Beyond bariatrics: A systematic review and meta-analysis of glucagon-like peptide-1 receptor agonists and novel anti-obesity medications in critical care settings

The rising global prevalence of obesity has led to an increase in patients with obesity-related comorbidities requiring intensive care. This systematic review and meta-analysis evaluates the emerging application of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in critical care settings. We analyzed recent randomized controlled trials and pilot studies investigating GLP-1 RAs in intensive care units. Results demonstrate that GLP-1 RAs provide effective glycemic control with reduced hypoglycemia risk compared to conventional insulin therapy, while potentially offering additional benefits including improved cardiovascular parameters and reduced inflammatory markers. However, challenges persist, including gastrointestinal side effects and administration difficulties in critical care contexts. This innovation represents a paradigm shift in approaching metabolic management in critically ill patients with obesity, though larger multicenter trials are needed to establish definitive protocols and patient selection criteria.