Which Drug is the Most Effective for Weight Loss?

Few drugs have been approved by the FDA for weight loss. However, until now, GLP-1 analogs are considered the most effective drugs for weight loss.

GLP-1 analogs include:

• Exenatide (Byetta)
• Dulaglutide (Trulicity)
• Albiglutide (Tanzeum)
• Liraglutide (Saxenda, Victoza)
• Semaglutide (Rybelsus, Ozempic, and Wegovy)

GLP-1 analogs are drugs that mimic the action of endogenous incretins. Incretin hormones cause the secretion of insulin in a glucose-dependent mechanism, inhibit glucagon secretion, and slow gastric movements.

GLP-1 analogs also act on the satiety and hunger centers in the brain and suppress appetite. However, this action has not been very well studied.

FDA-approved GLP-1 analogs for weight loss:

Only Semaglutide and Liraglutide have been approved for weight loss. These two GLP-1 analogs have been studied in clinical trials in obese individuals with or without diabetes.

Although in clinical trials, Semaglutide is associated with significantly greater weight loss, Liraglutide has greater real-life data regarding weight loss in obese people.

Liraglutide resulted in a weight loss of 6% when administered in a dose of 3 mg compared to 2% weight loss in the placebo group.

Semaglutide resulted in a weight loss of 14.9% and 16% in the STEP-1 and STEP-3 Clinical Trials.

Liraglutide resulted in a weight loss of 8% in the SCALE Obesity and Prediabetes trial compared to 2.6% in the placebo group.

Similarly, the Pioneer-IV trial directly compared Oral Semaglutide and Injectable Liraglutide. The efficacy of the two drugs in lowering the glycated hemoglobin was comparable, however, greater weight loss was observed with Oral Semaglutide than Liraglutide.

There was a mean weight loss of 4.4 kgs in the Oral Seamglutide group compared to 3.1 kgs in the Liraglutide group [Ref].

Which of the GLP-1 analogs is the most effective for weight loss?

Data from clinical trials suggest that Semaglutide is the most effective drug for weight loss. However, comparisons from real-world data are still needed.

Semaglutide is a novel GLP-1 analog. It is 94% similar in structure to the endogenous GLP-1. It also has three different formulations:

• Oral Semaglutide:
  • It is available by the brand name of Rybelsus and is administered once daily.
• Injectable Semaglutide:
  • It is available in two strengths, low dose, and high dose.
  • Low dose Injectable Semaglutide is available under the brand name Ozempic and is approved only for the treatment of Diabetes
  • High-dose injectable Semaglutide is available by the brand name of Wegovy and is approved only for the treatment of obesity.

Have you tried any of these weight loss drugs?

If you have been on any of the two most effective drugs for weight loss, kindly answer the poll at the end.