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Journal Article Epublish 25 citations

PubMed: 39819958 DOI: 10.1136/bmjopen-2024-089477

Factors associated with weight loss response to GLP-1 analogues for obesity treatment: a retrospective cohort analysis.

BMJ Open 15(1):e089477

Authors: Peter Squire, James Naude, Ali Zentner, Jesse Bittman, Nadia Khan

Affiliations

  • Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  • University of British Columbia, Vancouver, British Columbia, Canada.
  • Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Medicine, Revolution Medical Clinic, Vancouver, British Columbia, Canada.
  • Revolution Medical Clinic, Vancouver, British Columbia, Canada.
  • University of British Columbia, Vancouver, British Columbia, Canada. Revolution Medical Clinic, Vancouver, British Columbia, Canada.

Abstract

OBJECTIVES

The response to glucagon-like peptide-1 (GLP-1) analogues for weight loss varies significantly. We investigated the anthropometric, demographic and clinical characteristics associated with total body weight loss (TBWL) from subcutaneous GLP-1 analogue therapy in patients with obesity in a real-world setting.

DESIGN

Retrospective cohort analysis.

SETTING

An urban, multidisciplinary obesity community clinic in Vancouver, Canada, from November 2018 to April 2021.

PARTICIPANTS

483 adults with a body mass index (BMI) of ≧30 kg/m who had filled a new prescription for subcutaneous semaglutide or liraglutide, with at least 6-month follow-up, were included (mean follow-up: 17.3 months). Individuals with prior bariatric surgery were excluded.

OUTCOMES

The primary outcome was the %TBWL over a mean follow-up period of 520 days. Participant's TWBL was categorised as non-response (<5% TBWL), moderate response (5%-15% TBWL) or hyper-response (>15% TBWL).

RESULTS

The average %TBWL in the cohort was 12.2%. Among the participants, 17.8% had a non-response, 48.4% had a moderate response and 33.8% had a hyper-response. In the multivariable regression analysis, being a woman was associated with hyper-response (adjusted OR 1.92, CI 1.01 to 3.65, p=0.048). Age, diabetes status, baseline BMI, being sedentary, anxiety and depression were not independently associated with TBWL in response to GLP-1 analogue therapy.

CONCLUSIONS

In a real-world setting, female sex was found to be associated with a hyper-response to GLP-1 analogue therapy for obesity management. Other clinical factors evaluated, including diabetes status, were not associated with the response. Future research should assess additional variables and support the development of novel biomarkers that are associated with weight loss response.

MeSH

Diabetes Mellitus, Glucagon-Like Peptide 1, Obesity, Weight Loss, Therapeutics

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