EVALUATION OF SEMAGLUTIDE USE IN OBESE AND NON-OBESE PATIENTS AND PHYSICIANS’ PERCEPTION OF THE MEDICATION’S USE IN CURITIBA AND ITS METROPOLITAN REGION

INTRODUCTION: Obesity is a chronic and multifactorial disease, whose pharmacological treatment has increasingly incorporated GLP-1 receptor agonists. Semaglutide stands out as an effective option both for glycemic control in patients with type 2 diabetes mellitus and for weight reduction in patients with obesity. Although well-established clinical trials exist regarding the use of semaglutide, there is still a scarcity of real-world studies investigating its use in clinical practice, including the prescription profile, the occurrence of adverse effects, and the factors associated with weight loss response. AIMS: To assess the prescription and experience of semaglutide use by individuals and physicians in Curitiba and its metropolitan region, through the application of an online questionnaire. MATERIALS AND METHODS: A cross-sectional, observational study was conducted using structured questionnaires applied to prescribing physicians and patients using semaglutide. Qualitative variables were described by absolute and percentage frequency, and continuous variables by mean, standard deviation, median, and minimum and maximum values. Associations between variables were assessed using the Chi-square test or Fisher-Freeman-Halton exact test, the Mann-Whitney test, and Spearman’s correlation, and the factors independently associated with weight loss were assessed using a multivariable generalized linear model, adopting a significance level of 5%. RESULTS: The study included 9 doctors and 30 patients using semaglutide. Among the physicians, all prescribed the medication for diabetes and obesity, and nausea was the most reported adverse effect (100%), followed by vomiting (44.4%) and constipation (33.3%); all observed weight regains after treatment discontinuation. Among the patients (73.3% female; mean age 40.1 ± 15.9 years), the mean weight loss was 11.1 ± 7 kg, and 83.3% reported some adverse effect, with nausea (88%) and diarrhea (44%) being the most frequent. There was no significant difference in weekly dose, treatment duration, or weight loss between patients with and without adverse effects (p > 0.05). Age was inversely correlated with weight loss (rho = -0.376; p = 0.049), with no significant correlation with dose or treatment duration. In the adjusted multivariable model, only age remained independently and significantly associated with weight loss (β = -0.276; 95% CI: 0.468 to 0.085; p = 0.005), while weekly dose and treatment duration were not significantly associated with the outcome. FINAL CONSIDERATIONS: The findings show that age is an independently associated factor with the magnitude of weight loss with semaglutide use, with younger patients showing significantly greater weight reduction, even after adjustment for dose and treatment duration. The high frequency of gastrointestinal adverse effects and the weight regain reported after treatment discontinuation reinforce the understanding of obesity as a chronic condition requiring long-term follow-up.

KEYWORDS: Semaglutide; Weight loss; Obesity; Glucagon-Like Peptide-1 Receptor Agonists; Adverse effects.