Hormonal
GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) and multi-agonists (retatrutide, CagriSema, survodutide) produce clinically significant weight loss (typically >10-20%) in adults with obesity, with efficacy increasing with dose and number of receptor targets.
GLP-1 based medications (like semaglutide and tirzepatide) are highly effective for significant weight loss (15-20%+) in adults with obesity, often outperforming lifestyle changes alone. They work by targeting hormonal receptors to reduce appetite and slow digestion. While effective, they require medical supervision due to potential side effects like nausea, which usually subside with dose titration. They are indicated for those with a BMI over 27 with complications or over 30.
Results from the studies demonstrated that patients treated with liraglutide 3 mg experienced clinically significant weight reduction compared with placebo at 3 years of 6.1% for liraglutide vs. 1.9% for placebo... Semaglutide 2.4 mg... mean weight loss... was 15.3 kg versus 2.6 kg in the placebo group... Tirzepatide... Sustained reductions in body weight, of 15.0%, 19.5%, and 20.9%, respectively, were observed... Retatrutide... showed more than 24% weight loss... CagriSema... exhibited a significant 15.6% decrease in body weight... Survodutide... 18.7% weight loss was achieved.
Why this rating
Based on multiple Phase 2 and 3 randomized controlled trials (SCALE, STEP, SURMOUNT) with large sample sizes.
Source
Treatment of obesity with medications binding the glucagon-like peptide 1 receptor: what is the current state of play?
Carel W. le Roux et al. · Expert Opinion on Pharmacotherapy · 2024
DOI 10.1080/14656566.2024.2311731
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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