Role of lifestyle and glucagon‐like peptide‐1 receptor agonists for weight loss in obesity, type 2 diabetes and steatotic liver diseases
Open accessAbstract
Summary: Background: The current obesity pandemic has given rise to associated comorbidities and complications, including type 2 diabetes and metabolic dysfunction‐associated steatotic liver disease (MASLD). During the last decade, certain glucagon‐like peptide 1 receptor agonists (GLP‐1RA), originally developed as antihyperglycemic drugs, also demonstrated efficacy for weight loss. Aims: To review shared pathophysiologic features of common metabolic diseases and compare therapeutic strategies to reduce body weight and related complications. Methods: We performed an extensive literature research to describe the effects of lifestyle modification, first‐generation anti‐obesity drugs, and GLP‐1RA on weight loss in humans with obesity, type 2 diabetes and MASLD. Results: Until recently, treatment of obesity has been limited to lifestyle modification, which offer moderate degree and sustainability of weight loss. The few approved first‐generation anti‐obesity drugs are either limited to short term use or to certain forms of obesity. Some GLP‐1RA significantly decrease caloric intake and body weight. Liraglutide and semaglutide have therefore been approved for treating people with obesity. They also lead to a reduction of hepatic fat content and inflammation in people with biopsy‐confirmed MASLD. Possible limitations comprise adverse effects, treatment adherence and persistence. Conclusion: Certain GLP‐1RA are superior to lifestyle modification and first‐generation anti‐obesity drugs in inducing weight loss. They have therefore markedly changed the portfolio of obesity treatment with additional beneficial effects on steatotic liver disease.
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All approved GLP-1RA can induce weight loss by central GLP-1 receptor activation in specific regions in the hypothalamus and the brain-stem promoting satiety and decrease appetite.
“In general, all approved GLP-1RA (short-acting (e.g., exenatide) and long-acting (e.g., liraglutide, albiglutide, dulaglutide, semaglutide) can induce weight loss by central GLP-1 receptor activation in specific regions in the hypothalamus and the brain-stem promoting satiety and decrease appetite [101,102].”
From Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease? (2024) · cites this paper as [102]
There are substantial differences in the magnitude of weight loss achieved with the individual GLP-1RA compounds, with most molecules approaching 2-4 kg, but less with albiglutide and substantially higher with semaglutide.
“However, there are substantial differences in the magnitude of weight loss achieved with the individual compounds, with most molecules approaching 2-4 kg, but less with albiglutide and substantially higher with semaglutide [102].”
From Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease? (2024) · cites this paper as [102]
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Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease?
Huttasch, M., Roden, M., & Kahl, S. (2024) · Metabolism · doi:10.1016/j.metabol.2024.155937 · Cited by 169 · see citing works
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Unlocking the multifaceted roles of GLP-1: Physiological functions and therapeutic potential
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- Authors
- Giannakogeorgou, A., & Roden, M.
- Affiliations
- Deutsches Diabetes-Zentrum e.V. (DE)
- Düsseldorf University Hospital (DE)
- Corresponding author
- Roden, Michael
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2024-05-30
- Volume
- 59
- Issue
- S1
- Pages
- S52-S75
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W4399177746
- Cited by
- 30
- References
- 67
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 8
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- GLP-1 receptor agonists, weight loss, obesity, type 2 diabetes, non-alcoholic fatty liver disease, lifestyle modification, anti-obesity drugs, liraglutide, semaglutide, liver inflammation, medication adherence
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Liraglutide, Glucagon-Like Peptide-1 Receptor Agonists, Diabetes Mellitus, Type 2, Fatty Liver, Humans, Hypoglycemic Agents, Life Style, Obesity, Weight Loss, Anti-Obesity Agents
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