Do patients taking GLP1 (Glucagon-like peptide-1) medications, such as liraglutide (Victoza) or semaglutide (Ozempic), for weight loss typically show some response within 30 days?

From the Guidelines

Most patients taking GLP-1 medications like liraglutide (Victoza) or semaglutide (Ozempic) for weight loss will typically show some initial response within 30 days, though results vary between individuals. Early responses often include reduced appetite, increased feelings of fullness, and modest weight loss of approximately 1-3% of body weight in the first month 1. These medications work by mimicking the hormone GLP-1, which regulates appetite and food intake by acting on the brain's hunger centers and slowing gastric emptying. The full weight loss benefits develop gradually, with maximum effects usually seen after 3-6 months of consistent use. Some key points to consider when using these medications include:

• Starting with lower doses that increase gradually according to the prescribed titration schedule to minimize side effects like nausea, vomiting, or diarrhea 1
• Combining these medications with lifestyle modifications including diet and exercise for optimal results
• Maintaining regular follow-up appointments to monitor progress and adjust treatment as needed
• Being aware of potential contraindications, such as pregnancy and breastfeeding, personal or family history of medullary thyroid cancer or MEN2, and pancreatitis 1
• Monitoring for common side effects and safety concerns, including nausea, vomiting, diarrhea, and suicidal ideation and behavior 1

It's also important to note that the evaluation of initial therapies for obesity should consider a period of 6 months, with a goal of 5-15% weight loss, but some antiobesity medications, including semaglutide and liraglutide, may not show maximal benefit until after 6 months 1. Therefore, for individuals who respond with the requisite 5% weight loss, it is appropriate to continue treatment and evaluate the full treatment response after 12 months on the maximally tolerated dose 1.

From the Research

Weight Loss Response to GLP1 Medications

• Patients taking GLP1 medications, such as liraglutide or semaglutide, for weight loss may show some response within 30 days, but the provided studies do not specifically address this time frame 2, 3, 4, 5, 6.
• Studies have shown that GLP1 receptor agonists can lead to significant weight loss, with semaglutide achieving a mean weight loss of 9-16 kg and liraglutide achieving a mean weight loss of 4-7 kg 2, 3, 6.
• The effectiveness of GLP1 medications in promoting weight loss is attributed to their ability to augment hyperglycemia-induced insulin secretion, suppress glucagon secretion, decelerate gastric emptying, and reduce calorie intake and body weight 4.

Factors Influencing Weight Loss Response

• The degree of weight loss achieved with GLP1 medications can vary depending on the specific medication, dosage, and individual patient characteristics 2, 3, 5.
• Caloric restriction (CR) has been shown to lead to greater weight loss and more favorable improvements in body composition compared to treatment with liraglutide alone 5.
• The ratio of fat to lean mass decreased by 6.5% in the CR group, 2.2% in the liraglutide group, and 0% in the sitagliptin group, suggesting that CR may be more effective in reducing fat mass 5.

Adverse Events and Limitations

• Gastrointestinal symptoms are the most frequently encountered adverse events with GLP1 medications, with incidences between 5 and 30% 6.
• The cost of GLP1 medications remains one of the most critical challenges that limit their use 6.