Are diabetes medications effective in the management of obesity?

Updated: Jun 09, 2021
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Metformin does not have an indication for obesity, but it is useful in preventing diabetes and improving insulin resistance in conditions such as polycystic ovary syndrome. Its use was associated with weight neutrality or mild weight loss. [166]

The first glucagonlike peptide (GLP)-1 analogue, exenatide (Byetta), although not FDA approved for obesity management, has been associated with modest weight loss in subjects with type 2 diabetes. A similar effect was seen with liraglutide (Victoza) and long-acting exenatide (Bydureon), which also are not approved by the FDA for obesity management. Higher liraglutide doses of 2.4 mg and 3 mg/day were found to be significantly more effective than orlistat for the management of obesity in nondiabetic patients. The FDA approved liraglutide (Saxenda) for obesity in December 2014 (see above).

A systematic review and meta-analysis by Vilsbøll et al found that treatment with GLP-1 receptor agonists results in weight loss among overweight or obese patients with or without type 2 diabetes. [167] GLP-1 agonist regimens reviewed included exenatide twice daily, exenatide once weekly, and liraglutide once daily at clinically relevant doses for at least 20 weeks.


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