Weight Loss That Lasts: Reviewing the Long-Term Impact of GLP-1 Receptor Agonists

Abstract

This systematic review evaluates the long-term efficacy and safety of GLP-1 receptor agonists in the management of obesity, focusing on data from high-quality randomized controlled trials published between 2018 and 2025. This review synthesizes findings from studies assessing agents such as semaglutide, liraglutide, tirzepatide, and exenatide in diverse populations, including adults with and without type 2 diabetes and adolescents with severe obesity. Most studies demonstrated sustained weight loss and favorable glycemic control over treatment durations of 40-120 weeks. Additionally, the agents showed generally acceptable safety profiles, with gastrointestinal side effects being the most frequently reported adverse events. The results reinforce the need to conceptualize obesity as a chronic condition requiring long-term pharmacological management. Despite the promising outcomes, limitations in follow-up durations, population diversity, and real-world generalizability highlight areas for future research.

Keywords: exenatide; glp-1 receptor agonists; liraglutide; long-term treatment; obesity management; randomized controlled trials; safety profile; semaglutide; sustained weight loss; tirzepatide.

Figure 1. The PRISMA flowchart represents the study selection process.

PRISMA: Preferred Reporting Items for Systematic reviews and Meta-Analyses