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We evaluated the effect of the latest GLP-1 RA semaglutide on tongue fat storage in obese women. We conducted a randomized single-blind, pilot study. Twenty-five obese women with polycystic ovary syndrome (PCOS) (33.7±5.3years, body mass index (BMI) 36.1±3.9kg/m2, mean±SD) were randomized to semaglutide 1.0mg or placebo for 16weeks. We quantified tongue volume and its fat tissue and fat proportion by magnetic resonance imaging. Tongue fat tissue and fat proportion significantly reduced after semaglutide vs placebo (-1.94±5.51 vs.+3.12±4.