Obesity (Silver Spring, Md.)

Nutritional guidance to support weight loss treatment with GLP-1 therapy

Updated

Abstract

GLP-1s may reduce body weight by 5% to 18% in trials.

  • Real-world analyses show modestly lower weight reduction effects from GLP-1s compared to clinical trials.
  • Challenges associated with GLP-1 treatment include gastrointestinal side effects, , muscle and bone loss, and low long-term adherence.
  • Multiple practice guidelines advocate for combining GLP-1s with evidence-based nutritional and behavioral therapy for obesity management.
  • Priorities for effective GLP-1 treatment include patient-centered initiation, comprehensive assessments, and addressing social determinants of health.
  • Management of gastrointestinal side effects and preservation of muscle mass through diet and resistance training are crucial during GLP-1 use.

Simplified

Key numbers

5% to 18%
Weight Reduction Range
Placebo-adjusted weight reduction in trials for individuals with obesity.
33% to 50%
Discontinuation Rate
Reported adherence rates at one year for individuals prescribed GLP-1s.
$12,000 to $16,000
Cost of Therapy
Current US list price for GLP-1s for obesity treatment.

Full Text

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Funding

Competing interests

Dr. Mozaffarian reports research funding from the National Institutes of Health, Kaiser Permanente Fund at the East Bay Community Foundation, National Association of Chain Drug Stores Foundation, Google Health, and The Rockefeller Foundation; scientific advisory board, Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart Health, January Inc., WndrHLTH; scientific consulting, Amazon Health; equity in Calibrate and HumanCo; and chapter royalties from UpToDate. Dr. Alexander reports advisory board for Novo Nordisk and speakers bureau for Eli Lilly. Dr. Apovian reports research funding from PCORI and GI Dynamics, Inc.; and advisory boards for Altimmune, Inc., Arrowhead Pharmaceuticals, Inc., BioAge, Biolinq Incorporated, Caribou Biosciences, Inc., CinFina Pharma, Inc., Covidien LP, Cowen and Company, LLC, Currax Pharmaceuticals, LLC, EPG Communication Holdings Ltd., Form Health, Inc., Fractyl Health, Inc., Lilly USA, LLC, L‐Nutra, Inc., Mediflix Inc., NeuroBo Pharmaceuticals, Inc., Neurocrine Biosciences, Inc., NodThera Limited, Nutrisystem, OptumRx, Inc., Pain Script Corporation, Palatin Technologies, Inc., Pursuit By You, Redesign Health Inc., ReShape Lifesciences Inc., Riverview School, Roman Health Ventures Inc., Scholar Rock, Inc., Terns, Inc., Verily Life Sciences LLC, Veru Inc., Vida Health, Inc., Wave Life Sciences, Xeno Biosciences and Zyversa Therapeutics, Inc. Dr. Butsch reports advisory boards for Eli Lilly, Novo Nordisk, Abbott and Boehringer Ingelheim. S. Christensen reports advisory boards and speakers bureau for Novo Nordisk and speakers bureau for Eli Lilly. Dr. Kane reports research funding by the Ardmore Institute of Health. Dr. Stanford reports research funding from the National Institutes of Health; and scientific advisory boards for Eli Lilly, Novo Nordisk, Amgen, Pfizer, Currax, Calibrate, Vida Health, Ilant Health, Mellicell, Sweetch, Doximity, GoodRx, Empros Pharma, Clearmind Medicine, and Apnimed. The other authors report no disclosures.
PubMed

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