Hormonal
GLP-1 receptor agonists (GLP-1 RAs) such as semaglutide and liraglutide produce significant, sustained weight reduction in adults with obesity by acting on the gut-brain axis to reduce appetite and food intake.
Semaglutide 2.4 mg injected once weekly, combined with lifestyle counseling, leads to an average 14.9% body weight loss in adults with obesity over 68 weeks. Side effects like nausea are common initially but typically subside; starting with a lower dose helps manage this.
GLP-1 receptor agonists (GLP-1 RAs) represent the first agents in a rapidly evolving, highly promising landscape of nascent hormone-based obesity therapeutics... GLP-1 RAs can be deployed as monotherapy... These emerging entero-endocrine and endo-pancreatic agents combined or coformulated with GLP-1 RAs herald a new era of targeted, mechanism-based treatment of obesity.
Why this rating
Based on multiple Phase III randomized double-blind placebo-controlled trials (SCALE, STEP, SURMOUNT) with large sample sizes.
Source
New Frontiers in Obesity Treatment: GLP-1 and Nascent Nutrient-Stimulated Hormone-Based Therapeutics
Ania M. Jastreboff et al. · Annual Review of Medicine · 2023
DOI 10.1146/annurev-med-043021-014919
More from this paper
- Tirzepatide, a dual GIP/GLP-1 receptor agonist, produces greater weight reduction than GLP-1 monotherapy in individuals with obesity without type 2 diabetes.Strong
- Combining amylin receptor agonist (cagrilintide) with GLP-1 RA (semaglutide) results in greater weight reduction than semaglutide monotherapy.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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