What happened after the initial weight loss?
Adults with obesity or overweight, without diabetes, who completed the initial phase.
What did they want to find out?
What happens to weight when the intervention continues or is replaced with placebo?
What did researchers observe?
Weight continued falling on average with continuation and rose after the placebo switch.
What does this mean for you?
Lost weight can return; the finding describes maintenance under trial conditions.
What we still do not know
These percentages start at week 20, not the original weight. They do not tell an individual what to do.
Show study details
Original sources checked on 4 October 2026. AI-assisted editorial summaries, not a systematic review or an independent medical assessment.
Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial
JAMA · 2021
How it was studied
Double-blind randomized withdrawal trial; 20-week initial phase followed by a 48-week comparison.. 803 adults without diabetes, selected from 902 who entered the initial phase..
Study finding
From week 20, weight changed −7.9% with continuation and +6.9% after switching to placebo; both groups had lifestyle support.
Study limitations
Selected people who tolerated the initial phase. Gastrointestinal symptoms were common; this does not represent everyone starting treatment.
Who is behind the study?
- Identified authors
- Domenica Rubino, Niclas Abrahamsson, Melanie Davies, Dan Hesse, Frank L. Greenway, Camilla Jensen, Ildiko Lingvay, Ofri Mosenzon, Julio Rosenstock, Miguel A. Rubio, Gottfried Rudofsky, Sayeh Tadayon, Thomas A. Wadden, Dror Dicker
- Funding and involvement
- Novo Nordisk A/S; involved in design, analysis and manuscript preparation, with no declared publication veto.
- Disclosed interests and verification limits
- Authors disclosed Novo Nordisk employment, shares, fees or support. This is not independent confirmation of the manufacturer.
Terms explained
- Randomized withdrawal
- After an initial phase, chance decides who continues and who switches to placebo.
- Placebo
- An intervention without the active ingredient, used for comparison.
Read the source and its limitations. A reference does not automatically validate a commercial product.
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