STEP 7 reports 12.1% weight loss in a predominantly East Asian population

A phase 3 trial called STEP 7 found that once-weekly semaglutide 2.4 mg produced an average weight loss of 12.1% over 44 weeks in a study group made up mostly of people of East Asian ethnicity ^[1]. The trial, published in Lancet Diabetes & Endocrinology and funded by Novo Nordisk, was designed to fill a gap in data on how the drug performs in East Asian populations, who had been underrepresented in earlier global obesity trials ^[1].

The study enrolled 375 adults with overweight or obesity, with or without type 2 diabetes, at 23 hospitals and trial centers in China, Hong Kong, Brazil, and South Korea between December 2020 and August 2022 ^[1]. Participants were randomly assigned in a 2-to-1 ratio to receive either semaglutide 2.4 mg or a placebo injection once a week for 44 weeks, alongside advice on diet and physical activity ^[1].

By week 44, people on semaglutide had lost an average of 12.1% of their body weight, compared with 3.6% in the placebo group, a difference of 8.5 percentage points ^[1]. Among those taking semaglutide, 85% lost at least 5% of their starting body weight, versus 31% of those on placebo, giving semaglutide users more than 13 times the odds of hitting that benchmark ^[1].

Side effects followed a pattern seen in other semaglutide trials. Adverse events were reported by 93% of people on semaglutide and 86% of those on placebo, with gastrointestinal problems the most common complaint, affecting 67% of the semaglutide group compared with 36% of the placebo group ^[1]. The trial is registered with ClinicalTrials.gov under the identifier NCT04251156 and is now complete ^[1].

Why it matters for patients

STEP 7's authors say the results support using semaglutide 2.4 mg for weight management in people of East Asian ethnicity, whether or not they also have type 2 diabetes ^[1]. Earlier large trials of semaglutide for obesity, such as STEP 1, drew heavily from Western populations, so this study helps clarify whether the drug works similarly and carries similar risks in East Asian patients, a question that mattered for regulatory approval in Asian markets ^[1].

For patients in the United States, the trial itself was not conducted here, and it does not change how semaglutide is approved or labeled by the FDA. But it adds to the broader evidence base on how effective and how tolerable the drug is across different populations, information that can be useful context for anyone weighing this treatment with a clinician. The gastrointestinal side effects reported in this trial mirror what has been documented in other semaglutide studies, reinforcing that nausea and related symptoms remain a common experience for many users regardless of geography ^[1].

A companion commentary published alongside the trial in the same journal discusses GLP-1 therapy for obesity in people from Asia, though the sources reviewed here do not detail its specific conclusions ^[1].

What happens next

The sources do not specify further regulatory timelines or next steps stemming from this trial. The study is already complete, and its data were used to support semaglutide's evaluation in Asian markets, though exact approval dates and countries beyond those where the trial was conducted are not detailed in the available sources ^[1]. Anyone tracking specific regional approvals should check with regulators in those markets directly, since that information was not part of the trial report.