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עמוד בית
Mon, 26.02.24

ORIGINAL ARTICLES

IMAJ | volume 25

Journal 10, October 2023
pages: 664-668

Subcutaneous Semaglutide Use for Weight Management: Practice and Attitudes of Physicians in Israel

1 Department of Medicine D and Obesity Clinic, Rabin Medical Center (HaSharon Campus), Petah Tikva, Israel 2 Segal Israeli Center for Diabetes Research and Policy, Sheba Medical Center, Tel Hashomer, Israel 3 Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel 4 Israel Center for Weight Management, Sheba Medical Center, Tel Hashomer, Israel 5 Department of Endocrinology, Metabolism, and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel 6 Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Summary

Background:

In 2019, 1 mg subcutaneous semaglutide was registered for the treatment of diabetes in Israel. Recognition of its effect on weight has led to its use as a treatment for obesity.

Objectives:

To explore physicians’ pre-therapy considerations, therapy practices, and attitudes regarding subcutaneous semaglutide for weight loss.

Methods

: A 22-item questionnaire was disseminated to physicians who prescribed semaglutide 1-mg for weight loss using an authorized off-label path.

Results:

In total, 127 physicians completed the questionnaire. As for pretreatment requirements, in the absence of diabetes, 30% requested a minimal body mass index of 30 kg/m2. Additional requirements were documented lifestyle-change effort (67%) and prior weight loss medication use (13%). Half of the physicians regarded calorie restriction, and 23% considered physical activity as necessary for weight loss while on therapy. As for dose, most physicians (78%) started with a 0.25-mg weekly injection, 57% doubled the dose monthly, and all others recommended doubling when side effects subsided. Regarding weight loss goal, 43% of the physicians set a personal goal with each patient while 26% limited the goal to 10% of initial weight. Fewer than 50% of physicians discussed treatment duration with their patients, and 52% of patients discontinued therapy in the first 3 months. The main reasons for discontinuation were price, lack of effect, and fear of long-term side effects.

Conclusions:

The diverse approaches regarding off-label use of semaglutide for weight reduction highlight the necessity to guide physicians and standardize treatment regimen.

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