A study to evaluate the effectiveness and safety of the drug AZD6234 for managing weight in adults who are obese or overweight. These participants may or may not also have Type 2 Diabetes - SELENE-Asia

Inclusion Criteria

• Inclusion Criteria:
• - Aged 18 years or older at the time of signing informed consent.
• - Body mass index:
• -at least 28 kg/m²; or
• -at least 24 kg/m² and less than 28 kg/m² with at least one protocol-defined weight-related comorbidity, including type 2 diabetes mellitus, hypertension, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, heart failure, chronic kidney disease, metabolic dysfunction-associated steatotic liver disease, knee osteoarthritis, or stress urinary incontinence.
• - Stable body weight (≤ 5% body weight change) for at least 3 months prior to Randomisation.
• - Participants with type 2 diabetes mellitus must:
• -have been diagnosed at least 6 months before informed consent;
• -have HbA1c between 6.0% and 10.0% at Screening; and
• -be managed with diet and exercise alone or with a stable dose of 1 to 3 oral glucose-lowering medications for at least 3 months before Screening.
• - At least one previous self-reported unsuccessful attempt to lose body weight.
• - Participants of childbearing potential must comply with protocol-defined highly effective contraception requirements and have negative pregnancy tests at Screening and Randomisation.
• - Able to provide signed informed consent.
• Exclusion Criteria:
• - Obesity primarily caused by another endocrine disorder.
• - Severe heart failure, defined as New York Heart Association Class IV, or hospitalisation for heart failure within 3 months before Screening.
• - Type 1 diabetes mellitus or ketoacidosis or hyperosmolar coma/state within 3 months before Screening.
• - Clinically significant gastric-emptying abnormality requiring treatment.
• - Significant inflammatory bowel disease or another severe disease or prior surgery affecting the upper gastrointestinal tract.
• - Cardiovascular event, percutaneous coronary intervention, or coronary artery bypass graft within 3 months before Screening.
• - Previous or planned surgical treatment for obesity.
• - Uncontrolled hypothyroidism or hyperthyroidism.
• - Significant hepatobiliary disease, including protocol-defined elevations in alanine aminotransferase, aspartate aminotransferase, or total bilirubin.
• - Neoplastic disease within 5 years before Screening, except as otherwise permitted by the protocol.
• - Clinically important disease or disorder that may place the participant at risk or interfere with study participation.
• - Known or suspected drug abuse or alcohol abuse.
• - Planned elective surgery requiring discontinuation of study intervention for more than 6 weeks.
• - Weight-management treatment within 3 months before Randomisation.
• - Treatment with a glucagon-like peptide-1 receptor agonist or another glucagon-like peptide-1-containing medication within 3 months before Randomisation.
• - Treatment with a marketed or investigational amylin-based compound within 3 months before Randomisation.
• - Use of insulin therapy for type 2 diabetes mellitus.
• - Long-term systemic glucocorticoid treatment lasting more than 14 days or use of central nervous system stimulants.
• - Concomitant medication that may increase risk, affect study results, or interfere with study participation.
• - Unstable major depressive disorder or Patient Health Questionnaire-9 score of 15 or higher.
• - History of psychosis or active symptomatic bipolar disorder.
• - Active suicidal ideation corresponding to Category 4 or 5 on the Columbia-Suicide Severity Rating Scale, or history of a suicide attempt.
• - Participation in another clinical study within 30 days before Screening.
• - Known hypersensitivity to AZD6234.
• - Involvement in the planning and/or conduct of the study.
• - Unlikely or unable to comply with study procedures, restrictions, or requirements.
• - Previous randomisation in the present study.
• - Currently pregnant or breastfeeding.
• - Any other condition that, in the Investigator’s judgement, makes participation inappropriate.