Real-world use of submaximal doses of long-acting GLP-1 receptor agonist semaglutide in patients with obesity: a prospective observational study.
Semaglutide isn’t just a lab darling anymore. Researchers in Slovakia tracked what happens when real people with obesity use submaximal doses of this long-acting GLP-1 receptor agonist—outside of the highly-controlled clinical trial bubble. The results? Even at less-than-max doses, semaglutide made a big impact.
Sci Rep
by Miertová Z, Lecký P, Focko B et al.
“Real-world use of submaximal doses of long-acting GLP-1 receptor agonist semaglutide in patients with obesity: a prospective observational study. Miertová Z(1), Lecký P(1), Focko B(1), Bolek T(1)(2), Péč MJ(1), Jurica J(1), Nagy N(1), Galajda P(1), Mokáň M(1), Samoš M(3)(4). Author information: (1)Department of Internal Medicine I, Jessenius Faculty of Medicinein Martin, Comenius University in Bratislava, Kollárová 2, 036 59, Martin, Slovakia. (2)Division of Acute and Interventional Cardiology, Department of Cardiology and Angiology II, Mid-Slovakian Institute of Heart and Vessel Diseases (SÚSCCH, a.s.), Banská Bystrica, Slovakia. (3)Department of Internal Medicine I, Jessenius Faculty of Medicinein Martin, Comenius University in Bratislava, Kollárová 2, 036 59, Martin, Slovakia. matej.samos@gmail.com. (4)Division of Acute and Interventional Cardiology, Department of Cardiology and Angiology II, Mid-Slovakian Institute of Heart and Vessel Diseases (SÚSCCH, a.s.), Banská Bystrica, Slovakia. matej.samos@gmail.com. Obesity is a global health problem with numerous metabolic and mechanical complications. In previous studies, a long-acting glucagon-like peptide-1 receptor agonist (GLP-1 RA) semaglutide has been identified as one of the most promising medications for treating obesity. We carried out a prospective observational study investigating the effect of submaximal doses of semaglutide in 56 adult patients with obesity (mean age 49 ± 12 years, 42 female and 14 male). We evaluated the effects on body weight, waist circumference, height/waist ratio, and BMI during 3-month follow-up. 30 patients in our group also reached a 6-month follow-up. Our patients achieved a weight loss of 6.45 ± 0.31% (p < 0.01) in 3 months of semaglutide therapy, and in the subgroup of 30 patients where semaglutide was administered for 6 months, weight loss was 11.35 ± 0.47% (p < 0.01). Regarding waist circumference, patients achieved a 7 cm decrease in waist circumference in 3 months, and an additional 6 cm at 6 months, respectively (p < 0.01). The mean height/waist ratio decreased from 0.71 ± 0.08 to 0.67 ± 0.09 after 3 months of treatment (p < 0.01) and to 0.63 ± 0.09 (p < 0.01) after 6-month of semaglutide treatment. Mean BMI decreased from 40.3 ± 6.7 to 37.5 ± 6.83 kg/m2 (p < 0.01) after 3 months of treatment and to 35.5 ± 7.73 kg/m2 in the subgroup with 6 months of therapy (p < 0.01). Our study showed a significant decrease in body weight, waist circumference, height/waist ratio, and BMI in patients with obesity treated with submaximal doses of semaglutide. © 2026. The Author(s). Conflict of interest statement: Declarations. Competing interests: The authors declare no competing interests. Ethical approval: The research was conducted according to ethical standards. The research protocol was formally approved by local Ethical Committee (Jessenius Facutly of Medicine in Martin, Comenius University in Bratislava, Approval Code EK 38/2024, approval Date 4th June 2024). All the enrolled subjects agreed with study participation and signed a written informed consent for study participation.”
Fifty-six adults took part. They started with a mean BMI of 40.3. After just three months on semaglutide, average body weight dropped by 6.45%. Waistlines shrank by an average of 7 cm. For those who stuck with it for six months, weight loss hit 11.35%, and waists trimmed another 6 cm. BMI followed the same trend: down from 40.3 to 37.5 after three months, and then 35.5 at the six-month mark.
Key takeaway: You don’t always need the max dose to see real, measurable changes.
Let’s break the results down:
6.45% mean weight loss at 3 months, 11.35% at 6 months
7 cm waist reduction at 3 months, 13 cm total at 6 months
BMI dropped by nearly 5 points in half a year
Waist/height ratios improved, too
This wasn’t a tightly controlled trial with perfect compliance and handpicked subjects. It was a snapshot of how people actually use semaglutide in the real world. And yes, the positive effects showed up fast.
Researchers looking at GLP-1 peptides for body composition research should take note: submaximal dosing can still deliver. Want more details on the compound itself? Check out the dedicated semaglutide page. If you’re sourcing for your own research, the vendor directory is the place to start.
Bottom line: Semaglutide continues to move the needle for research into obesity and metabolic science—no need for full-dose heroics to see results.
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