A recent study published in JAMA Network Open has demonstrated that obese patients treated with injectable semaglutide or liraglutide experienced significant weight loss over one year, with semaglutide showing the most pronounced effects. The study involved 3,389 patients treated between 2015 and 2023, analyzing weight outcomes based on factors such as the type of medication, dosage, treatment indication, and adherence.
The research focused on adults with a body mass index (BMI) of 30 kg/m² or higher who completed a follow-up weight measurement 12 months after beginning treatment. The study findings revealed that patients treated with semaglutide for obesity achieved the most significant weight loss, with an average reduction of 12.9% for those with consistent medication use. In comparison, patients with T2D on semaglutide saw an average weight reduction of 5.9%. Liraglutide also demonstrated effectiveness, with an average weight loss of 5.6% for obesity patients and 3.1% for those treated for T2D with continuous use of the drug.
A substantial proportion of patients experienced significant weight reduction. Among those treated with semaglutide for obesity, 37% achieved a weight loss of 10% or more, compared to 16.6% of T2D patients on semaglutide. Similarly, 14.5% of obesity patients and 9.3% of T2D patients using liraglutide saw at least a 10% reduction in body weight. Key factors associated with greater weight loss included a higher baseline BMI, persistent medication use, and higher dosages.
Semaglutide and liraglutide are both glucagon-like peptide-1 (GLP-1) receptor agonists that help manage blood glucose levels and promote weight loss. Semaglutide activates GLP-1 receptors, enhancing insulin secretion and reducing glucagon release from the pancreas. It also delays gastric emptying, increasing feelings of satiety and decreasing overall food intake, while acting on the central nervous system (CNS) to reduce appetite. Liraglutide functions similarly, promoting insulin secretion and inhibiting glucagon, while also delaying gastric emptying and influencing appetite regulation in the CNS. The key differences between the two medications are in their dosing and potency; semaglutide is administered once weekly, whereas liraglutide requires daily injections. Semaglutide is generally considered more potent, often resulting in greater weight loss outcomes compared to liraglutide.
Additional studies support these findings. Kurtzhals et al. confirmed that semaglutide has a well-established safety profile and is approved in certain countries to reduce cardiovascular risk in T2D patients. Semaglutide aligns with clinical guidelines for T2DM management, emphasizing weight control and the reduction of cardiometabolic risk factors. Meanwhile, Mirabelli et al. found that prolonged use of liraglutide led to lasting benefits in weight and glycemic control, especially in women.
Gasoyan et.al. stated that a significant portion of patients achieved substantial weight loss, with 37% of those using semaglutide for obesity reaching a 10% or greater reduction in body weight, compared to 16.6% of T2D patients using the same drug. For liraglutide users, 14.5% of obesity patients and 9.3% of T2D patients saw at least a 10% reduction in weight. Factors such as a higher baseline BMI, continuous medication use, and higher drug doses increased the likelihood of achieving significant weight loss.
The study underscores the effectiveness of these medications in promoting weight loss, particularly in patients treated for obesity, though further research is needed to understand long-term adherence and reasons for discontinuation.
References
- Gasoyan H, Pfoh ER, Schulte R, Le P, Butsch WS, Rothberg MB. One-Year Weight Reduction With Semaglutide or Liraglutide in Clinical Practice. JAMA Network Open. 2024 Sep 13;7(9):e2433326.
- Kurtzhals P, Flindt Kreiner F, Singh Bindra R. The role of weight control in the management of type 2 diabetes mellitus: Perspectives on semaglutide. Diabetes Res Clin Pract. 2023 Sep;203:110881.
- Mirabelli M, Chiefari E, Caroleo P, Arcidiacono B, Corigliano DM, Giuliano S, et al. Long-Term Effectiveness of Liraglutide for Weight Management and Glycemic Control in Type 2 Diabetes. International Journal of Environmental Research and Public Health. 2019 Dec 27;17(1):207.
- Tamayo-Trujillo R, Ruiz-Pozo VA, Cadena-Ullauri S, Guevara-Ramírez P, Paz-Cruz E, Zambrano-Villacres R, et al. Molecular mechanisms of semaglutide and liraglutide as a therapeutic option for obesity. Front Nutr [Internet]. 2024 Apr 29 [cited 2024 Oct 18];11.