Efficacy and Safety of GLP-1 Receptor Agonists in Obesity Management among Otherwise Healthy Adults

Abstract

Background: Obesity is a chronic and progressive condition that can have metabolic, cardiovascular and psychosocial consequences. Glucagon-like peptide-1 receptor agonists have been shown to be useful weight management drugs, but the body of evidence for their chronic, daily use in otherwise healthy adults is still relatively small.

Objective: To determine the efficacy and safety of GLP-1 receptor agonists in obesity management among otherwise healthy adults.

Methods: This is a prospective observational study carried out at Bacha Khan Medical College, Mardan from January 2025 to June 2025. Total 82 adult (18–60 years) individuals with body mass index ≥30 kg/m² were recruited using non-probabilistic consecutive sampling. They were given either semaglutide or liraglutide in addition to diet and physical activity advice. Body weight, BMI, waist circumference, blood pressure, fasting glucose, HbA1c and lipid profile were measured. Proportions losing 5%, 10%, 15% and 20% of their weight were calculated. Treatment adherence and adverse effects were also recorded. The p value <0.05 was regarded as statistically significant.

Results: The mean age of participants was 36.8 ± 9.4 years, and 52.4% were female. Mean body weight decreased from 98.7 ± 13.6 kg at baseline to 87.9 ± 12.8 kg at follow-up, with a mean reduction of 10.8 ± 5.4 kg (p<0.001). BMI decreased from 35.9 ± 4.2 to 32.0 ± 4.0 kg/m², while waist circumference declined by 9.6 ± 5.7 cm (both p<0.001). At least 5% weight loss was achieved by 68.3% of participants, 43.9% achieved at least 10%, and 18.3% achieved at least 15%. Semaglutide produced greater mean percentage weight loss than liraglutide (12.4 ± 5.0% versus 8.6 ± 4.3%; p=0.001). Significant improvements were also observed in blood pressure, glycaemic indices, and lipid profile. Adverse effects occurred in 52.4%, most commonly nausea and constipation, while 4.9% discontinued treatment because of intolerance. No acute pancreatitis or serious hypoglycaemia was observed.

Conclusion: GLP-1 receptor agonists produced clinically meaningful weight loss and favourable metabolic changes among otherwise healthy adults with obesity. Semaglutide was more effective than liraglutide, while adverse effects were predominantly mild and gastrointestinal. Regular adherence, longer treatment duration, and physical activity contributed to improved treatment response.