Semaglutide for obesity management: A narrative review of efficacy, safety, and future directions.
Semaglutide is turning heads in the research community for its impact on weight management. This new narrative review from the Journal of the American Pharmacists Association dives into the latest data on semaglutide’s efficacy, safety, and potential for future study.
J Am Pharm Assoc (2003)
by Hajibandeh S, Tao YA, Hsieh MH et al.
“Semaglutide for obesity management: A narrative review of efficacy, safety, and future directions. Hajibandeh S(1), Tao YA(2), Hsieh MH(3), Liu HG(4), Cheng YF(5), Lee KH(6), Hsieh SY(7), Lu CH(8). Author information: (1)Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY. (2)Department of Pharmacy, Taipei Medical University Shuang-Ho Hospital, New Taipei City, Taiwan. (3)SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA. (4)Parkview Health, Fort Wayne, IN. (5)Institute of Biomedical Sciences, Academia Sinica, Taipei City, Taiwan. (6)Master in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung City, Taiwan. (7)Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. (8)Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY. Electronic address: chihualu@buffalo.edu. BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), particularly semaglutide, have demonstrated substantial efficacy for glycemic control and weight management and are increasingly prescribed across diverse populations. Rapid expansion of indications, formulations, and real-world use has outpaced comprehensive evaluation of long-term safety, tolerability, and adherence, raising important concerns for clinical practice. OBJECTIVES: This narrative review aims to synthesize current evidence on the efficacy and safety profile of semaglutide, with a focus on adverse events, treatment persistence, perioperative considerations, and use in special populations, to support clinical decision-making and pharmacist-led patient care. METHODS: A review of clinical trials, observational studies, pharmacovigilance reports, regulatory communications, and professional guidelines was conducted. Evidence was drawn from randomized controlled trials, post-marketing safety reports, systematic reviews, and relevant clinical and regulatory documents. RESULTS: From 1525 records, 34 studies and reports were included. Clinical trials consistently demonstrated meaningful weight reduction with semaglutide. Evidence regarding acute pancreatitis remains limited, although cases have been reported in clinical trials and postmarketing safety analyses. Evidence regarding suicidal ideation associated with semaglutide is mixed, with some analyses suggesting potential safety signals while others report no increased risk. Recent multi society clinical guidelines have addressed perioperative management of GLP-1 RAs, generally supporting individualized perioperative assessment. Emerging literature also examines semaglutide use in special populations, including patients with Alzheimer disease and individuals following bariatric surgery, although long-term neurologic and post-bariatric safety outcomes remain incompletely characterized. CONCLUSIONS: Semaglutide represents an important therapeutic option for chronic weight management. As clinical use expands, continued evaluation of long-term safety, tolerability, and treatment persistence will be important. Pharmacists play a key role in counseling patients, monitoring adverse effects, supporting adherence, and contributing to multidisciplinary obesity care. Copyright © 2026 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.”
Here’s what stands out: Consistent, meaningful weight reduction across diverse groups. That’s not hype — it’s what the clinical trials show. Researchers looked at 34 studies and reports, including randomized controlled trials and post-marketing data. The signal is clear: semaglutide leads to real, measurable changes in body weight. That’s why it’s being studied and used in so many populations.
On safety, the review lays out what’s known and where the gaps are:
Some evidence links semaglutide to acute pancreatitis, but cases are rare and the picture isn’t complete.
Reports of suicidal ideation are mixed. Some studies see a potential safety signal, others find no increased risk.
Perioperative management? Guidelines say it's all about individualized assessment — there’s no one-size-fits-all.
Researchers are also exploring semaglutide in special populations, like people with Alzheimer’s or those who’ve had bariatric surgery. Long-term neurologic and post-bariatric safety outcomes still need more data, so expect more papers on this soon.
Key takeaway: Semaglutide is a major player in peptide-based obesity research. The data so far is strong on efficacy, and the safety profile is under active review. For sourcing and research options, check the semaglutide page or our vendor directory.
Researchers are just getting started. Semaglutide is here to stay in the peptide conversation.
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