# Semaglutide References: The Cited Literature

> Semaglutide references: the full cited source list behind this digest — the STEP, SUSTAIN, SELECT and FLOW trials, the mechanism studies, and the safety literature, with DOIs and PubMed links.

Every quantitative claim in this digest traces to one of these peer-reviewed sources, listed with DOIs and PubMed links.

## How to read this list

The sources below are the primary clinical trials, mechanism studies, safety reviews and pharmacovigilance analyses cited throughout this site. Inline markers like [1] across the pages map to the numbered entries here. Each entry carries a DOI or PubMed link so a reader can go straight to the source. This digest summarizes these papers; it is not affiliated with their authors or sponsors, and it summarizes the published record rather than offering medical advice.

## References

[1] Wilding JPH, et al. (STEP 1 Study Group). Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002. https://pubmed.ncbi.nlm.nih.gov/33567185/
[2] Marso SP, et al. (SUSTAIN-6 Investigators). Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834-1844. https://pubmed.ncbi.nlm.nih.gov/27633186/
[3] Lincoff AM, et al. (SELECT Trial Investigators). Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. N Engl J Med. 2023;389(24):2221-2232. https://pubmed.ncbi.nlm.nih.gov/37952131/
[4] Gabery S, et al. Semaglutide lowers body weight in rodents via distributed neural pathways. JCI Insight. 2020;5(6):e133429. https://pubmed.ncbi.nlm.nih.gov/32213703/
[5] Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021;12:645563. https://pubmed.ncbi.nlm.nih.gov/34305810/
[6] Perkovic V, et al. (FLOW Trial Committees and Investigators). Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes. N Engl J Med. 2024;391(2):109-121. https://pubmed.ncbi.nlm.nih.gov/38785209/
[7] Aronne LJ, et al. (SURMOUNT-5 Investigators). Tirzepatide as Compared with Semaglutide for the Treatment of Obesity. N Engl J Med. 2025;392(20):2014-2025. https://pubmed.ncbi.nlm.nih.gov/40353578/
[8] Singh I, et al. Time and metabolic state-dependent effects of GLP-1R agonists on NPY/AgRP and POMC neuronal activity in vivo. Mol Metab. 2021;54:101352. https://pubmed.ncbi.nlm.nih.gov/34626854/
[9] Secher A, et al. The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. J Clin Invest. 2014;124(10):4473-4488. https://pubmed.ncbi.nlm.nih.gov/25202980/
[10] Davies M, et al. (STEP 2 Study Group). Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2). Lancet. 2021;397(10278):971-984. https://pubmed.ncbi.nlm.nih.gov/33667417/
[11] Avgerinos I, et al. Efficacy, safety and cardiovascular outcomes of once-daily oral semaglutide in patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes Obes Metab. 2020;22(3):335-345. https://pubmed.ncbi.nlm.nih.gov/32267058/
[12] Pratley RE, et al. Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial. Lancet Diabetes Endocrinol. 2018;6(4):275-286. https://doi.org/10.1016/S2213-8587(18)30024-X
[13] Aroda VR, et al. Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS). Lancet. 2023;402(10403):693-704. https://doi.org/10.1016/S0140-6736(23)01127-3
[14] Kushner RF, et al. Semaglutide improves cardiometabolic risk factors in adults with overweight or obesity: STEP 1 and 4 exploratory analyses. Diabetes Obes Metab. 2022;24(3):527-536. https://doi.org/10.1111/dom.14890
[15] Spotlight on the Mechanism of Action of Semaglutide. Curr Issues Mol Biol. 2024;46(12):14514-14541. https://pubmed.ncbi.nlm.nih.gov/39728000/
[16] Wharton S, et al. Gastrointestinal tolerability of once-weekly semaglutide 2.4 mg in adults with overweight or obesity, and the relationship between gastrointestinal adverse events and weight loss. Diabetes Obes Metab. 2022;24(1):94-105. https://pubmed.ncbi.nlm.nih.gov/34514682/
[17] Assessment of Thyroid Carcinogenic Risk and Safety Profile of GLP1-RA: A Review. Int J Mol Sci. 2024;25(8):4346. https://doi.org/10.3390/ijms25084346
[18] McCrimmon RJ, et al. Impact of Semaglutide on Body Composition in Adults With Overweight or Obesity. J Endocr Soc. 2021;5(Suppl 1):A16-A17. https://doi.org/10.1210/jendso/bvab048.030
[19] Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. https://pubmed.ncbi.nlm.nih.gov/35441470/
[20] Rubino D, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity (STEP 4): A Randomized Clinical Trial. JAMA. 2021;325(14):1414-1425. https://pubmed.ncbi.nlm.nih.gov/33755728/
[21] Alopecia associated with the use of semaglutide and tirzepatide: A disproportionality analysis. J Eur Acad Dermatol Venereol. 2025. https://pubmed.ncbi.nlm.nih.gov/38925559/
[22] Telogen Effluvium Associated With Weight Loss: A Single Center Retrospective Study. Ann Dermatol. 2024;36(6):348-355. https://pubmed.ncbi.nlm.nih.gov/39623615/
[23] Mahapatra MK, Karuppasamy M, Sahoo BM. Semaglutide. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK603723/
[24] Aroda VR, et al. Current Understanding of Sodium N-(8-[2-Hydroxylbenzoyl] Amino) Caprylate (SNAC) as an Absorption Enhancer: The Oral Semaglutide Experience. Clin Diabetes. 2024;42(1):74-86. https://pubmed.ncbi.nlm.nih.gov/38230324/
[25] Au Yeung SL, et al. Drug-Drug Interactions Between Glucagon-Like Peptide 1 Receptor Agonists and Oral Medications: A Systematic Review. Drug Saf. 2024;47(4):349-364. https://pubmed.ncbi.nlm.nih.gov/38273155/

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A calm reading room for the semaglutide literature — the brain's appetite circuitry, the STEP, SUSTAIN, SELECT and FLOW readouts, and the honest open questions, cited from the published record and prescribed by no one.