Browse the evidence

GLP-1 receptor agonists facilitate significant weight loss and metabolic improvement in non-pregnant women, but current evidence does not demonstrate that pre-pregnancy use improves pregnancy outcomes and may be associated with increased gestational weight gain.

GLP-1 drugs like Semaglutide cause significant weight loss in women with obesity. However, because there is no proof they improve pregnancy outcomes and animal studies suggest potential fetal growth restriction (likely due to maternal weight loss/nutrition), they are not currently recommended for improving pregnancy success. Women using these drugs should use effective contraception and stop the medication at least 6 weeks before trying to conceive, as advised by current guidelines.

GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) administered as adjunct therapy to bariatric surgery significantly reduce BMI and total body weight in patients with insufficient weight loss or weight regain.

If you have had bariatric surgery but are not losing enough weight or are gaining it back, ask your doctor about adding a GLP-1 agonist (like semaglutide or tirzepatide) to your regimen. These medications, taken weekly or daily, have been shown to significantly boost weight loss and improve metabolic health (blood sugar, blood pressure) in this specific group. Be prepared for potential mild stomach issues, which usually subside, and discuss cost coverage with your provider.

GLP-1 receptor agonists improve metabolic outcomes, including glycemic control, blood pressure, and lipid profiles, in post-bariatric surgery patients.

Beyond weight loss, GLP-1 agonists can help normalize blood sugar, lower blood pressure, and improve cholesterol levels in patients who have had bariatric surgery. This makes them a valuable tool for managing overall metabolic health, not just weight.

GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) show promising results for MASH resolution and weight loss, though phase 3 histological data is still emerging.

GLP-1 agonists like semaglutide and tirzepatide are showing strong promise for resolving MASH and reducing liver fibrosis, especially in those with obesity or diabetes. While not yet universally endorsed for MASH alone, they are beneficial for comorbidities.

Oral semaglutide 14 mg daily produces clinically significant weight loss (≥5%) in approximately half of non-diabetic obese adults, with an average loss of 5.7% and a favorable safety profile, though it is less effective than injectable semaglutide or tirzepatide.

If you are obese and do not have diabetes, taking 14mg of oral semaglutide daily for a year will likely result in about 6% body weight loss on average. While not as powerful as the injectable version, it is a safe option if you dislike injections or cannot access injectable medications. Expect mild nausea in some cases, but serious side effects are rare.

Switching from GLP-1 receptor agonists (dulaglutide or semaglutide) to tirzepatide for six months significantly reduces body weight, HbA1c, and markers of metabolic dysfunction-associated steatotic liver disease (MASLD) including the fatty liver index and FIB-4 index in patients with type 2 diabetes.

For patients with Type 2 Diabetes and fatty liver disease currently on GLP-1 RAs like dulaglutide or semaglutide, switching to tirzepatide (starting at 2.5mg weekly, increasing to 5mg after 4 weeks) for six months can lead to significant weight loss, improved blood sugar control, and reduced liver fat and fibrosis markers. This benefit persists even if the patient was previously on semaglutide, though appetite suppression may be less pronounced in that subgroup.

Dual and triple receptor agonists (Tirzepatide, Survodutide, Retatrutide) show promise in MASH resolution, with some demonstrating superior efficacy to single GLP-1 agonists in weight loss and MASH resolution, though long-term hepatic outcomes are still being established.

Newer multi-agonist drugs like Tirzepatide (5-15mg weekly) show strong results in resolving MASH and improving fibrosis in Phase 2 trials, often matching or exceeding the efficacy of single GLP-1 agonists. Patients should discuss access and cost with their providers, as these are newer, expensive therapies with robust but still maturing long-term data.

GLP-1 receptor agonists (GLP-1RAs) reduce systemic inflammation and improve metabolic parameters in patients with psoriatic disease (PsD) and its comorbidities (obesity, T2DM, cardiovascular disease).

If you have psoriasis or psoriatic arthritis along with obesity or type 2 diabetes, GLP-1 receptor agonists (like semaglutide or liraglutide) can help manage both your metabolic health and inflammation. These drugs not only promote significant weight loss but also reduce key inflammatory markers (TNF, IL-6) linked to psoriatic disease severity. While they are primarily known for diabetes and weight management, emerging evidence suggests they may also improve joint and skin symptoms, especially in patients who are obese. Consult your rheumatologist to see if adding a GLP-1RA to your current treatment plan is appropriate.

Semaglutide treatment (1.7-2.4 mg weekly) in patients with hypothalamic obesity secondary to craniopharyngioma produces sustained, clinically significant weight loss (median 16%) and improves metabolic biomarkers (HbA1c, LDL) over 24 months.

For patients with hypothalamic obesity, semaglutide (1.7-2.4 mg weekly) is an effective long-term treatment for weight loss and metabolic health. It is crucial to maintain consistent dosing, as interruptions can lead to fat mass regain. Side effects are generally mild and manageable.

Multi-modal anti-obesity medication (mmAOM) therapy yields significantly greater preoperative percent total body weight loss (%TBWL) than GLP-1 receptor agonist monotherapy or non-pharmacologic medically supervised weight loss in patients with BMI ≥ 70 kg/m².

If you have a BMI of 70 or higher and are preparing for weight loss surgery, combining multiple weight loss medications (mmAOM) under medical supervision leads to significantly more weight loss than using just one GLP-1 medication or lifestyle changes alone. This approach helps reduce surgical risks. Discuss with your doctor if a combination therapy is appropriate for your insurance coverage and health profile.

Weekly subcutaneous semaglutide (up to 2.4 mg) reduces BMI, HbA1c, and blood pressure, and improves self-rated quality of life in patients with schizophrenia or schizoaffective disorder and obesity.

For patients with schizophrenia or schizoaffective disorder and obesity, weekly semaglutide injections (up to 2.4 mg) can effectively reduce weight, improve blood sugar control, and lower blood pressure, while also improving quality of life. This treatment is feasible in inpatient settings, even for those with severe mental illness, though side effects like nausea may lead some to discontinue. It should be considered as part of a comprehensive care plan including dietary advice.

Yoga interventions significantly reduce serum leptin levels and increase serum adiponectin levels in individuals with obesity or metabolic syndrome.

If you have obesity or metabolic syndrome, incorporating yoga into your routine may help improve your hormonal balance by lowering leptin (which drives hunger) and raising adiponectin (which fights inflammation). For best results, look for programs that combine yoga with dietary changes, as the hormonal benefits appear stronger when diet is also addressed.

Long-term semaglutide treatment (0.5–2 mg weekly) induces significant weight loss (up to 14.4%) and appetite suppression in Prader-Willi syndrome (PWS) patients without diabetes, though efficacy is variable and weight regain occurs upon discontinuation.

For PWS patients, semaglutide (0.5-2mg weekly) is a viable option for weight loss and appetite control, even after bariatric surgery. However, results vary, and stopping the drug leads to weight regain. It should be used as a long-term maintenance therapy alongside strict dietary controls, not as a one-time fix.

Short-term intensive insulin therapy improves beta-cell function and insulin sensitivity, increasing the likelihood of achieving type 2 diabetes remission compared to oral hypoglycemic agents alone.

For early-stage Type 2 Diabetes, short-term intensive insulin therapy can help restore your pancreas's ability to produce insulin. This approach is more effective for achieving remission than oral medications alone, though it requires strict adherence and monitoring during the intensive phase.

Patients taking GLP-1 receptor agonists or dual GIP/GLP-1 agonists should continue these medications through the peri-operative period rather than withholding them, as evidence suggests withholding is insufficient to reduce aspiration risk.

If you take a GLP-1 or GIP/GLP-1 drug (like Ozempic, Wegovy, Mounjaro, Trulicity) for your upcoming elective surgery, do NOT stop taking it. Stopping it for a week or even three weeks does not guarantee your stomach is empty and may not reduce aspiration risk. Instead, tell your anesthesia team you are taking it so they can use specific techniques (like ultrasound or specific intubation methods) to keep you safe.

Patients taking SGLT2 inhibitors should omit these medications the day before and the day of surgery to prevent euglycemic diabetic ketoacidosis (DKA).

If you take an SGLT2 inhibitor (like Jardiance, Farxiga, or Invokana) for your upcoming elective surgery, stop taking it the day before your surgery and do not take it on the day of surgery. This is critical to prevent a rare but serious condition called euglycemic DKA. Your medical team will monitor your blood sugar closely during your stay and manage it with insulin if necessary, which is the safest approach.

Dual (GLP-1/GIP) and Triple (GLP-1/GIP/Glucagon) receptor agonists offer superior weight loss and metabolic benefits compared to GLP-1 mono-agonism by leveraging complementary mechanisms.

Newer multi-agonists (dual/triple) like retatrutide show much higher weight loss (up to 24%) than older GLP-1 drugs. They work by hitting multiple metabolic targets at once, which may be necessary for patients who don't respond sufficiently to GLP-1 alone.

In obese patients with preexisting hip or knee osteoarthritis, GLP-1 receptor agonist use is associated with a significantly reduced odds of conversion to total joint arthroplasty (THA and TKA) within one year, independent of weight loss.

If you are obese and have existing hip or knee osteoarthritis, using a GLP-1 receptor agonist (like semaglutide or liraglutide) is associated with a lower risk of needing joint replacement surgery within a year, even if your weight doesn't change significantly. This suggests the drug may have direct protective effects on your joints, not just benefits from weight loss. Discuss this potential benefit with your doctor, especially if you are considering these medications for weight management or diabetes.

Eloralintide (LY3841136), a selective amylin receptor agonist, promotes significant body weight loss primarily through fat mass reduction with favorable gastrointestinal tolerability compared to non-selective amylin agonists.

Eloralintide is a once-weekly injection that targets specific receptors to reduce appetite and food intake. In early trials, it led to modest but significant weight loss (up to 4.4% in 4 weeks) primarily by burning fat, with fewer stomach side effects than some competitors. It is currently in early clinical stages and not yet widely available.

GLP-1 receptor agonists (GLP-1RAs) are perceived by current and past users as safe and effective for weight loss, with users strongly disagreeing that risks outweigh benefits, whereas non-users exhibit significant skepticism regarding safety and efficacy.

If you are considering GLP-1RAs, be aware that skepticism about safety and cost are common barriers, especially if you haven't used them. However, data from current and past users shows they strongly disagree that risks outweigh benefits and highly recommend the medication. Consult a healthcare provider to address specific safety concerns and cost barriers, as user experience often contradicts public skepticism.

Glucagon-like peptide 1 receptor agonists (GLP-1RAs) significantly reduce rheumatoid arthritis (RA) disease activity and pain in patients with RA and overweight or obesity, independent of the magnitude of weight loss.

If you have Rheumatoid Arthritis and are overweight, GLP-1 medications (like Ozempic or Mounjaro) may help reduce your joint pain and disease activity, not just help you lose weight. This benefit appears to come from the drug's direct effect on inflammation, not just the weight loss itself. Be aware that stomach side effects are common and insurance coverage can be a hurdle, but the potential for improved RA control is a significant clinical benefit to discuss with your rheumatologist.

GLP-1 receptor agonists (GLP-1RAs) provide modest antidepressant effects and reduce binge eating behaviors, but their impact on suicidality remains uncertain and potentially elevated in high-risk subgroups.

GLP-1 medications like semaglutide and liraglutide may help with mild depression and binge eating, especially if you have diabetes or obesity. However, if you have a history of severe mental health issues or take other psychiatric meds, monitor your mood closely as there may be a small increased risk of suicidal thoughts. The mental health benefits appear to come from direct brain effects, not just weight loss.

Preoperative optimization with GLP-1 agonists (specifically semaglutide 2.4 mg/week) enables patients with severe obesity (BMI ≥ 35 kg/m²) to achieve target BMI ≤ 35 kg/m², making them eligible for complex abdominal wall repair.

If you have severe obesity and need complex abdominal wall surgery, standard diet and exercise often fail to lower your BMI enough for safe surgery. Using GLP-1 agonists (like semaglutide) for about 8 months can help you lose enough weight (average 11.3%) to meet the safety threshold (BMI ≤ 35) for the procedure. This makes you eligible for surgery that might otherwise be denied or deemed too risky.

In adults with Type 1 Diabetes (T1D) and obesity (BMI ≥27 kg/m²), 12 months of treatment with GLP-1 receptor agonists (tirzepatide, semaglutide, or liraglutide) produces significant weight loss (7.1%–10.9%) without increasing the risk of severe hypoglycemia or diabetic ketoacidosis (DKA).

If you have Type 1 Diabetes and obesity, GLP-1 based medications (tirzepatide, semaglutide, or liraglutide) can help you lose significant weight (7-11%) over a year without increasing your risk of dangerous low blood sugar or DKA, provided your insulin regimen is stable. These drugs also modestly improve blood sugar control and reduce insulin needs.