How effective is survodutide for obesity treatment?

In 2016, more than 1.9 billion adults were overweight (BMI ≥ 25), of which over 650 million had obesity (BMI ≥ 30). Even a 5% reduction in body weight can improve heart health, lower blood pressure, and reduce the risk of type 2 diabetes. While diet and exercise help some, others need prescription medications.

Survodutide is a dual glucagon receptor/GLP‑1 receptor agonist developed by Boehringer Ingelheim and Zealand Pharma. It is a once‑weekly subcutaneous injection, similar to existing GLP‑1 drugs, but with an added glucagon receptor effect. Clinical trials have examined its impact on weight and metabolic health.

Phase 2 obesity trial results

A randomized, double‑blind, placebo‑controlled Phase 2 trial tested survodutide at doses of 0.6 mg, 2.4 mg, 3.6 mg, or 4.8 mg versus placebo in overweight and obese adults over 46 weeks. The primary endpoint was percent change in baseline body weight; secondary endpoints included proportions achieving ≥5%, ≥10%, and ≥15% weight loss, plus changes in blood pressure and waist circumference.

• Average weight loss ranged from 6% to 15%, increasing with dose; the 4.8 mg group had the highest loss.
• The placebo group lost < 3% on average.
• Nearly 40% of survodutide recipients lost > 20% of baseline weight by week 46.
• Weight loss continued without plateau, suggesting greater losses with longer treatment.

Phase 2 MASH trial results

In overweight or obese participants with metabolic dysfunction‑associated steatohepatitis (MASH), survodutide led to significant histological improvements in 83% of treated patients versus 18% on placebo, based on liver biopsy results.

Safety and tolerability

Gastrointestinal adverse events (nausea, vomiting, diarrhea, constipation, abdominal pain) were the primary reasons for discontinuation, especially during rapid dose escalation. Gradual titration may improve tolerability.

Ongoing and planned studies

• Phase 3 obesity trials in overweight/obese adults with and without type 2 diabetes.
• MASH treatment trials.
• Long‑term cardiovascular safety study in obese/overweight adults with heart disease or CKD.

Sources

• World Health Organization. Obesity and Overweight. Accessed June 5, 2025.
• Sanyal AJ et al. A phase 2 randomized trial of survodutide in MASH and fibrosis. N Engl J Med. 2024;391(epub 7 June):311–319. DOI:10.1056/NEJMoa2401755. Accessed June 5, 2025.
• Le Roux CW et al. Dual agonist survodutide for obesity: a dose‑finding Phase 2 trial. Lancet Diabetes Endocrinol. 2024 Mar;12(3):162–173. doi:10.1016/S2213-8587(23)00356-X. Accessed June 5, 2025.
• Blüher M et al. Dose‑response effects with survodutide versus semaglutide in type 2 diabetes. Diabetologia. 2023; published online Dec 14. doi:10.1007/s00125-023-06053-9. Accessed June 5, 2025.