Three new Cochrane evaluations discover proof that GLP-1 medicine result in clinically significant weight reduction, although industry-funded research increase issues.
Three new evaluations from Cochrane have discovered that GLP-1 medicines can result in vital weight reduction, although questions stay concerning the affect of industry-funded analysis. Commissioned by the World Well being Group (WHO), these evaluations will assist form forthcoming international tips on utilizing these medicine to deal with weight problems.
The analyses centered on three medicines generally known as GLP-1 receptor agonists and concluded that every produced clinically significant weight reduction compared with a placebo. Nevertheless, researchers famous that information on long-term results, negative effects, and attainable conflicts of curiosity are nonetheless unsure or incomplete.
Glucagon-like peptide-1 (GLP-1) receptor agonists have been first developed within the mid-2000s to assist handle kind 2 diabetes. In sufferers with this situation, notably these with coronary heart or kidney illness, the medicine improved blood sugar management, lowered the chance of associated problems, aided in weight discount, and decreased the probability of untimely loss of life.
In recent times, these medicine have additionally been examined in folks with weight problems. By mimicking a pure hormone that slows digestion and promotes a way of fullness, they might help cut back meals consumption. In the UK, GLP-1 receptor agonists at the moment are accredited for weight administration in people with weight problems, or in those that are obese with well being situations linked to extra weight, when mixed with a calorie-controlled food plan and bodily exercise.
GLP-1 Medicine: Generic [and Brand Names]:
- Semaglutide [Ozempic, Wegovy, Rybelsus]
- Liraglutide [Victoza, Saxenda]
- Dulaglutide [Trulicity]
- Exenatide [Byetta, Bydureon]
- Tirzepatide (GLP-1/GIP twin agonist) [Mounjaro, Zepbound]
GLP-1 medicine present promise for weight administration
Throughout the evaluations, tirzepatide, semaglutide, and liraglutide every led to vital weight reduction in comparison with placebo after one to 2 years, with these results more likely to be sustained whereas remedy continues.
- Tirzepatide (administered as soon as weekly) resulted in roughly a 16% weight discount after 12 to 18 months. Proof from 8 randomized managed trials (6,361 members) additionally urged these results may very well be maintained for as much as 3.5 years, though long-term security information have been restricted.
- Semaglutide (additionally injected weekly) lowered physique weight by round 11% after 24 to 68 weeks, with results seemingly sustained as much as two years, drawing on 18 randomized managed trials (27,949 members). The drug elevated the probability of reaching at the least 5% physique weight reduction however was related to larger charges of mild-to-moderate gastrointestinal negative effects.
- Liraglutide (a day by day injection) resulted in a extra modest common weight discount of round 4–5%, primarily based on 24 trials (9,937 members), however nonetheless elevated the proportion of individuals reaching significant weight reduction in contrast with placebo. Proof for longer-term results past two years was extra restricted.
Throughout the evaluations, there was little to no distinction between these medicine and placebo for main cardiovascular occasions, high quality of life, or mortality. Nevertheless, antagonistic occasions, notably nausea and digestive signs, have been extra widespread amongst members taking GLP-1 medicine, and a few stopped remedy on account of negative effects.
“These medicine have the potential to result in substantial weight reduction, notably within the first yr,” says Juan Franco, co-lead researcher from Heinrich Heine College Düsseldorf, Germany. “It’s an thrilling second after many years of unsuccessful makes an attempt to search out efficient remedies for folks dwelling with weight problems.”
Impartial analysis and equitable entry are key
Most included research have been funded by the drug producers, who have been considerably concerned within the planning, conduct, evaluation, and reporting of the outcomes. This raises issues about potential conflicts of curiosity and the necessity for impartial analysis.
The authors additionally emphasised that the broader use of those medicine ought to think about social and industrial determinants of well being, together with entry, affordability, and insurance coverage protection, to keep away from deepening present well being inequities amongst folks dwelling with weight problems. The excessive costs of semaglutide and tirzepatide presently restrict entry, whereas liraglutide’s expired patent has allowed for extra inexpensive generic variations to turn into out there. Semaglutide’s patent may also expire in 2026.
Research included in all three evaluations have been carried out primarily in middle- and high-income international locations, with restricted or no illustration from areas comparable to Africa, Central America, and Southeast Asia. Contemplating the variety in physique composition, food plan, and well being behaviors throughout populations, the authors word the significance of assessing how these medicine carry out in numerous international contexts.
“We want extra information on the long-term results and different outcomes associated to cardiovascular well being, notably in lower-risk people,” says Eva Madrid, co-lead researcher from the Universidad de Valparaíso, Chile. “Weight regain after stopping remedy could have an effect on the long-term sustainability of the noticed advantages. Extra impartial research from a public well being perspective are wanted.”
The evaluations stress that impartial, long-term investigations are important to tell medical and public coverage selections and to raised set up the position of GLP-1 receptor agonists in long-term weight administration.
Commissioned by the World Well being Group, these evaluations will inform forthcoming WHO tips on the usage of GLP-1 receptor agonists for treating weight problems. The rules are anticipated to launch quickly, following a public session held in September.
References:
“Liraglutide for adults dwelling with weight problems” by Nicolás Meza, Javier Bracchiglione, Camila Micaela Escobar Liquitay, Eva Madrid, Lucia B Varela, Yang Guo, Gerard Urrútia, Selcuk Er, Sandra Tiller, Kamyar Shokraee, Felipe Alvarez Busco, Ivan Solà, Miranda Ocara Vargas, Victoria Novik A, Daniel Poloni and Juan VA Franco, 30 October 2025, Cochrane Database of Systematic Critiques.
DOI: 10.1002/14651858.CD016017
“Semaglutide for adults dwelling with weight problems” by Javier Bracchiglione, Nicolás Meza, Juan VA Franco, Camila Micaela Escobar Liquitay, Victoria Novik A, Miranda Ocara Vargas, Gabriel Lazcano, Daniel Poloni, Francisca Rinaldi Langlotz, Marta Roqué-Figuls, Sergio R Munoz and Eva Madrid, 30 October 2025, Cochrane Database of Systematic Critiques.
DOI: 10.1002/14651858.CD015092.pub2
“Tirzepatide for adults dwelling with weight problems” by Juan VA Franco, Yang Guo, Lucia B Varela, Zakariya Aqra, Murad Alhalahla, Mauricio Medina Rodriguez, Edison Leonardo Salvador Oscco, Bernarda Patiño Araujo, Susan Banda, Camila Micaela Escobar Liquitay, Javier Bracchiglione, Nicolás Meza and Eva Madrid, 30 October 2025, Cochrane Database of Systematic Critiques.
DOI: 10.1002/14651858.CD016018
