reserved.

Keywords

  • obesity
  • off-label
  • semaglutide
  • treatment guidelines
  • weight management

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