People receiving weight-loss drug Wegovy sustained weight loss for up to four years, shedding an average of 10% of their body weight in that time, as per a new study. Wegrovy is a brand that markets semaglutide injections, that have gained widespread attention for their weight-loss effects. The study also found that Semaglutide injections boost an individual's heart health, even when weight loss doesn't take place.

The study, called SELECT, was published in journal Nature Medicine. "At four years, we see ongoing benefits of semaglutide," said Cheng-Han Chen, MD, interventional cardiologist from Cardiologist, who was not involved in the research. Besides the weight loss, it also lead to a loss in cardiovascular outcomes.

The research was conducted on 17000 adults, who had obesity but did not have diabetes. Overall, people who received once-weekly injections of semaglutide lost on average 10.2% of their body weight over the course of four years. All of the study participants continued to lose weight for about 65 weeks, a year and three months, and then their weight remained at a stable level.

Were There Any Side Effects?

What Did The Results Say?

Of the people on the highest dose of Wegovy, 68% lost at least 5% of their body weight. This compared to 21% of people on the placebo. Additionally, of the total people on Wegovy about 23% lost at least 15% of their body weight. For those in the placebo group, only 1.7% lost that much body weight.

Semaglutide Shows Heart Benefits Beyond Weight Loss

Researchers found that even individuals who did not experience significant weight reduction while on the drug saw a reduced risk of major heart events. Recent analysis of the SELECT trial data revealed that semaglutide significantly lowers the risk of heart attack, stroke, and cardiovascular-related deaths in adults with obesity or those who are overweight. Notably, the results of this study lead the US FDA to approve Novo Nordisk's Wegovy for reducing heart-related risks in this group.

What Is Semaglutide?

Are Their Any Side Effects Of Semaglutide?

Semaglutide, marketed under the brand name Wegovy, is primarily an antidiabetic medication used to treat Type 2 diabetes. It is also an anti-obesity drug used for long-term weight management. While it can be taken as a subcutaneous injection or orally, it has significant side effects. It primarily impacts your gastrointestinal tract and its side effects include constipation, nausea, abdominal pain, diarrhoea, and fatigue amongst others.

It is a common belief that metabolic dysfunction-associated steatotic liver disease (MASLD)—formerly known as non-alcoholic fatty liver disease (NAFLD)—is primarily associated with diet, sedentary lifestyles, and obesity. However, there are other factors as well that affect this aspect. Post-menopausal women experience a significantly higher incidence and faster progression of fatty liver disease, even when maintaining a stable body weight.

In Pre-menopausal women, estrogen plays a central role in metabolism by promoting healthy fat accumulation in subcutaneous tissue (below the skin) rather than around internal organs; it also increases insulin sensitivity and suppresses liver inflammation.

After menopause, when estrogen levels drop, this protective function is lost; there is redistribution of fat leading to more fat accumulation around internal organs, including the liver, thus leading to increased chances of NAFLD and also increasing insulin resistance. Needless to say, with age, our metabolic rate also goes down, which also plays a role in this.

The important part lies not only in understanding the above but in going further in early detection and prevention of menopause associated NAFLD. As we know, fatty liver is a silent disease and often does not cause any signs and symptoms till a very advanced stage.

First and foremost is to change lifestyle with advancing age, changing both the dietary habits and physical activity. Regular screening and monitoring are warranted with blood tests, routine metabolic panels, keeping a tab on weight, sugar, and cholesterol levels, and a basic ultrasound of the abdomen. For someone already diagnosed with second or third stage fatty liver, a simple non-invasive FibroScan can help monitor and assess the response to treatment.

Coming to the treatment part of NAFLD in post-menopausal women, being primarily a lifestyle disease, the core of management also lies in managing lifestyle. Medicines are available for treating and controlling NAFLD in conjunction with lifestyle management. Hormone replacement therapy (HRT), when initiated early in post-menopausal women for symptomatic relief, may offer secondary benefits by maintaining metabolic health. However, HRT should always be initiated after proper evaluation and expert guidance.

NAFLD is a silent epidemic and primarily a lifestyle disease; knowing about it and knowing the triggering and precipitating factors helps with understanding and prevention better. Menopause, being a natural biological phenomenon in every female’s life, makes it essential for us to know how it affects our liver health and overall health as well.

Eating healthy is often associated with loading your plate with salads, fruits, whole grains, legumes, smoothies and sugar-free products. However, a diet that is considered healthy for one person may trigger digestive discomfort in another. Bloating, excessive gas, abdominal cramps, constipation or loose stools after eating “healthy” foods may indicate that your gut is struggling with the quantity or type of foods you are consuming.

One common reason is a sudden increase in dietary fibre. Fibre is essential for bowel health and can support regular bowel movements, but increasing it too quickly can cause fermentation in the large intestine, resulting in gas and bloating. Adults generally need around 22–34 grams of fibre daily, depending on age and sex, but it is better to increase intake gradually rather than making a sudden dietary shift.

Certain nutritious foods can also contain FODMAPs—short-chain carbohydrates that are poorly absorbed in the small intestine. Foods such as onions, garlic, beans, lentils, cauliflower, certain fruits and some dairy products can trigger bloating, abdominal discomfort, diarrhoea or constipation in susceptible individuals, particularly those with irritable bowel syndrome (IBS). A low-FODMAP diet may help selected IBS patients, but it should ideally be undertaken with medical or dietetic guidance and followed by gradual reintroduction of foods.

“Sugar-free” does not necessarily mean gut-friendly either. Sugar alcohols such as sorbitol, mannitol, xylitol and maltitol can be incompletely absorbed and may cause gas, bloating or diarrhoea in some people. Similarly, large quantities of fruit, fruit juices or certain whole grains may aggravate symptoms in people with specific carbohydrate intolerances.

Another overlooked factor is how we eat. Eating very quickly, consuming large meals, drinking fizzy beverages, chewing gum or using straws can increase swallowed air and contribute to belching and bloating. Smaller meals, slower eating and adequate hydration can often make a meaningful difference.

The solution is not to abandon healthy foods, but to personalise your diet. Maintain a food-and-symptom diary, introduce fibre gradually, identify individual triggers and avoid unnecessarily restrictive diets. Persistent symptoms should not simply be attributed to “food intolerance.” Recurrent abdominal pain, unexplained weight loss, anaemia, blood in the stool or black stools require medical evaluation because these may indicate an underlying gastrointestinal condition rather than simple dietary sensitivity.

A healthy diet should nourish your body without consistently making your gut uncomfortable. The goal is not to follow every trending diet, but to understand what works for your individual digestive system.

Being aware of personal and family cancer risk may be a critical component in women's knowledge and empowerment to make appropriate screening, prevention and treatment decisions.

Cancer treatment is fast evolving. Doctors are now focusing more on the person than the location or type of cancer and are considering the personal attributes of the patient and the disease. Genetic/genomic testing can complement this and can offer something more that could inform personalised cancer care.

Genetic testing: Knowing your inherited risk

Genetic testing screens for changes in the genes that could be passed down from parents. Some genetic mutations passed down from parents can make a woman more likely to get breast or ovarian cancer.

Having such a genetic change does not mean that a woman will develop cancer. This information will help her and her doctor discuss screening, monitoring and preventive action (if applicable) to reduce her risk.

This information may be useful for family members who could be at risk and should talk to their health care provider about their own risk.

Genomic testing: Understanding the cancer better

There is a difference between genetic testing and genomic testing. Genetic testing is usually performed on blood or saliva to look for inherited changes or genetic predisposition. Genomic testing is usually performed on the tumour or blood to identify its molecular features to enable better understanding of its biology and biomarkers.

Cancer is not one disease and even two patients with the same type of cancer can have different biological characteristics, which can help doctors decide on the treatment and options that may be suitable for an individual patient.

Genomic testing could help to pinpoint features of a tumour that can be used to consider particular targeted treatments or other methods. But not all of them will be suitable or available to all patients based on the results of testing.

Why Awareness About Health Issues Is Important

For women, knowing their family history and discussing any concerns with a doctor can be an important starting point. Genetic or genomic testing should not be done simply because it is available. A specialist may recommend testing based on factors such as family history, age at diagnosis and the type of cancer involved.

It is also important to understand test results correctly. Genetic counselling and discussions with an oncology specialist can help women understand what their results mean and what they do not mean.

Ultimately, genetic and genomic testing is not about predicting the future with certainty. It is about giving patients and doctors more information to make better-informed decisions.

As cancer care moves towards greater personalisation, the freedom to know your risk can become a powerful part of taking control of your health—helping women move from fear and uncertainty towards awareness, informed choices and personalised care.

(Dr. Jyoti Wadhwa, Principal Lead, Medical & Precision Oncology, Apollo Athenaa Women’s Cancer Center)