Turner’s syndrome is often accompanied by metabolic complications, including obesity, insulin resistance, and hepatic steatosis (now termed MASLD). While there are no large, controlled trials specifically assessing semaglutide in women with Turner’s, case-based extrapolation from the broader obesity and MASLD literature suggests potential benefit. GLP-1 receptor agonists like semaglutide improve satiety, decrease emotional eating, and promote sustained weight reduction, which can in turn improve insulin sensitivity and liver enzyme profiles. This makes them a rational, though still off-label, choice in Turner’s patients struggling with obesity and metabolic dysfunction.

Psychological factors—such as emotional eating and mood issues—are common in Turner’s and can complicate long-term weight management. Here, semaglutide may provide partial benefit by blunting hunger and cravings, but integrating cognitive behavioral therapy, nutritional counseling, and psychological support is critical. A multidisciplinary approach is recommended: endocrinology for Turner’s-specific hormonal concerns, hepatology for MASLD monitoring, and mental health specialists for emotional well-being.

Discontinuation of semaglutide after weight loss is achieved remains challenging, as many patients experience rebound weight gain due to physiological counter-regulation and re-emergence of appetite. Evidence suggests that tapering or abrupt withdrawal leads to significant regain unless strong behavioral and lifestyle frameworks are in place. In Turner’s patients—where underlying metabolic risk is high—long-term or maintenance-dose GLP-1 therapy may be preferable. If discontinuation is considered, it should be gradual and accompanied by structured lifestyle reinforcement, continued monitoring of liver function, and psychological support to reduce relapse risk.

Thank u for the reply. It was useful. Our pt has reached bmi of 18 on semaglutide

Weaning is a challenge as ridk of frailty etc

This we stoped and referee to psychogy service