4 Key Factors Affect How Much Weight You Lose With GLP-1 Drugs

• Researchers have used real-world data to identify key factors for long-term weight loss in patients taking GLP-1 drugs such as Ozempic and Wegovy.
• The study identified four of the most important factors as drug type, dosage, treatment indication and drug persistence.
• GLP-1 drugs are effective weight loss agents, but cost and access still pose barriers for many Americans.

Millions of Americans have taken Ozempic or similar GLP-1 drugs to lose weight, but many of them have found it difficult to maintain the weight long-term.

However, recent research suggests that there are four factors that may be critical to improving these outcomes.

Researchers at the Cleveland Clinic examined the electronic health records of nearly 3,400 patients who were prescribed one of two different GLP-1 drugs — semaglutide (sold under the brand names Ozempic and Wegovy) and liraglutide (sold under the brand names Saxenda and Victoza) — to see how various factors, such as dosage, indication and biological sex, affected weight loss after one year.

The researchers looked at how these factors affected weight loss in two ways: the overall percentage change in body weight and whether a person lost 10% or more of their body weight. The 10% mark is clinically significant because it is known that reaching this benchmark Improvement of other comorbidities such as high blood pressure and the risk of chronic diseases.

They identified four factors that seem to be most important for long-term weight loss, some of which are obvious and others more complex:

• The type of medication (Active ingredient) – Has the patient used semaglutide or liraglutide?
• The dosage – Did the patient use a high or low maintenance dose?
• Treatment instructions – Was the medicine prescribed for type 2 diabetes or obesity?
• Drug persistence – Were there any gaps in the patient’s medication supply?

“Our findings provide current data on longer-term weight outcomes in patients treated with injectable semaglutide or liraglutide for obesity or type 2 diabetes. In addition, they identify key characteristics that may predict the likelihood of achieving sustained weight loss at a rate that provides clinically meaningful health benefits,” Hamlet Gasoyan, PhD, lead author of the study and a researcher at the Cleveland Clinic's Center for Value-Based Care Research, told Healthline.

Gasoyan and his team used the Cleveland Clinic’s electronic health records for 3,389 patients who were prescribed either semaglutide or liraglutide from July 2015 to June 2022. To be included, patients had to BMI of at least 30, indicating that the person was obese.

More than half of the patients were female (54%) and had a mean age of 50 years. The cohort was predominantly white (68%), but also included a significant proportion of black (20%) and Hispanic (7%) populations.

After one year, four factors appeared to have the greatest impact on sustained weight loss. Here's how they affected whether patients lost 10% or more weight:

• Active ingredient: Patients taking semaglutide were more than twice as likely as patients taking liraglutide.
• Advertisement: Those prescribed their obesity medication were also more than twice as likely as those with type 2 diabetes.
• dosage: Patients who took a higher maintenance dose of their medication were 1.5 times more likely than patients who took a lower dose.
• Persistence: Patients with consistent coverage (access to their medications) were more than three times as likely to receive care as those with the least access.

The gender of the patients was also an important factor. Women in the study were 1.5 times more likely to reach the 10 percent mark than men.

Two of the factors seem obvious: active ingredient and dosage. Basically, the type of medication prescribed and the dosage influenced the weight loss outcome.

Semaglutide resulted in more than twice the average weight loss as liraglutide (5.1% versus 2.2%). However, this is nothing new: Views have shown that semaglutide is simply more effective than liraglutide for weight loss.

Evidence also has pointed that higher maintenance doses of semaglutide are more effective in weight loss than lower doses.

The indication is complicated. There is clear evidence that patients prescribed GLP-1 for obesity tend to lose more weight than patients with type 2 diabetes, but why this is so is not so obvious.

Caroline Apovian MD, professor of medicine at Harvard Medical School and co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital, told Healthline that these findings essentially confirm previous research..

It is the fourth factor – persistence – that has caught the attention of Apovian and other obesity experts.

“This study adds a lot to the question of persistence. The discussion these days tends to focus on the idea that these are really great drugs, but are patients actually taking them?” Dr. Beverly Tchang, an endocrinologist, spokesperson for the Obesity Society and assistant professor of clinical medicine at Weill Cornell Medicine, told Healthline.

“This creates a very clear connection between this consistency and the extent of weight loss,” she said.

As effective as GLP-1 drugs are, access to them remains a major obstacle for many Americans. Due to the increasing popularity of these drugs, patients across the United States are facing shortages as manufacturers cannot keep up with demand.

Cost and insurance coverage are also issues for many patients. Monthly costs for GLP-1 medications can easily be $1,000 or more, without considering insurance coverage or reimbursement.

If patients can't afford their medications or don't have access to them, they won't take them. It's that simple.

These latest research findings highlight this dilemma.

Gasoyan and his team found that after one year, only 40% of patients had continuous insurance coverage for their medications, which they defined as a cumulative interruption in coverage of less than 90 days.

However, those with continuous insurance coverage lost significantly more weight (5.5%) than those with the least insurance coverage (1.8%), i.e. less than 90 days of insurance coverage per year.

The data “reinforce that consistency is key to achieving meaningful weight results with these medications,” Gasoyan said.

“If we avoid interruptions in these medications, whether due to shortages or insurance coverage, we can be more likely to stick with these medications and lose more weight,” Tchang added.

GLP-1 drugs such as Ozempic and Wegovy are effective weight loss agents. However, long-term weight loss results can be affected by a variety of factors.

In a new study, researchers identified four of the most important factors for long-term weight loss in patients taking a GLP-1 drug. These include the type of drug, the dosage, the indication and drug persistence (how long the patient took the drug continuously).

Consistent medication use is essential for long-term weight loss, but access to GLP-1 medications and their cost continue to pose barriers for many Americans.