What the trial was testing
The STEP 1 enrolled 1,961 patients with obesity. The study was sponsored by Novo Nordisk and tracked outcomes across the full group of patients who matched the trial's eligibility profile.
It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.
What the results showed
~15% average body weight loss on weekly semaglutide vs. ~2.4% on placebo at 68 weeks.
New England Journal of Medicine · 2021 · NCT03548935
These findings — that average body weight loss on once-weekly semaglutide vs. placebo at 68 weeks — were published in the New England Journal of Medicine and represent the headline result of the study.
Researchers tracked outcomes across 1,961 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.
What this means for patients
For patients with obesity, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.
What you can do now
Semaglutide for weight management is FDA-approved as Wegovy and available now (supply has been tight on and off). It's a once-weekly injection that you give yourself at home. Coverage is the biggest barrier — many insurers don't pay for weight-management indications even though they cover the same drug for diabetes. Ask your doctor about eligibility and check Novo Nordisk's savings programs if you have commercial insurance.
Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.
Open obesity trials
OBESIAL: A Prospective Interventional Real-world Study of a Multidisciplinary Obesity Management Programme
The OBESIAL (Obesity Structured Intervention in Algeria) study aims to evaluate the clinical, metabolic, and organisational impact of a structured multidisciplinary obesity care pathway implemented under real-world conditions.
Fasted vs. Fed State Exercise
Although many medications exist for both heart disease and obesity, cost, lack of access for all people, side effects and the desire for a more natural solution have left many people seeking lifestyle treatments such as exercise. Scientists know that exercise is highly beneficial for heart health. When exercise also produces weight loss, these benefits are much improved. Although using exercise to treat or prevent heart disease / obesity is recommended, not all people respond well. Some see significant weight loss and health improvements while others see little changes. For these reasons, new strategies surrounding the use and design of an exercise program are needed. One such strategy could be performing aerobic exercise before breakfast (fasted exercise). When exercising fasted, food/energy stores are low, and one relies on stored body fat for energy. This may help heart health and weight loss. This has never been tested in a program long enough to see such changes. This study will, for the first time, assess the effects of a 16-week aerobic exercise program performed fasted compared to after eating. Outcomes will include blood fats, blood pressure, fat-burning abilities and weight loss. Starting an exercise program can also make people to eat more. This limits the success of exercise. The study will also evaluate ways fasted exercise could change eating, as it possible that fasted exercise could also cause people to eat more, which would limit weight loss and health improvements.