Semaglutide Results in a Pakistani Population: 10 kg Weight Loss at 6 Months in Obese Patients With and Without Diabetes | Research

The takeaway

In a real-world cohort of 65 obese Pakistani patients, semaglutide produced average weight loss of nearly 10 kg at 6 months with significant improvements in HbA1c and cholesterol, regardless of diabetes status.

9.86 kg average weight loss at 6 months
Obese Pakistani patients lost nearly 10 kg in 6 months on semaglutide — with most staying on the lower 0.5 mg dose — and saw equal benefits regardless of diabetes status.

What the researchers found

Average weight loss was 5.81 ± 2.64 kg at 3 months and 9.86 ± 3.54 kg at 6 months. Weight loss was similar in patients with and without type 2 diabetes. Significant reductions were observed in HbA1c, BMI, and cholesterol levels (all p<0.001). By 6 months, 40% of patients remained on 0.5 mg, 33.8% escalated to 1 mg, and 24.6% reached 2 mg weekly. Adverse effects were reported by 55.4% at 3 months but declined to 34.5% at 6 months, with most being mild-to-moderate GI symptoms. Only 1.5% reduced their dose due to side effects.

Why it matters

Most GLP-1 agonist data comes from Western populations. This study provides real-world evidence from South Asia, where obesity and diabetes patterns differ and where access to these medications is rapidly expanding. The finding that even low-dose semaglutide (most patients on 0.5 mg) produces meaningful weight loss in this population has practical implications for prescribing in resource-limited settings where higher doses may be cost-prohibitive.

How the study worked

Observational analytic cohort study at a private medical institute in Karachi, Pakistan, from August 2022 to January 2023. Enrolled 65 obese adults (>18 years) with or without type 2 diabetes. Semaglutide was started at 0.25 mg and escalated every 4 weeks to the maximally tolerated dose (up to 2 mg/week). Patients were evaluated at baseline, 3 months, and 6 months for weight, BMI, HbA1c, lipid profiles, and adverse effects.

What this study cannot tell us

Small sample size (65 patients) at a single private clinic limits generalizability. No control group means results could be influenced by concurrent lifestyle changes. Observational design cannot establish causation. Six-month follow-up is relatively short. The study was conducted at a private institute, which may not represent the broader Pakistani population in terms of socioeconomic status, adherence, and access to care. The abstract contains apparent formatting errors in the p-value reporting.

How to read the evidence

This is a small, single-center observational cohort without a control group. While it provides useful real-world data from an underrepresented population, the study design cannot establish causation and the sample size limits statistical reliability.

When this study was published

Published in 2024 based on data from 2022-2023, this is recent real-world evidence reflecting early adoption of semaglutide in Pakistan.

The bigger picture

As GLP-1 agonists become available globally, understanding their effectiveness in diverse ethnic and geographic populations is critical. South Asian populations have higher metabolic risk at lower BMI levels, so real-world data from this region helps validate that semaglutide's benefits extend across populations and are not limited to the demographics studied in pivotal trials.

Questions still open

Would semaglutide show similar efficacy and tolerability in larger, more diverse South Asian populations including public hospital patients?
Is the lower average dose used in this study (many on 0.5 mg) sufficient for South Asian patients, or would higher doses produce proportionally greater benefits?
How does long-term (>6 month) semaglutide efficacy and safety compare in South Asian vs. Western populations?

Common questions

How much weight can you lose on semaglutide?

In this real-world study of 65 obese Pakistani patients, the average weight loss was about 6 kg at 3 months and nearly 10 kg at 6 months. Weight loss was similar whether patients had type 2 diabetes or not. Most patients achieved these results on lower doses (0.5 mg weekly), suggesting meaningful benefits even without reaching the maximum dose.

What side effects does semaglutide cause?

In this study, about 55% of patients experienced side effects in the first 3 months — mostly mild-to-moderate gastrointestinal symptoms like nausea. By 6 months, only about 35% still reported side effects, suggesting the body adjusts over time. Only 1.5% of patients needed to reduce their dose because of side effects, and there were no differences in side effects between those with and without diabetes.

Read the original research

SEMAGLUTIDE: Weight loss, glycaemic control and safety profile in obese patients with and without type-II diabetes-An experience from Karachi, Pakistan.

Journal of family medicine and primary care, 13(10), 4188-4193

View on PubMed ↗Publisher’s paper ↗

Citation

Memon, Muhammad Y; Ahsan, Tasnim; Jabeen, Rukhshanda; Latif, Saba; Qasim, Saeeda F; Imran, Paras. (2024). SEMAGLUTIDE: Weight loss, glycaemic control and safety profile in obese patients with and without type-II diabetes-An experience from Karachi, Pakistan.. Journal of family medicine and primary care, 13(10), 4188-4193. https://doi.org/10.4103/jfmpc.jfmpc_159_24