Research
Hormonal
Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) promote weight loss in obese individuals with type 2 diabetes, whereas sulfonylureas, thiazolidinediones, and insulin typically cause weight gain.
If you have type 2 diabetes and are obese, ask your doctor about SGLT2 inhibitors (like Jardiance/Farxiga) or GLP-1 agonists (like Ozempic/Victoza). These drugs lower blood sugar and typically help you lose 2-3 kg, whereas older drugs like insulin or sulfonylureas often make you gain weight. Combining these with metformin can enhance weight loss.
GoodSupportsHIGH confidence
In general, sodium–glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide (GLP)-1 receptor agonists (GLP-1 RAs) result in an average weight loss of about 2–3 kg when used at the approved doses, whilst metformin, alpha-glucosidase inhibitors and dipeptidyl peptidase-4 inhibitors (DPP-IVi) are weight neutral... and sulfonylureas, glinides, thiazolidinediones and insulin result in weight gain [14]
Why this rating
Based on a review of multiple clinical trials and meta-analyses cited in the text.
Source
Medication use for the treatment of diabetes in obese individuals
John Wilding · Diabetologia · 2017
DOI 10.1007/s00125-017-4288-1
narrative_reviewCited 43×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
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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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