Patient initiation and maintenance of GLP-1 RAs for treatment of obesity: a narrative review and practical considerations for primary care providers

Postgrad Med. 2021 Apr;133(3):310-319. doi: 10.1080/00325481.2020.1845534. Epub 2020 Dec 3.

Abstract

Obesity is a chronic, relapsing metabolic disease, linked to a number of health risks and serious complications. Although highly prevalent in adults in the United States, it is underdiagnosed and untreated. Primary care providers (PCPs) are uniquely poised to diagnose and treat patients with obesity, using a selection of treatment strategies including lifestyle modifications and pharmacotherapies. As a physiological regulator of appetite and energy intake, the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide 3.0 mg is approved for chronic weight management in individuals with overweight (pre-obesity) or obesity. In this review, we provide an overview of the clinical data supporting the use of liraglutide 3.0 mg, as well as practical advice for PCPs on the initiation and maintenance of treatment over the long term. This also covers the management of side effects and how to manage patient expectations over time.

Keywords: GLP-1 RA; Obesity; liraglutide; pharmacotherapy; primary care.

Publication types

  • Systematic Review

MeSH terms

  • Anti-Obesity Agents / adverse effects
  • Anti-Obesity Agents / pharmacology
  • Anti-Obesity Agents / therapeutic use*
  • Body Mass Index
  • Clinical Trials, Phase III as Topic
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology
  • Diet, Reducing / methods
  • Dyslipidemias / epidemiology
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Humans
  • Hypertension / epidemiology
  • Liraglutide / adverse effects
  • Liraglutide / pharmacology
  • Liraglutide / therapeutic use*
  • Obesity / complications
  • Obesity / drug therapy*
  • Obesity / epidemiology
  • Randomized Controlled Trials as Topic

Substances

  • Anti-Obesity Agents
  • Glucagon-Like Peptide-1 Receptor
  • Liraglutide