Evaluating the Efficacy and Ethical Implications of Semaglutide and GLP-1 Receptor Agonists for Weight Management in Obesity

Authors

Ebonne' M. Quiller, University of LynchburgFollow

Specialty

Urgent Care, Primary Care

Abstract

Obesity is a global public health crisis, with more than 890 million adults living with obesity as of 2022.¹ Traditional weight management strategies, such as lifestyle modification, often yield only transient results, creating the need for effective pharmacotherapeutic options.² The advent of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), particularly semaglutide, has transformed obesity care, offering superior efficacy compared with older anti-obesity drugs.³ This paper evaluates semaglutide and related GLP-1 RAs in terms of clinical effectiveness, socioeconomic impact, and ethical concerns.

Clinical trials highlight the potential of semaglutide. In the STEP 1 trial, participants lost a mean of 14.9% of their body weight, compared to 2.4% with the placebo, at 68 weeks.³ Similarly, Rubino et al demonstrated that continued semaglutide use allowed patients to maintain 89.5% of weight lost, while discontinuation led to significant regain.⁴ Tirzepatide, a dual GLP-1/GIP agonist, has shown even greater weight loss (21% at 72 weeks), reflecting rapid pharmacologic progress.⁵⁻⁶ Meta-analyses confirm semaglutide’s efficacy in non-diabetic populations (mean reduction of 11.85%), though gastrointestinal adverse effects and discontinuation risks remain concerns.⁷

Despite efficacy, GLP-1 RAs pose socioeconomic and ethical challenges. Cost is prohibitive, with prescriptions for semaglutide and tirzepatide rising 5.3% annually, driven by high demand and aggressive marketing.⁸ While these drugs reduce cardiometabolic risk, their long-term outcomes and cost-effectiveness remain uncertain, straining healthcare systems.⁹ Ethical issues include inequitable access and industry practices prioritizing profit over equitable distribution.¹º Lower-cost medications such as phentermine remain widely used among low-income populations despite inferior efficacy, exacerbating disparities.⁸

This manuscript advocates for a balanced approach, integrating GLP-1 RAs into obesity treatment while addressing affordability, access, and ethical prescribing considerations. Policy measures such as price regulation, insurance expansion, and clinician education are essential to mitigate disparities.⁹ Future research must explore sustainable financing models and long-term health outcomes to optimize the public health impact of these therapies.⁹

Recommended Citation

Quiller EM. Evaluating the Efficacy and Ethical Implications of Semaglutide and GLP-1 Receptor Agonists for Weight Management in Obesity. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2025; 7(3).