Impact of Semaglutide as Weight Management Medication on Clinical Parameters and Health-Related Quality of Life: A Single-Center Study from Saudi Arabia

Background: Despite the cardiometabolic benefit of semaglutide, its impact on quality of life and whether patients’ characteristics influence clinical outcomes and health-related quality of life (HRQoL) remain ambiguous. Method: A retrospective review of patient charts was conducted after semaglutide initiation to assess the clinical impact of semaglutide, followed by a prospective analysis to evaluate HRQoL using the 36-Item Short Form Health Survey (SF-36). Descriptive and correlative analyses were conducted using SPSS software version 29 (IBM Corp., Armonk, NY, USA). Results: From a total of 715 patients, 255 (average age 59.1 years; 58.1% male participants) were subjected to clinical outcome analysis. The use of semaglutide was associated with significant reductions in HbA1c, total bilirubin, and TG and elevations in T4, TSH, Scr, and HDL. When each fifth value of each clinical parameter was compared with the baseline, gender revealed a significant impact, as females showed increased rates of elevated HDL (73.2% vs. 55.7%), reduced weight (69.8% vs. 55.7%), and reduced BMI (72.5% vs. 53.8%) compared to those in males. Despite the number of comorbidities significantly influencing BMI (p = 0.015), it had no impact on HbA1c post semaglutide use (p = 0.062). The same number of patients (n = 255), albeit having slightly different demographic and clinical characteristics, was included in the HRQoL analysis cohort. Females represented 54.5% of the cohort, and 71.0% were aged between 40 and <65 years. The average scores for all domains within the physical component summary (PCS) and mental component summary (MCS) were below 50, indicating a lack of perceived improvement in the overall quality of participants’ lives considering the pre-treatment period as the basis of comparison. In particular, younger age OR 0.975, CI95% 0.953–0.998, p = 0.033 and being female OR 0.273, CI95% 0.162–0.459, p < 0.001 led to reduced odds of scoring ≥ 50 in PCS, indicating a poor physical health state. On the contrary, older age OR 1.036, CI95% 1.011–1.06, p = 0.004 increased the odds of scoring ≥ 50 in MCS, indicating a better mental health state in elderly vs. young semaglutide users. Although education level had significant influence on PCS, this did not extend to MCS. Upon investigating if type of change in a clinical parameter correlates with PCS and MCS scoring, only the decline in T4 reduced the odds of scoring MCS ≥ 50 OR 0.5, CI95% 0.274–0.913, p = 0.024, while no significant influence was found either with other parameters or between clinical parameters and PCS. Conclusions: A lack of perceived improvement in HRQoL is noted with semaglutide use. Age, gender, and education play significant roles in HRQoL post semaglutide initiation. Overall, before prescribing semaglutide, patient counseling on its positive and negative effects is crucial to promote long-term adherence and optimize clinical outcomes.