In the fight against obesity, drugs like semaglutide (Wegovy, Ozempic) and liraglutide (Saxenda, Victoza), have attracted considerable attention. But what are the drug’s real-world effects outside of clinical trials? A new study has appeared in JAMA Network Open that seeks to answer this question.
The Study at a Glance
Cleveland Clinic researchers reviewed data on 3,389 patients with obesity who were receptive to treatment with semaglutide or liraglutide injections from 2015 to 2022. They examined one-year outcomes in terms of weight loss and weight loss effort.
Key Findings
1.Average Weight Loss: On average patients had lost 3.7% of their body weight within a period of one year.
2.Semaglutide vs. Liraglutide: In all of the trials semaglutide was superior, and weight losses of 5.1% and 2.2% were obtained for semaglutide and liraglutide respectively.
3.Obesity vs. Diabetes Treatment: For the drugs used primarily for the treatment of obesity, patients lost more weight, i.e. 5.9%, than those whose drugs were for the treatment of type 2 diabetes 3.2%.
4.Persistence Matters: Patients reaching out to their medication for 1 year (which is about 40% of this group only) had incredible outcomes. Those who were maintained with semaglutide for obesity with persistence lost an amazing average of 12.9% body weight on the drug.
5.Factors for Success: The study also identified a number of factors that can explain the success in losing 10% or more in body weight:
- The use of semaglutide (vs. liraglutide) Having a diagnosis of obesity (vs. diabetes) More medication-induced weight loss than usual
- Persistent medication use Status as a male sex
- Greater BMI at the start of the study
What This Means for Patients
The average achieved weight loss in this non-interventional study was lower when compared to the clinical study data, but the outcome should be of concern at least for those patients who remain adherers to treatment. The only way to translate theory into practice is to reinforce patients’ adherence, which is difficult in practice as less than half of patients adhered to medication for even one full year.
Dr. Hamlet Gasoyan, the lead author of the study cautioned: “More work is required and future studies should be directed towards the reasons for stopping taking the medication and ways of improving persistent enacted coverage.”
The Bottom Line.
Both semaglutide and liraglutide may be useful pharmacotherapy in achieving weight loss however substantial variability exists in the results. Patients initiating these medications should have discussions regarding the realistic outcomes and the possible impediments to long term use with their health providers. Long term management measures should be instituted for these patients who have difficulties in their obesity ideal weight along with encouragement and proper care many people even though they have struggled with obesity are capable of losing appreciable amounts of weight.
