There is a strong relationship between body weight and the risk of developing diabetes. Lorcaserin is a selective serotonin 2C receptor agonist that suppresses appetite, and has been shown to sustain weight loss. This randomized double-blind placebo-controlled trial aimed to evaluate the long-term effects of lorcaserin on diabetes prevention and remission. Patients with a BMI of 27 kg/m2 or higher were randomly assigned to receive either lorcaserin 10 mg twice daily, or matching placebo. All patients had access to a standardized weight management program based on lifestyle modification. Researchers found that 56.8% of patients had diabetes, 33.3% had prediabetes, and 9.9% had normoglycemia. At 1 year, diabetic patients treated with lorcaserin had a net weight loss of 2.6 kg when compared to placebo (95% CI 2.3 kg to 2.9 kg, p<0.0001). Prediabetic patients and those with normoglycemia also experienced significant weight loss compared to placebo (p<0.0001). Lorcaserin resulted in a non-significant increase in the rate of achievement of normoglycemia in patients with prediabetes (9.2% vs. 7.6%, HR 1.20, 95% Cl 0.97 to 1. 49, p=0.093). In patients with diabetes at baseline, severe hypoglycemia was rare, but more common in patients treated with lorcaserin (0.4% vs. 0.1%, p=0.054). This study therefore shows that lorcaserin may decrease the risk of incident diabetes and induce remission of hyperglycemia.