GLP-1 Agonists for Weight Loss: Pharmacology and Clinical Implications

This review investigates the various pharmacologic treatments for overweight and obesity in adults, especially glucagon-like peptide 1 (GLP-1) agonists. In light of the globally expanding obesity pandemic and the limited selection of treatments, physicians must be equipped with knowledge regarding proven medications and their nuanced differences to best support patients on their path to a healthier lifestyle. In this review, we explore the current medical therapies for obesity, including all major categories, individual mechanisms of action, pharmacokinetics and pharmacodynamics, adverse effects, risks, and absolute contraindications. Additionally, we review the evidence of four recent clinical trials, two systematic reviews, and two meta-analyses describing the efficacy of GLP-1 agonists in decreasing weight, lowering HbA1c, and improving obesity comorbidities. We also discuss total cost and cost-effectiveness compared to other categories, long-term adherence, barriers to use, and reasons for discontinuation of this drug category. Our goal is that this review can serve as a framework to aid providers in building their knowledge and selecting the most advantageous weight loss medication for each patient.