Obesity is no longer seen as only a problem of middle age. In many countries, especially wealthier nations, a large number of adults over the age of 65 are now living with obesity or excess weight.
Doctors say this trend is becoming a major public health concern because obesity can worsen many age-related diseases and reduce independence in later life.
As people grow older, extra body fat can increase the risk of heart disease, high blood pressure, joint pain, diabetes, stroke, sleep apnea, and reduced mobility. Obesity may also make everyday tasks more difficult and contribute to disability and lower quality of life.
Despite these risks, weight-loss treatment in older adults has always been complicated. Many older people already have fragile health, weaker muscles, or multiple medical conditions. Doctors often worry that aggressive weight loss could lead to weakness, falls, or poor nutrition.
Because of this, scientists have been carefully studying whether newer obesity medications can safely help older adults lose weight without causing too many harmful side effects.
A new analysis led by Professor Luca Busetto from the University of Padova in Italy now offers promising answers. The study looked at semaglutide, a medication that has become famous in recent years for its powerful effects on weight loss.
The research included scientists from Novo Nordisk, the company that manufactures semaglutide, and analyzed data from several large clinical studies known as the STEP trials.
Semaglutide is part of a newer class of medicines called GLP-1 receptor agonists. These drugs were first designed to treat type 2 diabetes because they help regulate blood sugar levels. Later, researchers discovered that the medications also strongly reduce hunger and help many patients eat less naturally.
The drug works by copying a hormone that the body normally releases after eating. This hormone signals fullness to the brain, slows stomach emptying, and helps control appetite. As a result, many people feel full faster and consume fewer calories.
Semaglutide has already shown impressive weight-loss results in younger adults, but researchers wanted to know whether older adults would experience similar benefits and whether the medication would remain safe in this more vulnerable population.
The new analysis focused specifically on adults aged 65 years and older who were overweight or living with obesity but did not have diabetes. Researchers excluded people with diabetes because weight loss in diabetes patients is usually smaller and would make comparisons more difficult.
Participants either had a body mass index of at least 30 or were overweight with at least one obesity-related health problem.
The researchers combined information from several STEP trials, including STEP 1, 3, 4, 5, 8, and 9. Participants were randomly assigned to receive either weekly injections of semaglutide at a dose of 2.4 milligrams or placebo injections.
Everyone in the study also received lifestyle advice such as healthy eating recommendations and physical activity support. One study included intensive behavioral counseling as well.
The participants were followed for 68 weeks.
In total, the original trials included more than 4,500 participants, but this special analysis focused on 358 adults aged 65 years and older. Most participants were between 65 and 74 years old, while a smaller number were over 75.
At the beginning of the study, the average participant was 69 years old and weighed around 99 kilograms. Most participants had severe obesity, with an average body mass index of 36.6. About 72% of the participants were women.
The findings showed that semaglutide produced substantial weight loss in older adults.
After 68 weeks, participants taking semaglutide lost an average of 15.4% of their body weight. Those taking placebo lost only 5.1% on average.
The drug also produced large improvements in waist size. Waist circumference dropped by more than 14 centimeters in the semaglutide group compared with about 6 centimeters in the placebo group.
Many participants achieved major weight-loss milestones. More than two-thirds of semaglutide users lost at least 10% of their body weight, nearly half lost at least 15%, and more than one-quarter lost at least 20%.
Researchers say these amounts of weight loss are medically meaningful because they may lower the risk of obesity-related diseases and improve physical function.
The medication also improved several markers linked to heart and metabolic health. Participants taking semaglutide showed better blood pressure, cholesterol, blood fats, blood sugar control, and inflammation levels compared with placebo.
Many people also moved into healthier weight categories during the study. Around 27% of participants taking semaglutide reached a body mass index below 27, compared with only 5.5% in the placebo group.
The researchers also carefully monitored safety.
Overall side effects were common in both groups, but serious adverse events were somewhat more frequent among semaglutide users. Constipation and dizziness occurred more often with semaglutide, although dangerous low blood sugar episodes and fractures were rare.
The researchers say the results suggest semaglutide works similarly in older adults as it does in younger populations.
Professor Busetto noted that obesity in adults over 65 is becoming a major cause of disability and reduced quality of life in many countries. He believes the findings support the careful use of semaglutide in this age group.
Still, medical experts stress that weight-loss treatment in older adults must be individualized. Rapid weight loss can sometimes reduce muscle mass as well as body fat, which may be harmful for frail individuals.
Doctors therefore recommend close medical supervision, proper nutrition, and physical activity to help preserve muscle strength during treatment.
The study also reflects broader changes in how obesity is viewed by healthcare professionals. Obesity is increasingly recognized as a chronic medical disease rather than simply a lifestyle problem. Researchers are now developing medications that target appetite and metabolism more directly than older treatments.
After analyzing the findings, the study appears important because it specifically addresses a group often underrepresented in obesity research. The large amount of weight loss seen with semaglutide suggests the drug may offer meaningful health benefits for many older adults struggling with obesity.
Improvements in blood pressure, cholesterol, and metabolic health further strengthen the findings. However, the increased rate of serious adverse events means the medication still requires careful monitoring, especially in frail elderly patients.
Another limitation is that relatively few participants were older than 75 years. Overall, the results suggest semaglutide may become an increasingly important option for treating obesity in older adults when used under proper medical care.
The findings were based on analysis of the STEP clinical trials conducted by researchers from the University of Padova and collaborators from Novo Nordisk.
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Source: University of Padova.
