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GLP-1 Agonists for Weight Loss: Pharmacology and Clinical Implications

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Abstract

This review investigates the various pharmacologic treatments for overweight and obesity in adults, especially glucagon-like peptide 1 (GLP-1) agonists. In light of the globally expanding obesity pandemic and the limited selection of treatments, physicians must be equipped with knowledge regarding proven medications and their nuanced differences to best support patients on their path to a healthier lifestyle. In this review, we explore the current medical therapies for obesity, including all major categories, individual mechanisms of action, pharmacokinetics and pharmacodynamics, adverse effects, risks, and absolute contraindications. Additionally, we review the evidence of four recent clinical trials, two systematic reviews, and two meta-analyses describing the efficacy of GLP-1 agonists in decreasing weight, lowering HbA1c, and improving obesity comorbidities. We also discuss total cost and cost-effectiveness compared to other categories, long-term adherence, barriers to use, and reasons for discontinuation of this drug category. Our goal is that this review can serve as a framework to aid providers in building their knowledge and selecting the most advantageous weight loss medication for each patient.

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Acknowledgements

Funding

No funding or sponsorship was received for this study or publication of this article.

Author Contributions

Study concept and design: Peyton W Moore, Delena VanValkenburg, Lauren L Rando, Brooke C Williams, Hannah G Matejowsky, Shahar Shekoohi, Elyse M Cornett, Alan David Kaye. Analysis and interpretation of data: Peyton W Moore, Delena VanValkenburg, Lauren L Rando, Brooke C Williams, Hannah G Matejowsky, Elyse M Cornett, Alan David Kaye. Drafting of the manuscript: Peyton W Moore, Delena VanValkenburg, Lauren L Rando, Brooke C Williams, Hannah G Matejowsky, Shahar Shekoohi, Elyse M Cornett, Alan David Kaye. Critical revision of the manuscript for important intellectual content: Peyton W Moore, Kevin Malone, Delena VanValkenburg, Lauren L Rando, Brooke C Williams, Hannah G Matejowsky, Shahab Ahmadzadeh, Elyse M Cornett, Alan David Kaye. Statistical analysis: Peyton W Moore, Delena VanValkenburg, Lauren L Rando, Brooke C Williams, Hannah G Matejowsky, Elyse M Cornett, Alan David Kaye.

Disclosures

Peyton W Moore, Kevin Malone, Delena VanValkenburg, Lauren L Rando, Brooke C Williams, Hannah G Matejowsky, Shahab Ahmadzadeh, Shahar Shekoohi, Elyse M Cornett, and Alan David Kaye have nothing to disclose.

Compliance with Ethical Guidelines

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Data Availability

Data sharing is not applicable to this article as no data sets were generated or analyzed during the current study.

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Authors and Affiliations

  1. School of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Peyton W. Moore, Kevin Malone, Lauren L. Rando, Brooke C. Williams, Hannah G. Matejowsky, Elyse M. Cornett & Alan D. Kaye

  2. School of Medicine, LSU Health Sciences Center, LSU HSC New Orleans, New Orleans, LA, 70112, USA

    Delena VanValkenburg

  3. Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Shahab Ahmadzadeh & Sahar Shekoohi

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  1. Peyton W. Moore
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Corresponding author

Correspondence to Elyse M. Cornett.

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Moore, P.W., Malone, K., VanValkenburg, D. et al. GLP-1 Agonists for Weight Loss: Pharmacology and Clinical Implications. Adv Ther 40, 723–742 (2023). https://doi.org/10.1007/s12325-022-02394-w

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  • DOI: https://doi.org/10.1007/s12325-022-02394-w

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