Mechanism of Action and Clinical Analysis of Semaglutide in Weight Loss

Abstract

Semaglutide is a long-acting Glucagon-Like Peptide-1 Receptor Agonist (GLP-1RA). It was initially applied in the treatment of type 2 diabetes mellitus, and later widely used in obesity management due to its prominent weightloss effect. As a novel long-acting GLP-1RA weight-loss drug, compared with traditional GLP-1RAs, it undergoes molecular structural modification to achieve reversible albumin binding, which reduces renal clearance and degradation by dipeptidyl peptidase Ⅳ. Meanwhile, it maintains high affinity to GLP-1 receptors, extending its half-life to 156 hours. The long half-life supports onceweekly injection, greatly improving patients' treatment compliance. Its structure is highly similar to natural human GLP-1, with an amino acid sequence homology of 94%. For the above reasons, it has attracted increasing attention. Accordingly, there is a growing demand for comparing the efficacy of semaglutide with that of other weightloss drugs. This article systematically summarizes the core weight-loss mechanism of semaglutide, efficacy data from large-scale clinical trials, characteristics of adverse reactions and clinical safety, and compares semaglutide with several other weight-loss drugs to clarify their differences and efficacy gaps. It aims to provide objective scientific evidence for the rational clinical application of relevant drugs and scientific weight loss for the public.