Year-Long Weight Reduction with Semaglutide and Liraglutide: Study Reveals Impact of Dosage and Adherence

In the study published in JAMA Network Open, weight loss after one year was linked to several factors, including the specific active agent in the medication, the dosage used, the purpose of the treatment, adherence to the medication regimen, and the patient’s sex.

Semaglutide and liraglutide, both medications initially developed for managing diabetes, have recently gained prominence for their significant role in treating obesity. However, there is limited data available on the long-term weight loss outcomes associated with semaglutide or liraglutide for type 2 diabetes (T2D) or obesity in clinical practice. To fill this knowledge gap, Hamlet Gasoyan, Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, and colleagues aimed to assess weight loss outcomes with injectable forms of semaglutide or liraglutide and identify factors linked to achieving a weight reduction of 10% or more after one year.

The retrospective cohort study analyzed electronic health records from a large, integrated health system in Ohio and Florida. It included adults with a body mass index (BMI) of at least 30.0 who began treatment with injectable semaglutide or liraglutide for type 2 diabetes or obesity between July 1, 2015, and June 30, 2022—the follow-up period concluded on July 28, 2023. The primary outcomes measured were the percentage change in weight and the proportion of patients achieving a weight reduction of 10% or more after one year.

The following were the key findings of the study:

• A total of 3389 patients (mean age, 50.4 years; 54.7% female) were identified. Of these, 1341 patients received semaglutide for T2D; 1444, liraglutide for T2D; 227, liraglutide for obesity; and 377, semaglutide for obesity.
• Mean percentage weight change at one year was −5.1% with semaglutide vs −2.2% with liraglutide; −3.2% for T2D as a treatment indication vs −5.9% for obesity; and −5.5% with persistent medication coverage (ie, a cumulative gap of less than 90 days) at one year vs −2.8% with 90 to 275 medication coverage days and −1.8% with fewer than 90 medication coverage days.
• In the multivariable model, semaglutide versus liraglutide (adjusted odds ratio [AOR], 2.19), obesity as a treatment indication versus T2D (AOR, 2.46), persistent medication coverage versus 90 medication coverage days (AOR, 3.36) or 90 to 275 medication coverage days within the first year (AOR, 1.50), high dosage of the medication vs low (AOR, 1.58), and female sex (AOR, 1.57) were associated with achieving a 10% or greater weight reduction at year one.

"These findings indicate that future research should explore the reasons behind medication discontinuation and develop strategies to enhance long-term adherence," the researchers concluded.

Reference:

Gasoyan H, Pfoh ER, Schulte R, Le P, Butsch WS, Rothberg MB. One-Year Weight Reduction With Semaglutide or Liraglutide in Clinical Practice. JAMA Netw Open. 2024;7(9):e2433326. doi:10.1001/jamanetworkopen.2024.33326