The Cleveland Clinic conducted a study to identify factors that impact the long-term weight loss in patients with obesity who were prescribed injectable semaglutide or liraglutide for type 2 diabetes or obesity. The study, published in JAMA Network Open, found that weight reduction varied significantly based on the medication’s active agent, treatment indication, dosage, and patient’s persistence with the medication. Semaglutide and liraglutide are glucagon-like peptide-1 receptor agonists (GLP-1 RA) that help lower blood sugar levels and promote weight loss. With obesity affecting over 41% of the U.S. adult population, there is limited data on the factors associated with long-term weight change and clinically significant weight loss in real-world settings.
The retrospective cohort study included 3,389 adult patients with obesity who started treatment with injectable semaglutide or liraglutide between July 1, 2015, and June 30, 2022, with follow-up ending in July 2023. The average baseline body mass index was 38.5, with 82.2% having type 2 diabetes as a treatment indication. More than half of the patients were female, with most receiving treatment for type 2 diabetes. Results showed that factors like persistence with medication, medication coverage days, and treatment indication were associated with changes in body weight.
After one year, patients who were persistent with the medication experienced a greater reduction in body weight compared to those with less coverage days. Those who persisted with their medication at 12 months showed average body weight reductions ranging from 5.9% with semaglutide for type 2 diabetes to 12.9% with semaglutide for obesity. Achieving sustained weight loss of 10% or more provides significant health benefits, with 37.4% of patients receiving semaglutide for obesity achieving this compared to 16.6% with semaglutide for type 2 diabetes and 14.5% with liraglutide for obesity.
The study found that persistence with medication was key to achieving meaningful weight loss results, with patients who persisted with their medication one year after the initial prescription’s fill having higher odds of achieving 10% or more weight reduction. Factors like medication type and treatment indication also played a role in long-term weight loss outcomes. Real-world data could help manage patient and provider expectations regarding weight reduction with GLP-1 RA medications, emphasizing the importance of persistence for substantial results.
The study’s lead author, Dr. Hamlet Gasoyan, highlighted the significance of the findings in informing patients and providers about the factors associated with achieving sustained weight loss with GLP-1 RA medications. Future research will continue to explore patients’ persistence and health outcomes with anti-obesity medications. Dr. Gasoyan’s work is supported by a grant from the National Cancer Institute, indicating the importance of continued research in this area to improve patient outcomes related to obesity and type 2 diabetes treatment.