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GLP-1R Agonists for Weight Loss in Psychiatric Disorders: A Systematic Review and Meta-analysis.

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Glucagon-like peptide-1 receptor agonists (GLP-1RAs) effectively manage obesity in psychiatric patients, significantly reducing weight and improving metabolic markers. These medications are well-tolerated, with manageable gastrointestinal side effects.

Keywords:
GLP-1 receptor agonistsliraglutideobesitypsychiatric disorderssemaglutideweight loss

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Area of Science:

  • Pharmacology
  • Psychiatry
  • Metabolic Health

Background:

  • Obesity is prevalent in individuals with psychiatric disorders, often exacerbated by psychotropic medications.
  • There is a critical need for safe and effective pharmacological weight management strategies in this population.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for weight and metabolic outcomes in psychiatric patients with obesity.
  • To assess the impact of GLP-1RAs on weight, BMI, waist circumference, glucose levels, and adverse events.

Main Methods:

  • A systematic literature search was conducted across PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov up to May 2025.
  • Included were 10 randomized controlled trials evaluating GLP-1RAs in adults with psychiatric disorders and obesity.
  • Data extraction and risk of bias assessment were performed independently by two reviewers.

Main Results:

  • GLP-1RAs demonstrated significant reductions in body weight (MD -5.03 kg), BMI (MD -1.59 kg/m²), waist circumference (MD -3.4 cm), and fasting glucose (MD -0.29 mmol/L).
  • Gastrointestinal side effects were more common but generally mild and did not lead to increased discontinuation rates.

Conclusions:

  • GLP-1RAs are effective and well-tolerated for obesity management in psychiatric populations, yielding substantial weight and metabolic benefits.
  • Further research is warranted for newer agents like semaglutide and tirzepatide, especially in longer-term, standardized trials.