Related Experiment Video

Updated: Oct 10, 2025

Multidisciplinary Approach to Obesity Management: A Case Report
05:10

Multidisciplinary Approach to Obesity Management: A Case Report

Published on: May 30, 2025

461

Association of Glucagon-like Peptide 1 Analogs and Agonists Administered for Obesity with Weight Loss and Adverse

Kia Vosoughi1, Jessica Atieh1, Lehar Khanna1

  • 1Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN.

Eclinicalmedicine
|December 8, 2021
PubMed
Abstract

Insights

Semaglutide SQ 2.4mg and liraglutide >1.8mg demonstrated the greatest weight loss among glucagon-like peptide 1 (GLP-1) agents. This network meta-analysis compared seven GLP-1 agents for obesity treatment effectiveness.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Obesity is a complex metabolic disease with limited effective pharmacological treatments.
  • Glucagon-like peptide 1 (GLP-1) receptor agonists are increasingly used for weight management.
  • Comparative effectiveness of different GLP-1 agents for weight loss is not well-established.

Purpose of the Study:

  • To conduct a network meta-analysis (NMA) comparing the effectiveness of seven GLP-1 agents for weight loss in obesity.
  • To rank GLP-1 agents based on their weight loss efficacy and safety profiles.
  • To assess the certainty of evidence for weight loss and adverse events associated with GLP-1 agents.

Main Methods:

  • Systematic review and frequentist random-effects network meta-analysis (NMA) of randomized clinical trials (RCTs) with ≥12 weeks duration.
  • Data sources included MEDLINE, EMBASE, Scopus, Cochrane Central, and clinical trial registries up to March 2, 2021.
  • Outcomes assessed were weight loss over placebo (WLOP) and adverse events (AEs); relative rankings determined by Surface Under the Cumulative Ranking (SUCRA).

Main Results:

  • 64 RCTs involving 27,018 patients were analyzed.
  • Highest weight loss over placebo (WLOP) was observed with semaglutide SQ 2.4mg (-9.88kg), semaglutide SQ <2.4mg (-4.33kg), and liraglutide >1.8mg (-4.49kg).
  • Semaglutide SQ 2.4mg, semaglutide SQ <2.4mg, and liraglutide >1.8mg showed the highest efficacy (SUCRA 100, 86.1, 82.8 respectively). Taspoglutide and liraglutide >1.8mg had the highest discontinuation rates due to AEs.

Conclusions:

  • High doses of semaglutide (SQ 2.4mg) and liraglutide (>1.8mg) are the most effective GLP-1 agents for weight loss in obesity.
  • The certainty of evidence for weight loss and adverse events varied among agents, with significant heterogeneity noted.
  • Further research may be needed to address the risk of bias identified in several included RCTs.

More Related Videos

Roux-en-Y Gastric Bypass Operation in Rats07:37

Roux-en-Y Gastric Bypass Operation in Rats

Published on: June 11, 2012

23.7K
An Acupoint Catgut-embedding Therapy for Treating Obesity04:50

An Acupoint Catgut-embedding Therapy for Treating Obesity

Published on: April 4, 2025

688

Related Concept Videos

Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
469
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
336
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
295
Oral Hypoglycemic Agents: &#945;-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
308
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
282
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
375