BACKGROUND: Obesity is an escalating global health challenge, particularly among patients with inflammatory bowel disease (IBD), where the coexistence of metabolic dysfunction and chronic intestinal inflammation complicates clinical management. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are potent weight-management agents; however, their efficacy and safety profiles in patients with obesity and IBD specifically regarding gastrointestinal tolerability remain poorly characterized.
METHODS: We conducted a systematic review to evaluate the impact of GLP-1 RAs on anthropometric outcomes in patients with obesity and IBD. A comprehensive search of PubMed, Embase, and Web of Science was performed through November 10, 2024. Observational studies reporting weight-related metrics were synthesized. To ensure scientific rigor, all imperial units were converted to metric (kg), and a narrative synthesis was employed to address heterogeneity in study designs.
RESULTS: A total of n = 7 studies (sample sizes from 16 to 47,424 participants) were analyzed. GLP-1 RAs consistently demonstrated significant weight reduction, with reported losses ranging from a median of -6.2 kg (range: -3.4 to -8.5 kg) to a mean of approximately -9.5 kg (SD = 8.5) over follow-up periods of 3-18 months. Greater weight loss was observed in patients with higher baseline body mass index and longer treatment duration. Overall, reductions ranged from approximately -16 lbs (SD = 13) to -26 lbs (SD = 20), with longer follow-up studies (up to 450 days) showing median reductions of -8.15 kg (range: -15.9 to -2.2 kg).
CONCLUSIONS: GLP-1 RAs are effective pharmacological adjuncts for weight loss in patients with obesity and IBD, with outcomes modulated by treatment duration and agent selection. These findings support the clinical utility of incretin-based therapies in this complex patient population. However, large-scale randomized controlled trials are essential to establish long-term safety and determine the impact of these agents on IBD disease activity.
