Glucagon-like Receptor-1 agonists for obesity: Weight loss outcomes, tolerability, side effects, and risks
Background: This review examines the side effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs), including liraglutide, semaglutide, and tirzepatide, which are widely recognized for their effectiveness in facilitating weight loss in individuals with obesity. The goal is to understand the balance between their therapeutic benefits and potential risks.
Methods: A comprehensive clinical review was conducted, encompassing systematic reviews, meta-analyses, randomized controlled trials (RCTs), and cohort studies. Data were gathered from databases such as PubMed, Scopus, Embase, MEDLINE, and Google Scholar, with a focus on assessing the tolerability, severity, and risks associated with these medications.
Results: GLP-1RAs were shown to be highly effective in promoting weight loss. In clinical trials, liraglutide resulted in a placebo-corrected weight loss of approximately 5%, semaglutide 12%, and tirzepatide 18%. The most common side effects were gastrointestinal in nature, including nausea, diarrhea, constipation, and vomiting. Although rare, serious adverse events such as gallbladder disorders and acute pancreatitis were observed. Additionally, emerging evidence from multiple studies suggests new risks, such as an increased aspiration risk during anesthesia due to delayed gastric emptying and difficulties with bowel preparation for colonoscopies.
Conclusion: Although GLP-1RAs are effective in treating obesity, they are linked with gastrointestinal side effects and rare but serious adverse events. These findings highlight the need for individualized dosing and thorough patient evaluation. Ongoing research and careful monitoring are crucial to ensure their safe use. Further studies are warranted to refine treatment guidelines, particularly in light of emerging concerns like delayed gastric emptying and its implications for anesthesia management.