Adult women with obesity or overweight achieved an average weight reduction of 25.0% after 68 weeks of treatment with Novo Nordisk’s investigational drug CagriSema, according to new post hoc clinical trial analyses presented on October 20, 2026, at The Menopause Society Annual Meeting in San Diego. The findings, announced by Novo Nordisk, evaluate data from the Phase 3 REDEFINE 1 trial and indicate that the next-generation weekly injection delivers substantial weight loss across premenopausal, perimenopausal, and postmenopausal stages.

CagriSema combines two distinct active ingredients at 2.4 mg doses each: semaglutide, the GLP-1 receptor agonist found in the obesity medication Wegovy and the diabetes medication Ozempic, and cagrilintide, an experimental amylin analog. By targeting both the GLP-1 pathway and the amylin pathway—which involves a hormone released in the pancreas alongside insulin to regulate hunger and satiety—the dual-therapy injection is designed to surpass the weight-reduction outcomes of existing single-hormone treatments. According to CNBC, Novo Nordisk expects to launch CagriSema early next year.

Trial Results Across Menopausal Stages

The primary REDEFINE 1 study was a 68-week, double-blind Phase 3 trial that enrolled 3,417 adults with obesity or overweight and at least one weight-related comorbidity, according to MarketScreener. Initial findings across the broader study population of both men and women showed an average weight loss of 22.7% at week 68 compared with 2.3% in the placebo group. However, women made up roughly 67% of the overall trial cohort, prompting investigators to examine sex-specific and reproductive-stage outcomes.

In the first post hoc analysis examining all 2,309 female participants, women treated with CagriSema lost an average of 25.0% of their body weight at 68 weeks, compared with 3.0% among those receiving a placebo. As reported by Pharmacy Times, the overall women's analysis also evaluated individual comparator arms, revealing that the 25.0% reduction with CagriSema exceeded the 19.0% average weight loss seen with semaglutide alone and the 13.4% reduction achieved with cagrilintide alone.

A second post hoc analysis evaluated 1,902 women grouped by their reproductive stage, which investigators assigned after the trial using age, medical history, and recorded symptoms rather than biochemical confirmation. Average weight loss at week 68 remained high across all cohorts:

  • Premenopausal women: 26.7% weight loss with CagriSema, compared with 2.1% on placebo.
  • Perimenopausal women: 24.8% weight loss with CagriSema, compared with 1.7% on placebo.
  • Postmenopausal women: 23.1% weight loss with CagriSema, compared with 2.6% on placebo.

Across both analyses, treatment with the combination drug was also associated with improvements in waist circumference, a secondary endpoint used to measure abdominal fat accumulation.

Clarifying Trial Methodology and Scope

While some early summaries have conflated these results with diabetes trials examining blood sugar benefits, clinical reports from Novo Nordisk and CNBC clarify that the REDEFINE 1 trial specifically enrolled adults without type 2 diabetes. The latest women's subgroup analyses focused on body weight and waist circumference rather than new blood-sugar outcomes. Novo Nordisk is evaluating CagriSema for adults with type 2 diabetes in a separate clinical track known as the REIMAGINE program.

Researchers and analysts also note important methodological caveats regarding the 25.0% weight-loss figure. In Novo Nordisk's announcement, the outcomes are reported under an "efficacy estimand," a statistical measurement assuming all participants adhered to the medication for the full 68 weeks. CNBC notes that this represents an idealized scenario in which patients remained on treatment without interruptions, rather than the real-world average for all participants regardless of whether they discontinued the drug early.

Why Midlife Weight Management Matters

According to U.S. Census Bureau figures cited by the company, more than 86 million women in the United States are aged 40 and older—the life stages when perimenopause, menopause, and postmenopause occur. During this transition, declining estrogen levels slow down metabolism, making it easier to gain weight and harder to preserve muscle mass. These hormonal changes frequently trigger a shift toward central fat distribution around the abdomen, which increases the risk of hypertension, dyslipidemia, dysglycemia, and cardiovascular disease.

"Many women with obesity or overweight experience weight gain as they move through menopause, and it is important to explore investigational products such as CagriSema across the reproductive lifespan," said Michelle Skinner Moore, PharmD, MBA, interim head of clinical development, medical and regulatory affairs at Novo Nordisk.

Lead study author Maria D. Hurtado Andrade, MD, PhD, an assistant professor at the Mayo Clinic Alix School of Medicine, called the weight reductions across each cohort encouraging. In comments to Pharmacy Times, she noted that while postmenopausal women saw slightly less weight loss than premenopausal participants, the overall reduction remained substantial and clinically meaningful across all reproductive stages.

Safety Signals and Patient Guidance

Consistent with existing GLP-1 therapies, gastrointestinal side effects were the most common adverse events recorded in the REDEFINE 1 trial. According to data reported by Pharmacy Times, gastrointestinal symptoms affected 79.6% of participants taking CagriSema compared with 39.9% of those taking the placebo. The company stated that these events were mostly transient and mild to moderate in severity.

Because the combination therapy can cause rapid weight reduction, medical experts emphasize the need for careful clinical monitoring, particularly for older women who already face higher risks of bone and muscle loss after menopause. Hurtado Andrade advised that healthcare providers reassess patients within four to six weeks of starting treatment and maintain follow-ups during dose increases. If significant gastrointestinal side effects occur, dose escalation can be delayed or slowed.

To protect lean muscle mass and bone health during treatment, clinicians recommend pairing medication with adequate protein intake, resistance exercise, and targeted nutritional support. Patients can also manage digestive side effects by eating smaller meals, eating slowly, and stopping when full.

Frequently Asked Questions

Did the REDEFINE 1 analysis study diabetes and blood sugar outcomes?

No. The REDEFINE 1 trial enrolled 3,417 adults with overweight or obesity who did not have type 2 diabetes. The recent post hoc analyses evaluated weight loss and waist circumference in women. Novo Nordisk studies CagriSema in adults with type 2 diabetes under a separate clinical program called REIMAGINE.

Do the 25% weight-loss figures apply to every patient who starts the drug?

The 25.0% average weight loss is based on an efficacy estimand, which calculates results under the assumption that participants adhered to the weekly injections for all 68 weeks without interruption. Outcomes can vary for patients who pause or discontinue treatment due to side effects such as gastrointestinal discomfort, which affected 79.6% of the CagriSema group.

How does CagriSema compare to taking semaglutide alone?

In the REDEFINE 1 women's subgroup analysis, the combination of cagrilintide and semaglutide (CagriSema) produced an average weight loss of 25.0% at 68 weeks. That outperformed both individual components tested in comparator arms, where women lost an average of 19.0% on semaglutide alone and 13.4% on cagrilintide alone, versus 3.0% on placebo.

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