Prescribing Advice for GPs

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Liraglutide for obesity?

The Lancet has published the results of a study that aimed to assess the efficacy and tolerability of liraglutide in the treatment of obesity in individuals without type 2 diabetes. This study has been reported in the general media (BBC).

The study recruited men and women aged 18 to 65 years old with a body mass index (BMI) of 30-40kg/m2. Patients with type1 or type 2 diabetes and those with a fasting glucose of 7mmol/L or above were excluded. Participants were then randomly assigned to a placebo injection, one of four dose regimens of liraglutide (1.2mg, 1.8mg, 2.4mg or 3.0mg daily) or open-label orlistat. Follow up was for 20 weeks in total which included a 4 week titration phase and 16 weeks of stable dosing. All participants were also advised regarding a 500 kcal per day energy-deficient diet and increased their physical activity throughout the trial.

Mean body weight, waist size and blood pressure were reduced in all groups. Liraglutide produced significantly greater reductions in body weight compared to placebo at all doses and at the two higher doses when compared to orlistat. Participants on the higher dose of liraglutide (3.0mg daily) lost an average of 7.2kg over the 20 week study.

Nausea and vomiting occurred much more frequently with liraglutide therapy and these side effects were also dose related. 5.1% of patients on the placebo injection experienced nausea compared to 24.2% to 47.3% of patients on liraglutide.

The authors note that the open label orlistat treatment and the different injection volumes of the daily doses of liraglutide may introduce some bias. They also note that the long-term effects of this treatment on body weight, lipids, cardiovascular risk and mortality need to be assessed in longer studies.

The authors conclude that, "the results of this study indicate the potential benefit of liraglutide" but also suggest that "the long-term risk–benefit profile for liraglutide, as well as its weight maintenance capabilities, remain to be established". In addition, patient acceptability of an injectable therapy to aid weight loss remains unknown.

Action: Clinicians should be aware of the results of this study. Liraglutide is not currently licensed as a weight management product. Use of this drug in patients without diabetes, with the aim of aiding weight loss, should be avoided pending further research and a license for this indication.

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4 Comments to “Liraglutide for obesity?”

  1. Being a type two diabetic myself - I feel that this is not just related to 'lack of exercise'. yes I'm over weight - but just round my tummy area and I exercise regularly - cycling to work and going down the gym. There are many reasons and condtions that can lead to diabetes. I suffer from Polycyctic ovary syndrome - which leads to diabetes, I have fat found my middle - which can lead to diabetes and it is also hireditary. some people are effected because of lack of exercise, but please do not put every 'diabetic' person in this catagory !!

    Comment by Helen — October 15, 2011 #
    Reply

  2. here in Philippines, obesity is also becoming a problem. More and more children are getting obese due to a lifestyle that is not fully of physical activities. most kids just wants to watch TV, play computer games and surf the net.

    Comment by Jimmy Cruz — March 28, 2010 #
    Reply

  3. Obesity is really an epidemic these days. People have become very lazy and does not want to exercise anymore. I do a lot of jogging and brisk walking everyday just to be fit and healthy.

    Comment by Jamie Apple — March 1, 2010 #
    Reply

  4. Obesity and diabetes is a growing problems nowadays. It is caused by todays lifestyle which does not involve lots amount of exercise. Most people are just happy sitting in their office chair and they do not even want to sweat.

    Comment by Bridgette — January 13, 2010 #
    Reply

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