Use of Semaglutide for Successful Weight Loss and Maintenance in a Non-Obese Population: An Observational Study

Objectives: This study aimed to assess the efficacy of compounded semaglutide, the active ingredient of an FDA-approved weight loss drug for patients with obesity, for weight loss in otherwise healthy, normal, and overweight individuals (BMI < 29.9). Additionally, a novel method to declare the ideal or target weight—which bridges the differences in body composition, bone structure, and sex—is proposed. Achieving a target weight is also proposed as a measure of success for the weight loss program. Methods: An internal, prospective, non-randomized, dynamic cohort, observational study—Elective Weight Loss™—was the design adopted in this study. Weight was collected from 326 patients (male n = 23, female n = 303), with a mean age of 42.2 years, over 12 to 120 weeks. Weekly doses, dose adjustments, cessation of semaglutide, achievement of target weight, and weight maintenance were documented. No diet was prescribed. This is an ongoing, rolling database. Results: The results showed that 96% of the patients lost weight. Five patients gained weight, and seven lost no weight. In non-obese patients (n = 233), the mean starting BMI was 25.44 ± 2.6 (range: 20–28), and the mean end BMI was 22.99 ± 2.55 (p < 0.001). Obese patients (n = 93) had a mean starting BMI of 34.98 ± 4.6 and a mean end BMI of 30.72 ± 4.98 (p < 0.001). Conclusions: Compounded semaglutide was found to be a safe and highly effective off-label option for elective weight loss in normal and overweight individuals. It promotes weight loss at lower doses and shows potential benefits comparable to moderate calorie restriction in improving cardiometabolic health and supporting anti-aging in non-obese individuals.