Hormonal
GLP-1 receptor agonists (semaglutide and tirzepatide) produce significantly greater average weight loss (14.9% and 18.5%, respectively) than physicians estimate (9.22%), and are associated with high rates of gastrointestinal side effects (80-90%) that are significantly underestimated by prescribers.
If you are prescribing GLP-1 agonists, ensure you are counseling patients on the high likelihood of gastrointestinal side effects (up to 90%) and the significant magnitude of weight loss (15-18%). Underestimating these factors leads to poor adherence and unrealistic expectations.
Physicians reported an average patient weight loss of 9.22%, significantly lower than the 14.9% and 18.5% reported in the STEP and SURMOUNT trials, respectively. Estimated side effect rates (32.62%) were markedly lower than trial-reported rates (89.7% and 80.5%)
Why this rating
Based on large, landmark randomized controlled trials (STEP, SURMOUNT) cited in the paper.
Source
Physician Perceptions of the Safety and Efficacy of GLP-1 Receptor Agonists: Underestimation of Cardiovascular Risk Reduction and Discrepancies with Clinical Evidence
Srikanth Krishnan et al. · Journal of Cardiovascular Development and Disease · 2025
DOI 10.3390/jcdd12010019
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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