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Purpose of review <p>This review evaluates the strength and scope of clinical evidence for GLP-1RAs—liraglutide, semaglutide, and tirzepatide—across obesity and associated complications, providing a structured rationale for prioritisation in clinical practice and policy.</p> Recent findings <p>GLP-1RAs demonstrate significant and reproducible weight loss—approximately 15% with semaglutide and 20% with tirzepatide at one year. Their efficacy in obesity-related health conditions has been best demonstrated through large clinical trials in cardiovascular disease, type 2 diabetes, obstructive sleep apnoea and metabolic dysfunction-associated steatotic liver disease. There is emerging evidence in the form of clinical trials and large retrospective studies for a number of other health conditions including chronic kidney disease, polycystic ovary syndrome, osteoarthritis, and other inflammatory conditions. Finally, GLP-1RAs may be a safe and effective treatment in time-critical contexts requiring rapid weight reduction for access to interventions such as organ transplantation, oncology surgery, sight-threatening idiopathic intracranial hypertension, and assisted conception.</p> Summary <p>While all individuals meeting NICE eligibility criteria should ultimately access GLP-1RA therapy, current capacity constraints necessitate a phased approach prioritising high-evidence or time-sensitive conditions. This framework provides a scientifically grounded and evidence-based model to support clinical decision-making and service development in obesity management. Continued research is warranted to expand the evidence base, optimise cost-effectiveness, and ensure equitable implementation of obesity pharmacotherapy within public health services<b>.</b></p>

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The Role of GLP1 Receptor Agonists and Multi-agonist Incretin Therapies for Specific Obesity-related Health Conditions: Evidence and Rationale for Prioritisation

  • 期刊论文

  • 发表日期：

    2026年4月2日

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  • Christo Albor,
  • Oluwaseun Anyiam,
  • Luke D. Boyle,
  • Janine Makaronidis,
  • Rachael Tan,
  • Sahar Iftikhar,
  • Amna Burzic,
  • Fannie Lajeunesse Trempe,
  • Moira Stanley,
  • Aniqah Bhatti,
  • Jadine Scragg,
  • Layla Badawy,
  • Komal Moqeem,
  • Iskandar Idris,
  • Rob C. Andrews,
  • Piya Sen Gupta,
  • David Hughes,
  • Katherine McCullough,
  • Tricia Tan,
  • Barbara McGowan

摘要

Purpose of review

This review evaluates the strength and scope of clinical evidence for GLP-1RAs—liraglutide, semaglutide, and tirzepatide—across obesity and associated complications, providing a structured rationale for prioritisation in clinical practice and policy.

Recent findings

GLP-1RAs demonstrate significant and reproducible weight loss—approximately 15% with semaglutide and 20% with tirzepatide at one year. Their efficacy in obesity-related health conditions has been best demonstrated through large clinical trials in cardiovascular disease, type 2 diabetes, obstructive sleep apnoea and metabolic dysfunction-associated steatotic liver disease. There is emerging evidence in the form of clinical trials and large retrospective studies for a number of other health conditions including chronic kidney disease, polycystic ovary syndrome, osteoarthritis, and other inflammatory conditions. Finally, GLP-1RAs may be a safe and effective treatment in time-critical contexts requiring rapid weight reduction for access to interventions such as organ transplantation, oncology surgery, sight-threatening idiopathic intracranial hypertension, and assisted conception.

Summary

While all individuals meeting NICE eligibility criteria should ultimately access GLP-1RA therapy, current capacity constraints necessitate a phased approach prioritising high-evidence or time-sensitive conditions. This framework provides a scientifically grounded and evidence-based model to support clinical decision-making and service development in obesity management. Continued research is warranted to expand the evidence base, optimise cost-effectiveness, and ensure equitable implementation of obesity pharmacotherapy within public health services.