OBJECTIVES: The global prevalence of obesity has drastically increased over the past three decades, increasing the risk of obesity-related morbidity and premature mortality. Lifestyle/behavioral interventions for weight loss have had limited success. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are emerging as highly effective anti-obesity medications (AOMs). This research aims to identify key trends in systematic literature reviews (SLRs) on GLP-1 RAs in adults with obesity.

METHODS: Embase, Medline, and Cochrane databases were searched for SLRs published between 1/Jan/2018 and 16/May/2023 using a NICE-published search strategy for obesity, along with intervention and SLR terms. SLRs of adults with obesity treated with GLP-1 RAs were included. SLRs exclusively on other AOMs, herbal treatments, or non-pharmacological interventions were excluded. A single reviewer screened references, with a 10% check by a second reviewer.

RESULTS: After removing duplicates, 1317 publications were identified and screened, with 106 retained for assessment of full text. A total of 47 relevant SLRs met inclusion criteria. The number of SLRs more than quadrupled from 2018 to 2022, and as of 2023, seven additional SLRs had been published. The majority included meta-analysis (80.85%). The most commonly assessed GLP-1 RA was liraglutide (85%), followed by semaglutide (43%), exenatide (34%), and dulaglutide (13%). Lixisenatide (9%), efpeglenatide (6%), albiglutide (2%), and tirzepatide (2%), were also identified. The most common subpopulations were those without diabetes (21.3%), diabetes (10.6%), polycystic ovary syndrome (8.5%), and schizophrenia/psychosis (6.4%). Overall, the SLRs found GLP-1 RAs to be effective AOMs.

CONCLUSIONS: Recent SLRs reflect the growing number of GLP-1 RAs, which uniquely target both peripheral and brain mechanisms involved in weight regulation. GLP-1 RAs show promise as efficacious and safe pharmacological treatment for obesity; however, the long-term benefits are not yet known. Subsequent SLRs are needed to synthesize evidence on newer AOMs, including dual receptor agonists such as tirzepatide, once data are published.