Effects of GLP-1 agonists on proportion of weight loss in obesity with or without diabetes: Systematic review and meta-analysis

Vosoughi, Kia; Roghani, Roham Salman; Camilleri, Michael

doi:10.1016/j.obmed.2022.100456

Cited by 16 publications

(19 citation statements)

References 82 publications

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“…[22][23][24]66,[75][76][77][78][79][80][81][82] The data for weight reduction in patients with type 2 diabetes are not presented here; prior studies showed that weight loss efficacy with GLP-1 receptor agonists (RAs) were superior for obese non-diabetic, compared to patients with type 2 diabetes. 83…”

Section: Effec Ts Of In Cre Tin Ag Onis Ts and The Wei G Ht Lossmentioning

confidence: 99%

“…93 Another systematic review and meta-analysis conducted in patients with obesity with or without diabetes found that non-T2DM patients achieved greater mean weight loss and nausea could have contributed to excess weight loss (coefficient: 0.12, 95% CI: 0.06-0.17). 83 The question whether gastrointestinal adverse events such as nausea contributed to weight reduction has been challenged. In a post-hoc analysis by Meier et al of the effects of oral semaglutide, this was assessed, and they found that nongastrointestinal adverse effects were responsible for the weight loss.…”

Section: Semaglutidementioning

confidence: 99%

“…The clinical trials pertaining to effects of incretin agonists on weight reduction in non‐diabetic patients are summarised in Table 1, which also provides details of doses, comparator, trial duration, major efficacy endpoints (mainly as mean weight reduction compared to the baseline for active treatment and comparator groups) and adverse effects 22–24,66,75–82 . The data for weight reduction in patients with type 2 diabetes are not presented here; prior studies showed that weight loss efficacy with GLP‐1 receptor agonists (RAs) were superior for obese non‐diabetic, compared to patients with type 2 diabetes 83 …”

Section: Effects Of Incretin Agonists and The Weight Lossmentioning

confidence: 99%

See 2 more Smart Citations

Review article: Pharmacologic management of obesity ‐ updates on approved medications, indications and risks

Lupianez‐Merly,

Dilmaghani,

Vosoughi

et al. 2024

Aliment Pharmacol Ther

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SummaryBackgroundObesity has reached epidemic proportions, with >40% of the US population affected. Although traditionally managed by lifestyle modification, and less frequently by bariatric therapies, there are significant pharmacological advancements.AimsTo conduct a narrative review of the neurohormonal and physiological understanding of weight gain and obesity, and the development, clinical testing, indications, expected clinical outcomes, and associated risks of current FDA‐approved and upcoming anti‐obesity medications (AOMs).MethodsWe conducted a comprehensive review in PubMed for articles on pathophysiology and complications of obesity, including terms ‘neurohormonal’, ‘obesity’, ‘incretin’, and ‘weight loss’. Next, we searched for clinical trial data of all FDA‐approved AOMs, including both the generic and trade names of orlistat, phentermine/topiramate, bupropion/naltrexone, liraglutide, and semaglutide. Additional searches were conducted for tirzepatide and retatrutide ‐ medications expecting regulatory approval. Searches included combinations of terms related to mechanism of action, indications, side effects, risks, and future directions.ResultsWe reviewed the pathophysiology of obesity, including specific role of incretins and glucagon. Clinical data supporting the use of various FDA‐approved medications for weight loss are presented, including placebo‐controlled or, when available, head‐to‐head trials. Beneficial metabolic effects, including impact on liver disease, adverse effects and risks of medications are discussed, including altered gastrointestinal motility and risk for periprocedural aspiration.ConclusionAOMs have established efficacy and effectiveness for weight loss even beyond 52 weeks. Further pharmacological options, such as dual and triple incretins, are probable forthcoming additions to clinical practice for combating obesity and its metabolic consequences such as metabolic dysfunction‐associated steatotic liver disease.

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Section: Effec Ts Of In Cre Tin Ag Onis Ts and The Wei G Ht Lossmentioning

confidence: 99%

Section: Semaglutidementioning

confidence: 99%

Section: Effects Of Incretin Agonists and The Weight Lossmentioning

confidence: 99%

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Review article: Pharmacologic management of obesity ‐ updates on approved medications, indications and risks

Lupianez‐Merly,

Dilmaghani,

Vosoughi

et al. 2024

Aliment Pharmacol Ther

Self Cite

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“…Insulin secretagogues and insulin itself may help to lower circulating glucose levels but are themselves associated with weight gain, promoting a vicious cycle. The introduction of gut hormone‐based pharmacotherapies for T2D, and latterly obesity in the absence of dysglycaemia, has been revolutionary 6 . The latest generation of GLP‐1 receptor agonists (GLP‐1RA) are associated with up to a 15% reduction in bodyweight in clinical trials of obesity and a 1.5% reduction in HbA1c, 6,7 although real‐world data suggests their efficacy to be somewhat less impressive, with a significant proportion of patients failing to lose weight at all 8 .…”

Section: Weight Loss and The Remission Of Type 2 Diabetesmentioning

confidence: 99%

“…The introduction of gut hormone‐based pharmacotherapies for T2D, and latterly obesity in the absence of dysglycaemia, has been revolutionary 6 . The latest generation of GLP‐1 receptor agonists (GLP‐1RA) are associated with up to a 15% reduction in bodyweight in clinical trials of obesity and a 1.5% reduction in HbA1c, 6,7 although real‐world data suggests their efficacy to be somewhat less impressive, with a significant proportion of patients failing to lose weight at all 8 . In the pipeline, the next iteration of gut hormone‐based therapies targeting multiple hormone receptors, for example GIP and GLP‐1R co‐agonists, have reported truly life‐changing weight loss results in trials, causing an average placebo‐adjusted 9% reduction in body weight and a third or patients exceeding 20% 9 .…”

Section: Weight Loss and The Remission Of Type 2 Diabetesmentioning

confidence: 99%

What can functional brain imaging teach us about remission of type 2 diabetes?

Hirani,

Alabdulkader,

Miras

et al. 2023

Diabet Med

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With a paradigm shift in attitudes to type 2 diabetes (T2D), “weight‐loss responsive” diabetes is now thought of as a curable disease state. As a result, national programmes are being orchestrated to induce T2D remission soon after diagnosis with aggressive dietary interventions – such as very‐low‐calorie diets (VLCD). However, dietary interventions to achieve weight loss and diabetes remission lack the same long‐term sustainability and cardiovascular risk reduction evidence as bariatric surgery. Improving our understanding of the neural implications of T2D that promote disadvantageous eating behaviours will enable prevention of disease as well as mitigation against a vicious cycle of metabolic dysfunction and associated cognitive complications. Here we summarise how functional MRI (fMRI) studies have helped to fashion our understanding of the neurobiology of human appetite and obesity. We explore how these neural correlates are affected by insulin resistance and T2D itself as well as its different treatment approaches. Finally, we comment on the need for more personalised approaches to maintaining metabolic health and how fMRI studies may inform this.

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Transformative weight loss with Dulaglutide: A case report of success in a challenging patient profile of an ex‐sumo wrestler

Bade,

Sharma

et al. 2024

Clinical Case Reports

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Key Clinical MessageDulaglutide is a relatively unpopular GLP‐1 receptor agonist used for weight loss. This case demonstrates that dulaglutide may be beneficial for weight loss in morbidly obese patients with multiple comorbidities after thoroughly evaluating its efficacy, benefits, and long‐term adverse effects through clinical trials.AbstractWe present a case of a 27‐year‐old ex‐sumo wrestler with bipolar II disorder, morbid obesity, hypertension, Type 2 Diabetes Mellitus (DM), and a Body Mass Index (BMI) of 49.66 kg/m2. He was non‐compliant with lifestyle modifications and resistant to conventional treatments, including metformin, and was also using multiple antipsychotic drugs. After introducing dulaglutide, he achieved a 40 kg (−21%) weight loss and a BMI reduction of 10.3 kg/m2 over 6 months, with no side effects and improved glycemic control, demonstrating dulaglutide's efficacy for weight loss in such challenging presentations.

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Effects of GLP-1 agonists on proportion of weight loss in obesity with or without diabetes: Systematic review and meta-analysis

Cited by 16 publications

References 82 publications

Review article: Pharmacologic management of obesity ‐ updates on approved medications, indications and risks

Review article: Pharmacologic management of obesity ‐ updates on approved medications, indications and risks

What can functional brain imaging teach us about remission of type 2 diabetes?

Transformative weight loss with Dulaglutide: A case report of success in a challenging patient profile of an ex‐sumo wrestler

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