ABSTRACT
Glucagon-like peptide-1 (GLP-1) is an incretin hormone with physiological effects on both glycaemic control and weight regulation. Acting on both peripheral and central receptors, it delays gastric emptying while modulating appetite and increasing satiety. Subsequently, these benefits have been harnessed in the development and licensing of safe and effective GLP-1 agonists for the treatment of type 2 diabetes and obesity.
Two GLP-1 agonists are currently approved for the treatment of obesity: liraglutide and semaglutide, both administered through subcutaneous injection. Semaglutide is currently the most effective anti-obesity agent demonstrating weight loss of about 15% in phase III clinical trials, with improvements in glycaemia, cardiovascular risk factors, and quality of life. Furthermore, GLP-1 agonist use reduces the incidence of cardiovascular events in people with type 2 diabetes. Thus, this drug class uniquely addresses the multisystem nature of clinical obesity. Gastrointestinal side effects have been shown to be mild and self-limiting in most individuals. GLP-1 agonists can be utilized as safe and novel management options in individuals with obesity regardless of underlying diabetes status.
GLP-1 agonists mark an exciting era for drug therapy in obesity management. Future changes in their formulation, used in combination with other gut hormone analogs and oral preparations will allow for easier administration, improved treatment adherence, and potentially even greater weight loss potential.
