Semaglutide for Metabolic Health in Severe Mental Illness: Psychiatrist-Led Clinic Outcomes
Stogios N, Prasad F, De R, Maksyutynska K, PrasannaKumar A, Korann V, Ahmed T, Sanches M, Burton L, Alarabi MA, Isinger T, Desanti M, Oliveira R, Korczak DJ, Graff-Guerrero A, Remington G, Hahn MK, Agarwal SM
Summary
In a large naturalistic cohort of 378 patients with severe mental illness attending a psychiatrist-led metabolic clinic, add-on semaglutide achieved ≥5% body weight loss in 77.8% of patients—the highest efficacy among all interventions tested (metformin 36.9%, topiramate 46.2%, nonpharmacological 34.9%). The number needed to treat for semaglutide was just 2, compared to 3 for other approaches.
Clinical Significance
This is among the first real-world datasets demonstrating semaglutide's exceptional efficacy specifically in the psychiatric population—a group disproportionately affected by antipsychotic-induced weight gain and cardiometabolic disease. The NNT of 2 positions semaglutide as the most effective pharmacological intervention for psychotropic-induced metabolic dysfunction, supporting its integration into psychiatric care pathways.
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