Efficacy of GLP-1 agonists vs. other weight management medications in obese and overweight patients

Background Glucagon-like peptide-1 (GLP-1) agonists are efficacious for weight management; however, there are barriers that prevent access. Although studies have shown the efficacy of individual treatments, there is a lack of evidence that compares different classes of weight management medications with each other. Objective This study aimed to compare the efficacy of GLP-1 agonists with other classes of weight management medications. Methods This retrospective chart review included patients prescribed a weight management medication by a primary care pharmacist at Corewell Health between June 1, 2022, and June 1, 2023. Patients were assigned to (1) the GLP-1 agonist group or (2) the non-GLP-1 agonist group. The primary outcome was the percentage of patients who reached ≥ 5% weight loss at the end of the treatment course. The secondary outcomes include the percentage of patients who reached ≥ 10% weight loss and ≥ 15% weight loss at the end of the treatment course and average change in body mass index (BMI) at the end of the treatment course. Results A higher number of patients in the GLP-1 agonist group achieved the primary end point of ≥ 5% weight loss compared with the non-GLP-1 agonist group (29 patients [50.9%] vs. 17 patients [30.9%], P = 0.0318). A logistic model was done, which showed that, when accounting for medication duration, the number of patients in the GLP-1 agonist group who reached the primary end point was not statistically significant compared with the non-GLP-1 agonist group with a P value of 0.0772. There was not a statistically significant difference in the number of patients who achieved ≥ 10% and ≥ 15% weight loss between groups, whereas BMI change was statistically significantly greater in the GLP-1 agonist group. Conclusion A higher percentage of patients in the GLP-1 agonist group reached ≥ 5% weight loss as compared to patients in the non-GLP-1 agonist group, without regard to medication duration.