Brain Stimulation Matches Semaglutide for Weight Loss at One Year in Diabetic Patients | Research

The takeaway

Repetitive transcranial magnetic stimulation (rTMS) produced weight loss (-8.2 kg) comparable to semaglutide 0.5 mg (-5.7 kg) and significantly better than SGLT2 inhibitors (-2.0 kg) at 12 months.

rTMS ≈ semaglutide
Non-invasive brain stimulation (5-week course) matched semaglutide's weight loss through 12 months

What the researchers found

At 12 months: rTMS -8.2 ± 1.0 kg, semaglutide 0.5 mg -5.7 ± 0.9 kg (not significantly different), SGLT2i -2.0 ± 0.7 kg (significantly less than both, p<0.01). rTMS and semaglutide showed progressive weight loss; SGLT2i showed regain after 6 months.

Why it matters

rTMS is a non-pharmacological option that may complement or substitute for GLP-1 drugs in patients who can't tolerate them, offering sustained weight loss without medication side effects.

How the study worked

Retrospective comparative analysis of 107 patients with T2D and obesity: 40 on SGLT2i, 37 on semaglutide 0.5 mg, 30 on rTMS (3×/week for 5 weeks), all with dietary advice, followed for 12 months.

What this study cannot tell us

Retrospective non-randomized design. Semaglutide used at low dose (0.5 mg). Small groups. rTMS protocol (5 weeks) differs fundamentally from ongoing drug therapy. Not blinded.

How to read the evidence

Retrospective comparative analysis. Interesting findings but non-randomized and non-blinded.

When this study was published

Published in 2025, registered as NCT03009695.

The bigger picture

This positions non-invasive brain stimulation as a viable weight loss intervention comparable to GLP-1 peptide drugs, potentially through modulation of appetite-regulating brain circuits.

Questions still open

Would rTMS combined with higher-dose semaglutide produce additive weight loss?
How long do rTMS weight loss effects persist after the 5-week treatment course?
What brain circuits does rTMS modulate that overlap with GLP-1 drug effects?

Common questions

What is rTMS and can it help with weight loss?

rTMS (repetitive transcranial magnetic stimulation) uses magnetic pulses to stimulate brain areas controlling appetite. In this study, just 5 weeks of treatment produced weight loss comparable to a year of semaglutide medication.

Is rTMS better than Ozempic for weight loss?

In this study, they were comparable (rTMS -8.2 kg vs semaglutide -5.7 kg, not statistically different). However, semaglutide was used at a low dose (0.5 mg). Higher doses would likely produce more weight loss.

Read the original research

Weight Loss With SGLT2 Inhibitors, Semaglutide, and Transcranial Magnetic Stimulation in Type 2 Diabetes and Obesity.

Obesity (Silver Spring, Md.), 34(2), 317-322

View on PubMed ↗Publisher’s paper ↗

Citation

Ferrulli, Anna; Senesi, Pamela; Sonaglioni, Andrea; Cannavaro, Daniele; Massarini, Stefano; Macrì, Concetta; Cipponeri, Elisa; DeFronzo, Ralph A; Luzi, Livio. (2026). Weight Loss With SGLT2 Inhibitors, Semaglutide, and Transcranial Magnetic Stimulation in Type 2 Diabetes and Obesity.. Obesity (Silver Spring, Md.), 34(2), 317-322. https://doi.org/10.1002/oby.70105