Home Medizin Übung, GLP-1-Rezeptor-Agonist oder kombinierter Ansatz, der in einer einjährigen Studie untersucht wurde

Übung, GLP-1-Rezeptor-Agonist oder kombinierter Ansatz, der in einer einjährigen Studie untersucht wurde

von NFI Redaktion

Recently, a study published in eClinicalMedicine compared the extent of weight loss maintenance after one year of discontinuation of active intervention with a Glucagon-like Peptide-1 (GLP-1) receptor agonist, supervised exercise program, or a combination of both.

Study: Maintenance of healthy weight loss through exercise, GLP-1 receptor agonists, or both combined, followed by one year without treatment: a post-treatment analysis of a randomized, placebo-controlled study. Image source: photobyphotoboy / Shutterstock.com

Background

Obesity is a health condition characterized by the accumulation of excess body fat. Several studies have indicated that obesity influences the development of various health conditions, including type 2 diabetes and cardiovascular diseases.

In recent years, many treatments and weight loss programs have been developed to reduce obesity. For example, GLP-1 receptor agonists have been approved by regulatory authorities globally for the treatment of obesity and type 2 diabetes.

GLP-1 receptor agonists have been shown to reduce appetite, leading to decreased food intake. Compared to single-agent weight loss treatment, combination treatment with the GLP-1 receptor agonist liraglutide and a supervised exercise program resulted in better weight loss maintenance and improved body composition.

GLP-1 receptor agonists such as semaglutide and tirzepatide led to greater weight loss compared to a placebo-treated control group after 68 and 78 weeks of treatment, respectively. Despite several studies reporting on the positive effects of these obesity interventions, long-term adherence to these treatments is challenging due to their gastrointestinal side effects and high costs.

Most obesity interventions are discontinued after one year. Furthermore, many studies have shown that discontinuation of GLP-1 receptor agonists leads to weight gain.

These observations underscore the importance of continued use of GLP-1 receptor agonists as a medication for sustained positive effects. However, a new strategy is needed to minimize weight gain even after discontinuation of weight loss medications.

Exercise is a cost-effective measure that can be performed over an extended period and is an extremely effective way to reduce weight. Therefore, it is important to assess whether a combination of physical activity and treatment with GLP-1 receptor agonists improves weight loss maintenance after treatment discontinuation.

About the Study

The current randomized and controlled study hypothesized that weight loss and body composition could be better maintained after one year of discontinuation of active treatment with a supervised exercise program and a GLP-1 receptor agonist, or a combination of both for one year. Additionally, it was assumed that a combination intervention would achieve better outcomes compared to single GLP-1 receptor agonist treatment.

The study recruited overweight individuals aged 18 to 65 years. Participants with a history of chronic diseases, including diabetes, were excluded from the study cohort.

All study participants underwent an eight-week low-calorie diet and were randomly assigned to four groups, including liraglutide and usual physical activity, placebo and usual physical activity, combined exercise and placebo, combined exercise plus liraglutide, and liraglutide and usual physical activity for 52 weeks.

One year after completion of 52 weeks of the above interventions, participants were invited for a post-treatment study to assess weight maintenance.

Study Results

In the post-treatment study conducted between December 17, 2018, and December 17, 2020, a total of 109 individuals participated. Importantly, the characteristics of participants were similar across all intervention groups.

Participants assigned to a combination treatment of supervised exercise and treatment with a GLP-1 receptor agonist showed better weight loss maintenance and a reduction in body fat after one year of treatment. Interestingly, individuals who received only liraglutide experienced a maximum weight gain of six kg after one year of intervention discontinuation.

Despite the initial weight loss observed during the intervention’s early phase, there was disproportionate weight gain after one year of treatment discontinuation in participants receiving only supervised exercise and liraglutide. A stronger weight gain was observed in the liraglutide group one year after treatment discontinuation.

The liraglutide monotherapy group showed better effects on body composition, healthy body weight, and glucose levels. However, the combination of liraglutide with exercise resulted in an effective reduction in fat percentage, waist circumference, and fat mass.

Conclusions

The current study has some limitations, including the small number of participants in the placebo group, especially in the post-treatment study. Participants who experienced positive effects during active interventions participated in the post-treatment study across all treatment groups.

Despite these limitations, the study results suggest that a combination of supervised exercise and pharmacotherapy allows for better maintenance of healthy body weight and body composition one year after treatment discontinuation.

Journal Reference:

  • Jensen, KBS, Blond, MB, Sandsdal, RM, et al. (2024) Maintenance of healthy weight loss through exercise, GLP-1 receptor agonists, or both combined, followed by one year without treatment: a post-treatment analysis of a randomized, placebo-controlled study. eClinicalMedicine. doi:10.1016/j.eclinm.2024.102475

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