The 33rd European Congress on Obesity (ECO 2026) was recently held in Istanbul, Türkiye.

Novo Nordisk unveils two key data points:
Higher doses of Wegovy injection (semaglutide 7.2 mg) resulted in nearly 28% weight loss in early responders;
Wegovy oral tablets achieved a 21.6% weight loss and significantly improved physical activity in early responders.

These two sets of data indicate that smegglutide has the best performance in its class in terms of comprehensive benefits such as weight loss, muscle health improvement, and improved mobility.

01
STEP UP subgroup analysis:
Higher doses offer weight loss advantages

The STEP UP trial was a 72-week, randomized, double-blind, parallel-group, placebo-controlled superiority trial designed to evaluate the efficacy and safety of semaglutide 7.2 mg as an adjunct to lifestyle interventions compared to semaglutide 2.4 mg and placebo. The trial enrolled over 1400 obese adults without type 2 diabetes.

A recent subgroup analysis showed that, regardless of how quickly individuals responded to treatment, higher doses of the weight-loss drug Wegovy demonstrated good efficacy in helping obese patients achieve significant weight loss.

Early responders treated with 7.2 mg Wegovy (weight loss ≥15% at week 24) achieved an average weight loss of 27.7% by week 72. Participants receiving higher doses of Wegovy reached their weight loss goals faster compared to those receiving semaglutide 2.4 mg.

Furthermore, another STEP UP subgroup analysis (55 participants) presented at ECO showed that weight loss from Wegovy (2.4 mg and 7.2 mg) treatment was primarily due to a reduction in body fat: approximately 84% of the weight loss was attributable to a decrease in fat mass. Smegglutide treatment reduced abdominal visceral fat by more than 30%.

Meanwhile, during the weight loss process, the muscle mass of the smegglutide treatment group decreased by only about 10% from baseline, accompanied by an improvement in muscle health.

The assessment was based on changes in muscle fat content. Both visceral fat and muscle fat are highly correlated with the risk of cardiovascular and metabolic complications, indicating that smegglutinin demonstrates good efficacy in targeting different sites of body fat storage.

Notably, despite significant weight loss, participants treated with semaglutide maintained functional muscle strength. Muscle function was assessed using a 30-second sit-to-stand test, and results showed that functional muscle strength levels were comparable between the semaglutide and placebo groups before and after treatment. Taken together, these results further highlight the health improvements semaglutide brings to body composition and muscle function.

02
OASIS 4 subgroup analysis:
Oral tablets improve patient mobility

OASIS 4 is a randomized, double-blind, placebo-controlled phase 3 clinical trial designed to evaluate the efficacy and safety of Wegovy tablets (25 mg) in adult patients who are obese or overweight with at least one weight-related complication and who do not have type 2 diabetes.

The latest subgroup analysis shows that Wegovy tablets have shown good therapeutic effects in adult obese patients compared with placebo.

Nearly one-third (28.8%) of adult patients treated with Wegovy tablets were early responders, with an average weight loss of 13.2% at week 16 of treatment and a 21.6% weight loss by the end of the OASIS 4 clinical trial.

Meanwhile, participants who did not meet the "early response" criteria still achieved an 11.5% weight loss by the end of the trial. This indicates that both groups achieved clinically significant weight loss by the end of the trial.

In addition to significant weight loss, another analysis of the OASIS 4 trial, presented at ECO2026, showed that nearly 80% of patients taking Wegovy tablets experienced significant improvements in mobility (77.3%, compared to 42.9% in the placebo group), encompassing bending, standing comfortably, and maintaining daily activities—almost double the improvement. Meanwhile, the weight loss achieved in this group was comparable to that of the overall Wegovy tablet population.

The ORION indirect treatment comparison study and the OPTIC patient preference study, also presented and published at ECO2026, showed that Wegovy tablets achieved greater weight loss than orforglipron and were less likely to be discontinued due to side effects.

Indirect treatment comparisons with ORION showed that Wegovy tablets resulted in significantly greater average weight loss than orforglipron 36 mg, while the risk of discontinuing orforglipron due to gastrointestinal side effects was approximately 14 times higher. In the OPTIC patient preference study, 84% of respondents preferred treatment characteristics similar to Wegovy tablets compared to orforglipron.

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