GLP-1 receptor agonists for weight loss: A systematic review and meta-analysis of randomized controlled trials
Abstract
Background: Obesity is a complex condition marked by excessive body fat, linked to comorbidities such as type 2 diabetes and cardiovascular disease. Glucagon-like peptide-1 (GLP-1) receptor agonists, initially developed for diabetes, are increasingly used for weight management.
Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (PubMed, last 5 years, English language) evaluating GLP-1-based pharmacotherapies versus placebo or active comparators for weight loss. The primary endpoint was the proportion of participants achieving any weight loss during follow-up. Pooled odds ratios were estimated using a fixed-effect model with 95% confidence intervals; heterogeneity was quantified with I2. A frequentist network meta-analysis generated SUCRA rankings. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. No protocol was registered.
Results: Twenty-one trials met the inclusion criteria (n = 7024 in pairwise analyses). Across 16 placebo-controlled trials, a higher proportion of participants achieved weight loss with GLP- 1-based agents than with placebo: 78.54% (3231/4114) versus 26.53% (772/2910); pooled odds ratio: 11.37 (95% confidence interval: 8.10-15.98), P < .0001; I2 = 82%. In the network meta-analysis, tirzepatide and semaglutide ranked highest (surface under the cumulative ranking curve 91.2% and 85.4%, respectively).
Conclusion: GLP-1 receptor agonists significantly increase…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 7,024 participants or records.
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