What Are The Risks And Benefits Of GLP-1 Receptor Agonists For Weight Loss?
What Are The Risks And Benefits Of GLP-1 Receptor Agonists For Weight Loss?
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as liraglutide and semaglutide, have been shown to be effective for weight loss in individuals with obesity, both with and without diabetes. They have been all the rave lately in the weight loss arena. The benefits and risks of these agents are well-documented in the medical literature.
Benefits:
Significant Weight Loss: Clinical trials have demonstrated that GLP-1 RAs can induce substantial weight loss. For instance, liraglutide 3.0 mg/day has shown an average placebo-subtracted weight loss of 5.5 kg over 1 to 3 years, while semaglutide 0.4 mg once daily has reported an average weight loss of 11.6% (~13.1 kg) after one year. Another study found that semaglutide led to a mean weight loss of 9-16 kg, with more than 50% of treated individuals achieving 10-15% or more weight loss.[1-2]
Improvement in Cardiometabolic Parameters: GLP-1 RAs not only promote weight loss but also improve glycemic control, blood pressure, and lipid profiles. For example, they have been associated with reductions in systolic and diastolic blood pressure, as well as improvements in cholesterol levels.[3]
Cardiovascular Benefits: GLP-1 RAs have been shown to reduce cardiovascular risk in patients with type 2 diabetes, and ongoing trials are evaluating their cardiovascular benefits in individuals with obesity.[4]
Risks:
Gastrointestinal Adverse Events: The most common side effects are gastrointestinal in nature, including nausea, vomiting, diarrhea, and constipation. These adverse events are generally transient but can lead to treatment discontinuation in some cases.[1][3]
Potential Risk of Retinopathy: There is some evidence suggesting an increased risk of retinopathy with semaglutide, although this requires further investigation.[5]
Other Adverse Events: Additional risks include abdominal pain, cholelithiasis, and injection site reactions. Hypoglycemia is generally not a significant risk unless combined with other hypoglycemic agents.[6]
Conclusion:
GLP-1 RAs are effective for weight loss and offer additional cardiometabolic benefits. However, their use is associated with gastrointestinal side effects and other potential risks, which necessitates careful patient selection and monitoring. The decision to use GLP-1 RAs should involve shared decision-making, considering the balance of benefits and risks for each individual patient. The long-term effects of these medications have not yet shown any significant risks however longer studies are needed. Also, weaning or stopping these medications have been a challenge.
References
- Benefit-Risk Assessment of Obesity Drugs: Focus on Glucagon-Like Peptide-1 Receptor Agonists. Christensen RM, Juhl CR, Torekov SS. Drug Safety. 2019;42(8):957-971. doi:10.1007/s40264-019-00812-7.
- Glucagon-Like Peptide 1 Receptor Agonists: A Medication for Obesity Management. Taha MB, Yahya T, Satish P, et al. Current Atherosclerosis Reports. 2022;24(8):643-654. doi:10.1007/s11883-022-01041-7.
- Efficacy and Safety of Glucagon-Like Peptide-1 Receptor Agonists on Body Weight and Cardiometabolic Parameters in Individuals With Obesity and Without Diabetes: A Systematic Review and Meta-Analysis. Ansari HUH, Qazi SU, Sajid F, et al. Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2023;:S1530-891X(23)00758-9. doi:10.1016/j.eprac.2023.11.007.
- Glucagon-Like Peptide 1 Receptor Agonists: Cardiovascular Benefits and Mechanisms of Action. Ussher JR, Drucker DJ. Nature Reviews. Cardiology. 2023;20(7):463-474. doi:10.1038/s41569-023-00849-3.
- Is It Time to Expand Glucagon-Like Peptide-1 Receptor Agonist Use for Weight Loss in Patients Without Diabetes?. Updike WH, Pane O, Franks R, et al. Drugs. 2021;81(8):881-893. doi:10.1007/s40265-021-01525-x.
- GLP-1 Receptor Agonists for Weight Reduction in People Living With Obesity but Without Diabetes: A Living Benefit-Harm Modelling Study. Moll H, Frey E, Gerber P, et al. EClinicalMedicine. 2024;73:102661. doi:10.1016/j.eclinm.2024.102661
If you would like to discuss these medications or weight loss in general more, please contact Dr. Johnson for an appointment.
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Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding any medical questions or concerns.