Weight loss pills and unhealthy dieting with medication concept
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A recent Cleveland Clinic study has shed light on the critical factors influencing long-term weight loss in patients with obesity prescribed GLP-1 receptor agonist (RA) medications like semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda, Victoza).

These drugs, widely used to lower blood sugar and promote weight loss in individuals with type 2 diabetes and obesity, have proven effective in clinical trials. However, there has been limited data on their long-term effectiveness in real-world clinical settings. This study followed 3,389 adult patients who began treatment between 2015 and 2022, offering valuable insights into the factors that impact sustained weight loss.

Published in JAMA Network Open, the study, led by Hamlet Gasoyan, PhD, a researcher at Cleveland Clinic’s Center for Value-Based Care Research, analyzed how treatment factors affected long-term weight loss.

“We found that long-term weight reduction varied significantly based on the medication’s active agent, treatment indication, dosage, and persistence with the medication,” said Gasoyan.

Results showed that semaglutide led to a greater average weight reduction (-5.1%) than liraglutide (-2.2%). Additionally, patients who received higher doses of either drug experienced more significant weight loss compared to those on lower doses.

Persistence with the medication played a crucial role in determining success; those who remained on treatment for a full year saw better outcomes than those with shorter treatment durations. Semaglutide users, particularly those being treated for obesity, saw the most substantial weight loss, while the results were less pronounced for patients treated for type 2 diabetes.

The study highlighted that achieving a 10% or greater reduction in body weight is a critical health milestone. A higher percentage of patients on semaglutide for obesity reached this goal compared to those treated for type 2 diabetes. Liraglutide was less effective, with fewer patients achieving the 10% weight loss target.

A multivariable analysis found that several factors increased the likelihood of achieving significant weight loss, including the use of semaglutide, higher doses, treating obesity over type 2 diabetes, persistence with treatment, and having a higher initial body mass index. Women were also more likely than men to reach this level of weight reduction.

Gasoyan emphasized the importance of these findings for both patients and healthcare providers. “Having real-world data can help manage expectations regarding weight reduction with GLP-1 RA medications and reinforce that persistence is key to achieving meaningful results,” he said.

The research team plans to further explore the role of persistence with GLP-1 RA medications in improving long-term health outcomes.

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