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Review
. 2023 Jun 21;24(13):10449.
doi: 10.3390/ijms241310449.

Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials

Mihaela-Simona Popoviciu  1 , Lorena Păduraru  1 , Galal Yahya  2   3 , Kamel Metwally  4   5 , Simona Cavalu  1
Affiliations
Review

Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials

Mihaela-Simona Popoviciu et al. Int J Mol Sci. .

Abstract

Obesity is a chronic disease with high prevalence and associated comorbidities, making it a growing global concern. These comorbidities include type 2 diabetes, hypertension, ventilatory dysfunction, arthrosis, venous and lymphatic circulation diseases, depression, and others, which have a negative impact on health and increase morbidity and mortality. GLP-1 agonists, used to treat type 2 diabetes, have been shown to be effective in promoting weight loss in preclinical and clinical studies. This review summarizes numerous studies conducted on the main drugs in the GLP-1 agonists class, outlining the maximum achievable weight loss. Our aim is to emphasize the active role and main outcomes of GLP-1 agonists in promoting weight loss, as well as in improving hyperglycemia, insulin sensitivity, blood pressure, cardio-metabolic, and renal protection. We highlight the pleiotropic effects of these medications, along with their indications, contraindications, and precautions for both diabetic and non-diabetic patients, based on long-term follow-up studies.

Keywords: GLP-1 agonists; Lixisenatide; exenatide; liraglutide; obesity; semaglutide; tirzepatide; type 2 diabetes; weight loss.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The worldwide prevalence of obesity in 2025: (a) females and (b) males. Obesity refers to BMI ≥ 30 kg/m2. Age-standardized estimates for adults aged 20 years and older. Data obtained from NCD-RisC study. Available online: https://www.ncdrisc.org (accessed on 15 February 2023).
Figure 2
Figure 2
Complications of obesity.
Figure 3
Figure 3
The structure of GLP-1-parent.
Figure 4
Figure 4
Development of exenatide and the corresponding chemical structure.
Figure 5
Figure 5
Development of Lixisenatide and the corresponding chemical structure.
Figure 6
Figure 6
Development of liraglutide and the corresponding chemical structure.
Figure 7
Figure 7
Development of semaglutide and the corresponding chemical structure.
Figure 8
Figure 8
Development of tirzepatide and the corresponding chemical structure.
Figure 9
Figure 9
Development of albiglutide and the corresponding chemical structure.
Figure 10
Figure 10
Distribution of GLP-1 receptors. GLP-1Rs (pdb6X18) mainly exist in the neurons of the brain and the beta cells of the pancreas.
See this image and copyright information in PMC

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