Introduction
Recent advances in pharmacotherapy for obesity have shown that the magnitude of weight loss is not the only relevant goal. At ObesityWeek 2025, results were presented from the secondary analysis of the STEP UP study, which evaluated the application of a “treat-to-target” (TTT) treatment strategy with semaglutide, aimed at achieving specific low cardiometabolic risk targets.
The STEP UP study and the “Treat-to-Target” approach
The STEP UP study is a phase 3 clinical trial that compared semaglutide 7.2 mg, 2.4 mg, and placebo, in combination with lifestyle changes, in adults with obesity without diabetes.
The analysis presented focused on two control targets:
Body mass index (BMI) less than 27 kg/m².
Waist-to-height ratio (WHtR) less than 0.53.
Both parameters are associated with lower cardiovascular and metabolic risk and were proposed as measurable therapeutic goals within the TTT model.
Main results
Among the 1,310 participants evaluated after 72 weeks of treatment:
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