Changes in Gait Speed During a 12-Month Multidisciplinary Obesity Management Program Including Semaglutide: A Real-World Observational Study in Japanese Adults With Musculoskeletal Disorders.

Background　Obesity is associated with musculoskeletal disorders, impaired mobility, and frailty. While semaglutide induces substantial weight loss, its effects on objectively measured physical function in routine clinical practice are unclear. We investigated the changes in gait speed and physical function during a multidisciplinary obesity management program that included semaglutide.Methods　This retrospective observational study included 22 adults with obesity and musculoskeletal disorders who completed a 12-month multidisciplinary obesity management program. The program included nutritional counseling every two months, physical therapist-guided exercise intervention, and semaglutide treatment. The primary outcome was the usual gait speed. The secondary outcomes included body weight, pain score, step count, muscle function, and body composition.Results　Body weight decreased significantly from 89.2±18.6 kg to 81.5±17.3 kg (p<0.001). Usual gait speed improved significantly from 0.77±0.20 m/s to 0.91±0.19 m/s (p<0.001). Pain scores also significantly improved (p<0.001). Improvements in gait speed were not associated with weight loss (r=0.22, p=0.32) or pain reduction (r=-0.04, p=0.84). Baseline gait speed was inversely associated with gait speed improvement (r=-0.44, p=0.043), indicating greater gains in participants with poorer baseline mobility.Conclusions　A 12-month multidisciplinary obesity management program, including semaglutide, significantly improved gait speed in patients with obesity and musculoskeletal disorders. Greater improvements were observed in participants with impaired baseline mobility. These findings support the evaluation of obesity treatment not only by weight loss, but also by recovery of mobility.