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The article discusses a post hoc analysis of a phase 2 clinical trial on survodutide, a dual agonist for glucagon and GLP-1 receptors, in adults with obesity. The study showed significant weight loss and reductions in blood pressure with survodutide treatment compared to placebo. The results suggest that survodutide may help alleviate cardiovascular risk, regardless of hypertension status at baseline. The study was supported by Boehringer Ingelheim, and the authors disclosed potential conflicts of interest related to the research. [Extracted from the article]

Objective: The objective of this study was to describe the rationale and design of two multinational phase 3 clinical trials of survodutide, an investigational glucagon and glucagon‐like peptide‐1 receptor dual agonist for the treatment of obesity with or without type 2 diabetes (T2D; SYNCHRONIZE‐1 and ‐2). Methods: In these ongoing double‐blind trials, participants were randomized to once‐weekly subcutaneous injections of survodutide or placebo added to lifestyle modification. Survodutide doses are uptitrated to 3.6 or 6.0 mg, and dose flexibility is permitted. Participants (n = 726) in SYNCHRONIZE‐1 (NCT06066515) have a baseline BMI ≥ 30 kg/m2 or ≥27 kg/m2 with at least one obesity‐related complication but without T2D; participants (n = 755) in SYNCHRONIZE‐2 (NCT06066528) have a baseline BMI ≥ 27 kg/m2 and T2D. The primary endpoints are percentage change in body weight and proportion of participants achieving ≥5% body weight reduction from baseline to week 76. Secondary endpoints include change in systolic blood pressure and measures of glycemia. A SYNCHRONIZE‐1 substudy is evaluating changes in body composition and liver fat content using magnetic resonance imaging. Conclusions: These trials are designed to provide robust evaluation of the efficacy, safety, and tolerability of survodutide for the treatment of obesity in the presence or absence of T2D. [ABSTRACT FROM AUTHOR]

A cross-sectional, online survey was conducted in the United Kingdom, France, Germany, and the United States (14 November-22 December 2022) to investigate preferences for anti-obesity medication (AOM) among people with obesity (PwO) and healthcare providers (HCPs). Eligibility: Adult PwO who self-defined their body type as overweight/obese, were trying to lose weight and had BMI ≥30.0 or 27.0-29.9 kg/m 2 with ≥1 obesity-related complication; HCPs had to see ≥30 PwO in a typical month and be a decision-maker regarding their weight loss. The survey included 2500 PwO and 500 HCPs. Exercise (96%) and diet (90%) were the most common weight management methods; AOM use was low (8%). Key barriers to use of prescribed AOMs among PwO were not wanting to take AOM (34%), side effects concerns (33%), and not trusting AOM (26%). Most HCPs (79%) had prescribed/recommended AOMs. Efficacy was the most common reason for preferring one of the shown product profiles among PwO (60%) and HCPs (86%); improving cardiovascular risk was also important to 95% of HCPs when deciding which AOM to prescribe. AOM preference is largely driven by efficacy. Increasing knowledge could help to address barriers to AOM use and improve outcomes for PwO., (© 2024 The Author(s). Clinical Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Aim: To explore the effects of sex and baseline body mass index (BMI) on the efficacy and safety of survodutide in people with a BMI ≥27 kg/m 2 ., Materials and Methods: Totally 387 people (aged 18-75 years, BMI ≥27 kg/m 2 , without diabetes) were randomized 1:1:1:1:1 to once-weekly subcutaneous survodutide (0.6, 2.4, 3.6 or 4.8 mg) or placebo for 46 weeks (20-week dose escalation; 26-week dose maintenance). Participants were categorized according to sex and baseline BMI. Data were analysed descriptively for the full analysis set (FAS), according to dose assigned at randomization (planned treatment) using on-treatment data or all data censored for COVID-19-related treatment discontinuations. (ClinicalTrials.gov number: NCT04667377)., Results: After 46 weeks of survodutide treatment, females had greater reductions in bodyweight and waist circumference than males. Participants with a lower baseline BMI had greater proportional reductions in bodyweight than those with a higher baseline BMI; the trend was reversed for reductions in waist circumference. Rates of adverse events (AEs) were comparable between subgroups for sex and baseline BMI. Nausea was the most frequently reported gastrointestinal AE in all subgroups., Conclusions: In people with a BMI ≥27 kg/m 2 , survodutide was associated with clinically meaningful reductions in bodyweight and waist circumference when compared with placebo, in prespecified subgroups based on sex and baseline BMI, and was tolerated at all doses tested., (© 2025 Boehringer Ingelheim International GmbH and The Author(s). Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)

Competing Interests: Declaration of interests FR declares research grants from Ethicon (Johnson & Johnson), Novo Nordisk, and Medtronic; consulting fees from Morphic Medical; speaking honoraria from Medtronic, Ethicon, Novo Nordisk, Eli Lilly, and Amgen; has served (unpaid) as a member of the scientific advisory board for Keyron, and a member of data safety and monitoring board for GI Metabolic Solutions; is president of the Metabolic Health Institute (non-profit); and is sole director of Metabolic Health International and London Metabolic and Bariatric Surgery (private practice). JRLF declares personal consulting or speaker fees from Novo Nordisk, IFA Celtics, Eli Lilly, and Merck. PS declares research grants (paid to institution) from the National Health and Medical Research Council; coauthorship of manuscripts with medical writing assistance from Novo Nordisk and Eli Lilly; and an unpaid position in the leadership group of the Obesity Collective. WAB declares research grants from Johnson & Johnson, Medtronic, Gore, Applied Medical, Novo Nordisk, National Health and Medical Research Council, Myerton, and the Australian Commonwealth Government; and personal consulting fees for lectures and advisory boards from Johnson & Johnson, Gore, Novo Nordisk, Pfizer, Medtronic, Eli Lily, and Merck Sharp & Dohme. GM declares consulting fees from Novo Nordisk, Boehringer Ingelheim, Eli Lilly, Medtronic, Fractyl, and Recor; and is a scientific advisor for Keyron, Metadeq, GHP Scientific, and Jemyll. MB declares personal honoraria as a consultant and speaker from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, Novo Nordisk, Novartis, Pfizer, and Sanofi. ML declares personal consulting fees from, and has served on scientific boards for, Novo Nordisk, Pfizer, and Eli Lilly. LMSC declares consultancy fees from Antaros Medical. MTvdM declares past consulting fees from Netcare PTY and Novo Nordisk. RVC declares research grants from Johnson & Johnson and Medtronic; honoraria for lectures and presentations from Johnson & Johnson, Medtronic, and Novo Nordisk; and serving on scientific advisory boards for Morphic Medical, Johnson & Johnson, and Medtronic. AM declares research grants from USV (India) and AstraZeneca; honoraria for lectures from USV (India), Eli Lilly, Lupin, Boehringer Ingelheim, Janssen, Cipla, AstraZeneca, Glenmark, Zydus, Novo Nordisk, Sanofi, Danone, Abbott, and the Almond Board of California; support for attending meetings or travel from USV (India), Eli Lilly, Boehringer Ingelheim, AstraZeneca, Lupin, and the Almond Board of California. KC is a primary investigator for Rhythm Pharmaceuticals, Bioprojects, and Integrative Phenomic (SME) trials; declares support for attending meetings or travel from Rhythm Pharmaceuticals and Novo Nordisk; and received research grants or support from Rhythm Pharmaceuticals to conduct research or deliver lectures via Institutions (Assistance Publique-Hôpitaux de Paris, Sorbonne Université). RFK declares consulting fees from Novo Nordisk, Weight Watchers, Eli Lilly, Boehringer Ingelheim, Altimmune, Structure, and Regeneron. JN has no personal relationships with industry; is an employee of the Obesity Action Coalition, which receives unrestricted support from a wide variety of companies and organisations interested in obesity care including, from the pharmaceutical industry (NovoNordisk, Eli Lilly, Boehringer Ingelheim, Pfizer, Amgen, Genentech, Regeneron, Wave Life Sciences, Zealand Pharma, KVKTech, Madrigal Pharmaceuticals, Structure Therapeutics, Biohaen Pharmaceuticals, and Currax), surgical industry (Intuitive, Ethicon, Medtronic, and Boston Scientific), behavioural care (WW International and WondrHealth), and not-for-profit medical societies (American Society for Metabolic and Bariatric Surgery, the Obesity Society, and the Obesity Medicine Association); and is president and chief executive officer for the Obesity Action Coalition. NS declares consulting or speaker honoraria from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Janssen, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Roche Diagnostics, and Sanofi; and grants (paid to institution) from AstraZeneca, Boehringer Ingelheim, Novartis, and Roche Diagnostics. WTG declares consulting fees as a member of advisory boards for Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Pfizer, Fractyl Health, Alnylam Pharmaceuticals, Inogen, Zealand Pharma, Allurion, Carmot Therapeutics (Roche), Regeneron, and Merck; research grants as a site principal investigator for multicentre clinical trials sponsored by his university and funded by Novo Nordisk, Eli Lilly, Epitomee, Neurovalens, and Pfizer; has served as a consultant on an advisory board for the non-profit Milken Foundation; and is a member of the data monitoring committee for phase 3 clinical trials conducted by Boehringer Ingelheim and Eli Lilly. BL declares research grants from US National Institutes of Health (not related to this Commission); and personal consulting fees from UpToDate. RHE declares consulting fees from Novo Nordisk, The Healthy Aging Co, and WW International. AK declares research grants from Novo Nordisk, ELPEN Pharma, and Pharmaserve–Lilly; serving on scientific advisory boards for Novo Nordisk, Pharmaserve–Lilly, Sanofi, and Boehringher Ingelheim; and honoraria for lectures by Novo Nordisk, Pharmaserve–Lilly, AstraZeneca, MSD, Sanofi, Bausch Health, Ethicon, Galenica Pharma, Epsilon Health, and Winmedica. J-PD declares grants from the Canadian Institutes of Health Research; and personal consulting fees from INVERSAGO Pharma as a member of the advisory board. KWT declares speaker honoraria or consulting fees from Novo Nordisk, Eurodrug Laboratories, iNova Pharmaceuticals, and DKSH; travel support from Novo Nordisk; and serving on advisory boards of Novo Nordisk, DKSH (representing Eli Lilly), Abbott Nutrition, and Boehringer Ingelheim. ER declares research grants from Eli Lilly and Novo Nordisk; and consulting fees from Energesis Pharmaceuticals, Eli Lilly, Amway, Kintai Therapeutics, YSOPIA Bioscience (previously LNC Therapeutics), CINFINA Pharmaceuticals, and Boehringer Ingelheim. JBD declares personal consulting fees from Reshape Lifescience, and Nestle Health Science Australia; serving on advisory boards and speaker panels for Reshape Lifescience, Nestle Health Science Australia, Novo Nordisk, Eli Lilly, and I-nova; and speaker fees from HealthED and Eurodrug Laboratories. FP declares personal consulting fees from Medtronic, Ethicon, Novo Nordisk, and Eli Lilly. DEC declares serving on scientific advisory boards for GI Dynamics, Gila Therapeutics, and Endogenex. TK declares research grants from Nippon Boehringer Ingelheim and Sumitomo Pharma; consulting fees from Taisho Pharmaceutical, Eli Lilly Japan, and Novo Nordisk; and honoraria for lectures from Nippon Boehringer Ingelheim, Sumitomo Pharma, Teijin Pharma, MSD, Eli Lilly Japan, Mitsubishi Tanabe Pharma Corporation, Taisho Pharmaceutical, and Novo Nordisk. NBAB declares research grants from NovoNordisk and AstraZeneca; and honoraria for lectures and presentations from Novo Nordisk, Boehringer Ingelheim, AstraZeneca, Merck, MSD, Sanofi, and Servier. JV was national clinical director for diabetes and obesity at NHS England from April, 2013, to September, 2023; declares funding support from the North West London National Institute for Health and Care Research Applied Research Collaboration, CW+ (the official charity of Chelsea and Westminster Hospital NHS Foundation Trust), European Commission Horizon Europe 2022, and UK Research and Innovation Horizon Europe. CWlR declares grants from the Irish Research Council, Science Foundation Ireland, Anabio, and the Health Research Board; serving on advisory boards and speakers panels for Novo Nordisk, Herbalife, GI Dynamics, Eli Lilly, Johnson & Johnson, Glia, Irish Life Health, Boehringer Ingelheim, Currax, Zealand Pharma, Keyron, and Rhythm Pharmaceuticals; was the chief medical officer and director (unpaid) of the Medical Device Division of Keyron in 2021; was a previous investor in Keyron, which develops endoscopically implantable medical devices intended to mimic the surgical procedures of sleeve gastrectomy and gastric bypass (no patients have been included in any of Keyron's studies and they are not listed on the stock market); was gifted stock holdings in September, 2021, and divested all stock holdings in Keyron in September, 2021; continues to provide scientific advice (unpaid) to Keyron; and provides (unpaid) obesity clinical care in the Beyond BMI clinic (Dublin, Ireland), and is a shareholder in the clinic. NJF-L declares personal consulting fees from WHO and the European Commission (Best Re-MaP joint action [a project aimed to develop and implement policy proposals in nutrition for children]). NFA declares personal consulting fees from Ethicon and Eli Lilly; and serving on scientific advisory boards for Novo Nordisk and Eli Lilly. ISF declares personal consulting fees from Rhythm Pharmaceuticals, Eli Lilly, Novo Nordisk, SV Health, Nodthera Therapeutics, and Goldman Sachs. VMM declares personal consulting fees from Boehringer Ingelheim and Novo Nordisk. JPK declares research grants from the US National Institutes of Health (grants U54, U01, and U54 GM104940 that could be indirectly linked to the work of this Commission); and honoraria for serving on scientific advisory boards of Novo Nordisk and the Annual Reviews of Nutrition. KMM reports serving on scientific advisory boards for Novo Nordisk and Rhythm Pharmaceuticals; and is a member of a drug safety and monitoring board for Novartis. PRS declares research grants from Ethicon and Medtronic; personal consulting fees or honoraria from GI Dynamics, Keyron, Persona, Mediflix, Metabolic Health International, Eli Lilly, Heron, Novo Nordisk, and Klens; serving on scientific advisory boards for SE Healthcare Board of Directors, GI Dynamics, Keyron, Persona, and Mediflix; and has ownership interest in SE Healthcare, Mediflix, and Metabolic Health International. HT declares research grants from Amgen, Boehringer Ingelheim, Daiichi Sankyo, Novartis, and Novo Nordisk; serving on advisory boards for Novo Nordisk, Daiichi Sankyo, and Novartis; and speakers fees from Daiichi Sankyo, Novartis, and Novo Nordisk. MHT declares participation in a scientific advisory board meeting of ERX Pharmaceuticals (Cambridge, MA, USA) in 2019; was a member of the Research Cluster Advisory Panel of the Novo Nordisk Foundation between 2017 and 2019; funding for research projects from Novo Nordisk (2016–20) and Sanofi-Aventis (2012–19); consulted twice for Boehringer Ingelheim (2020 and 2021); delivered scientific lectures for Sanofi-Aventis (2020), Boehringer Ingelheim (2024), and AstraZeneca (2024); is cofounder of the biotech startups Ghrelco and Bluewater Biotech (2024); is chief executive officer and chief scientific officer of Helmholtz Munich, and is co-responsible for countless collaborations of the employees with a multitude of companies and institutions worldwide (in this capacity, discusses potential projects with and signs contracts for the centres institutes related to research collaborations worldwide, including, but not limited to, pharmaceutical corporations such as Boehringer Ingelheim, Novo Nordisk, Roche Diagnostics, Arbormed, Eli Lilly, and SCG Cell Therapy, and as chief scientific officer is responsible for commercial technology transfer activities); and is a former member of the scientific advisory board of ERX, which is developing the drug celastrol, but has no current competing interests. JPHW declares consultancy or advisory board work for the pharmaceutical industry contracted via the University of Liverpool (no personal payment) for Altimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Napp, Novo Nordisk, Menarini, Pfizer, Regeneron, Rhythm Pharmaceuticals, Sanofi, Saniona, Tern, Shionogi, and YSOPIA Bioscience; research grants for clinical trials from AstraZeneca and Novo Nordisk; personal honoraria or lecture fees from AstraZeneca, Boehringer Ingelheim, Medscape, Napp, Novo Nordisk, and Rhythm Pharmaceuticals; is past president of the World Obesity Federation; and was national lead for the Metabolic and Endocrine Speciality Group of the National Institute of Health and Reasearch Clinical Research Network from 2010–24; and is a member of the Rank Prize Funds Nutrition Committee and a past member of the RCP committee on nutrition, weight, and health. FCS declares personal consulting fees from Eli Lilly, Novo Nordisk, Boehringer Ingelheim, Pfizer, Gelesis, Currax, and Rhythm Pharmaceuticals; and has served on scientific advisory boards for Eli Lilly and Novo Nordisk. LAB declares serving on scientific advisory board for Novo Nordisk (for the ACTION Teens study) and Eli Lilly; and speaker fees (paid to institution) from Novo Nordisk. LMK declares participation on advisory boards for Boehringer Ingelheim and Eli Lilly; and consulting fees from Altimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Cytoki, Ethicon, Glyscend, Kallyope, Eli Lilly, Neurogastrx, Novo Nordisk, Optum Health, Perspectum, Pfizer, Sidekick Health, Xeno Biosciences, and Zealand Pharma. RLB declares research grants from the Sir Jules Thorn Trust, National Institutes for Health and Care Research, Rosetrees Trust, and Novo Nordisk; personal consulting fees from Eli Lilly, Novo Nordisk, Gila Therapeutics, Epitomee Medical, Medscape, ViiV, and International Medical Press; serving on scientific advisory boards for Eli Lilly, Novo Nordisk, Pfizer, ViiV, and International Medical Press; leadership or fiduciary roles (unpaid) in other board, society, committee, or advocacy groups for the Royal College of Physicians; is a committee member of the British Obesity and Metabolic Surgery Society and the National Bariatric Surgery Registry; is scientific chair of the International Federation for the Surgery of Obesity, European Chapter; is a trustee for the Association for the Study of Obesity and the Obesity Empowerment Network UK; is a member of the Obesity Guideline Update Committee for the National Institutes for Health and Care Excellence; and, since May 15, 2023, is senior vice president for Eli Lilly and holds shares in Eli Lilly, and as a result has had no active involvement in this Commission since May 1, 2023 (however, to comply with authorship requirements, RLB read and approved the final draft [see Acknowledgements for details]). RV declares research grants from Pfizer; fees for educational purposes from Novo Nordisk, AstraZeneca, and Eli Lilly; and serving on scientific advisory boards for Eli Lilly and Novo Nordisk. MO-G declares research grants from Adamed Poland; personal consulting fees from Baush Health, Novo Nordisk, and Promed Poland; and serving on scientific advisory boards for Baush Health, Novo Nordisk, and Boehringer Ingelheim. HJG declares consulting fees from Gila Pharmaceuticals and Pfizer. SL declares research grants from Merck Sharp & Dohme, Novo Nordisk, and LG Chem; and honoraria as a consultant or speaker for AstraZeneca, Boehringer Ingelheim, Abbott, LG Chem, Daewoong Pharmaceutical, Chong Kun Dang Pharmaceutical, and Novo Nordisk. All other authors have no competing interests.