A study by the Cleveland Clinic in the United States identified key factors that can affect long-term weight loss in obese patients who were prescribed semaglutide (Ozempic) or liraglutide (Saxenda) to treat type 2 diabetes or obesity.
Factors positively associated with achieving at least 10% weight loss in the first year of semaglutide treatment included obesity as the reason for treatment, persistence on treatment, high dose, and female sex. The study results were published in JAMA Network Open on September 13.
“In obese patients treated with semaglutide or liraglutide, we found that long-term weight loss varied significantly based on the active ingredient in the drug, the reason for treatment, the dose, and the duration of treatment,” said Dr. Hamlet Gasoyan, lead author of the study and a researcher at the Cleveland Clinic.
Weight loss diabetes medications
Semaglutide, sold under the brand names Wegovy and Ozempic, and liraglutide, sold under the brand names Saxenda and Victoza, are glucagon-like peptide-1 receptor agonists. These FDA-approved medications help lower blood sugar levels and promote weight loss.
Obesity is a complex chronic disease that affects more than 41% of adults in the United States, and although clinical trials (in humans) have demonstrated the effectiveness of anti-obesity medications, data in real-world settings on factors associated with long-term weight change and clinically significant weight loss are limited.
In this study, researchers identified key factors associated with long-term weight loss in obese patients. They also identified elements associated with the chance of achieving 10% or more weight loss.
the study
This study included 3389 adult patients with obesity who started treatment with semaglutide or liraglutide between July 1, 2015 and June 30, 2022. Follow-up ended in July 2023.
At the start of the study, the average baseline BMI of participants was 38.5, and 82.2% had type 2 diabetes as the reason for treatment. More than half of the participants were female (54.7%). Overall, 39.6% were prescribed semaglutide for diabetes, 42.6% for diabetes, 11.1% for obesity, and 6.7% for liraglutide for obesity.
Factors associated with weight change
The results showed that the change in weight after one year of starting the drug prescription was associated with the following factors:
- Active drug agent: On average, weight loss was 5.1% with semaglutide versus 2.2% with liraglutide.
- Dosage: Patients experienced an average weight loss of 3.5% with the low dose versus 6.6% with the high dose.
- Reason for treatment: Patients who received the drugs to treat type 2 diabetes experienced a weight loss of 3.2% compared to 5.9% for the treatment of obesity.
- Medication persistence: On average, patients who continued taking the medication for a year experienced a 5.5% weight loss compared to 2.8% among patients who had medication coverage between 90-275 days in the first year and 1.8% among those who had less than 90 days of coverage.
The study showed that 40.7% of patients were continuing to take their medication one year after starting treatment. The persistence rate was higher among patients taking semaglutide (45.8%) than among patients taking liraglutide (35.6%).
Among patients who continued taking their medications for 12 months, the average weight loss was 12.9% with semaglutide for obesity, compared with 5.9% with semaglutide for type 2 diabetes. Weight loss was 5.6% with liraglutide for obesity, compared with 3.1% with liraglutide for type 2 diabetes.
Factors associated with a 10% increased likelihood of achieving weight loss:
Studies have shown that achieving sustained weight loss of 10% or more provides significant health benefits. Accordingly, Dr. Jasovian and his colleagues looked at the percentage of patients who achieved weight loss of 10% or more. They found that:
- Patients who took semaglutide were more likely to achieve a weight loss of 10% or more after one year of starting treatment than those who took liraglutide.
- Patients who used a high dose of the drug were more likely to achieve a weight loss of 10% or more after one year of starting treatment than those who took a low dose.
- Obesity as a reason for treatment made it more likely that those who took their medication for type 2 diabetes would achieve a weight loss of 10% or more after one year of starting treatment.
- Patients who continued taking the medication during the first year or had received treatment between 90-275 days versus less than 90 days of treatment.
- Patients with a higher BMI were more likely to achieve a weight loss of 10% or more after one year of starting treatment.
- Female patients were more likely to achieve a weight loss of 10% or more after 1 year of starting treatment than male patients.
37.4% of patients who received semaglutide for obesity achieved a weight loss of 10% or more, compared with 16.6% of patients who received semaglutide for type 2 diabetes. In comparison, 14.5% of patients who received liraglutide for obesity achieved a weight loss of 10% or more, compared with 9.3% of patients who received liraglutide for type 2 diabetes.
Among patients who continued taking their medications after one year, 61% achieved a weight loss of 10% or more with semaglutide for obesity, 23.1% with semaglutide for type 2 diabetes, 28.6% with liraglutide for obesity, and 12.3% with liraglutide for type 2 diabetes.
“Our findings could help guide patients and providers on some of the key factors associated with the chance of achieving weight loss sustained enough to provide significant health benefits,” Dr. Gasoyan said, according to EurekAlert. “Real-world data may help manage expectations about weight loss with GLP-1 receptor agonists, and reinforce the idea that consistency is key to achieving tangible results.”