Trial review
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STEP-1: The approved product 2.4 mg for Weight Management, Explained
How much weight does the drug 2.4 mg produce in adults with obesity and without diabetes?
STEP-1 was a randomised, double-blind, placebo-controlled, phase 3 funded by Novo Nordisk. Mean weight change of −14.9% against −2.4% on placebo; about 86% reached 5% or more, about 51% reached 15% or more. That figure belongs to the population, dose and 68 weeks shown below, and describes a group average rather than a prediction for any individual.
| Design | Randomised, double-blind, placebo-controlled, phase 3 |
|---|---|
| Population | Adults with BMI 30 or above, or 27 or above with at least one weight-related comorbidity, without diabetes |
| Sample size | 1961 |
| Intervention | Semaglutide |
| Comparator | Placebo, both arms with lifestyle intervention |
| Duration | 68 weeks |
| Primary endpoint | Percentage change in body weight |
| Main result | Mean weight change of −14.9% against −2.4% on placebo; about 86% reached 5% or more, about 51% reached 15% or more |
Show this figure as a table
| Step | Stage | What happens |
|---|---|---|
| 1 | Who was eligible | Adults with BMI 30 or above, or 27 or above with at least one weight-related comorbidity, without diabetes |
| 2 | What they received | Semaglutide |
| 3 | What it was compared against | Placebo, both arms with lifestyle intervention |
| 4 | For how long | 68 weeks |
| 5 | What was measured first | Percentage change in body weight |
| 6 | What the group average was | Mean weight change of −14.9% against −2.4% on placebo; about 86% reached 5% or more, about 51% reached 15% or more |
| 7 | What it does not tell you | A group average is not a prediction for any individual reader. |
Show this figure as a table
| Item | Weight change | Evidence |
|---|---|---|
| Semaglutide 2.4 mg | 15% | published, peer-reviewed |
| Placebo | 2% | published, peer-reviewed |
Show this figure as a table
| Item | Mean reduction | Evidence |
|---|---|---|
| Tirzepatide 15 mg (SURMOUNT-1) | 21% | Verified |
| Oral semaglutide 25 mg, adherent (OASIS 4) | 17% | Verified |
| Injectable semaglutide 2.4 mg (SURMOUNT-5) | 14% | Verified |
| Oral semaglutide 25 mg, treatment-policy (OASIS 4) | 14% | Verified |
| Orforglipron 17.2 mg (ATTAIN-1) | 12% | Reported |
| Liraglutide (SCALE) | 8% | Reported |
| Product | Starting self-pay price | Reported mean reduction | Trial |
|---|---|---|---|
| Zepbound (tirzepatide) injectable | $299/mo direct | about 20.9% at 15 mg | SURMOUNT-1, 72 weeks |
| Wegovy pill (oral semaglutide 25 mg) | $149/mo starting dose | 13.6–16.6% depending on estimand | OASIS 4, 64 weeks |
| Wegovy injectable (semaglutide 2.4 mg) | $349/mo maintenance | about 13.7% | SURMOUNT-5, 72 weeks |
| Foundayo (orforglipron) | $149/mo starting dose | about 11–12.4% at 17.2 mg | ATTAIN-1, 72 weeks |
Frequently asked questions
Does this apply to compounded versions?
No. The trial studied an FDA-approved product at studied doses.
Is this drug as effective as tirzepatide?
By mean reduction across separate trials, no. The efficacy ladder above sets out the figures with the trial that produced each one.
Related on this site
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GLP-1 Semaglutide Rx. “STEP-1: Semaglutide 2.4 mg for Weight Management, Explained.” S.J Partners LLC, 2026-08-03. https://glp1semaglutiderx.com/research/step-1/
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