Semaglutide's Limited Effectiveness and Safety Concerns Highlighted in JAMA Cardiology Letter

A letter published in the Journal of the American Medical Association (JAMA) Cardiology has shed light on the limited effectiveness and safety concerns associated with semaglutide, a medication primarily used for weight loss. According to the letter, semaglutide has several significant limitations, including weight regain after treatment is stopped, a high prevalence of adverse events, and unknown long-term safety. In contrast, plant-based dietary interventions have been found to be a safe and effective way to achieve significant weight loss and improve cardiometabolic risk factors.

Key Takeaways:

• Semaglutide is associated with a high prevalence of adverse events, including a fourfold and sevenfold risk of nonarteritic anterior ischemic optic neuropathy in people taking semaglutide for type 2 diabetes and weight loss, respectively.
• After four years of semaglutide treatment, only 12% of participants in the SELECT trial attained a normal body mass index (BMI), and 44.6% and 43.3% of participants had BMIs in the overweight and obese categories, respectively.
• Semaglutide is often followed by weight regain after treatment is stopped, according to the STEP-1 extension study.
• Plant-based dietary interventions have been found to lead to significant weight loss, with an average weight loss of 12.1 kg at 6 months compared to 1.6 kg in the standard-care group in the BROAD study.
• A recent Physicians Committee/Morning Consult survey found that half of U.S. adults believe eating a plant-based diet can improve their health and help prevent chronic diseases, but only 1 in 5 primary care practitioners discuss this lifesaving message with patients.

Statistics:

• 137 million U.S. adults are eligible for semaglutide for weight loss.
• Four years of semaglutide treatment resulted in 12% of participants attaining a normal BMI, 44.6% having BMIs in the overweight category, and 43.3% having BMIs in the obese category.
• A plant-based diet led to an average weight loss of 12.1 kg at 6 months in the BROAD study.
• A plant-based diet resulted in a fourfold and sevenfold risk of nonarteritic anterior ischemic optic neuropathy in people taking semaglutide for type 2 diabetes and weight loss, respectively.

Sources:

• "Letter to the Editor," Journal of the American Medical Association (JAMA) Cardiology.
• BROAD study, 2022.
• Physicians Committee/Morning Consult survey, 2025.
• SELECT trial, 2022.
• STEP-1 extension study, 2022.