GLUCAGON-LIKE peptide-1 receptor agonists (GLP-1RA) produce greater weight loss results among women than men, a 2026 systematic review and meta-analysis has found.
The efficacy of GLP-1RAs did not differ across other subpopulations: age, sex, race, ethnicity, baseline BMI, and haemoglobin A1c (HbA1c).
GLP-1RAs
GLP-1RAs are drugs that were initially marketed for the improvement of glycaemic control in individuals with Type 2 diabetes.
Given the prevalence of diabetes, obesity, and cardiovascular disease as major causes of global morbidity and mortality, GLP-1RAs have seen enormous interest in recent decades.
Women Lost More Weight than Men
Researchers identified nearly 50 randomised controlled trials, with a mean study population of almost 2,000 participants taking GLP-1RAs.
They measured patients’ change in body weight in kg or percentage change from baseline over time.
Among six trails that analysed sex differences, totalling almost 20,000 patients, the average weight loss for women was more than 10%.
Men, on the other hand, had a substantially lower average weight loss of less than 7%.
There was no evidence that the effect of treatment differed significantly across age, race, ethnicity, baseline BMI, or baseline HbA1c.
Randomised Controlled Trials
Researchers noted that their analysis excluded randomised controlled trials that did not report on results stratified by the subpopulations in question.
They also sometimes summarised information at the article level, which could have affected the precision of details such as treatment duration.
Some information, including BMI and HbA1c, was not reported consistently, so researchers had to make informed decisions about how to synthesise the relevant factors.
Implications for Clinicians and Patients
Findings suggest that the effectiveness of GLP-1RAs may extend to subpopulations that are typically underrepresented in clinical trials, researchers reported.
They noted that GLP-1RA therapies will continue to evolve and the study offers useful insight and opportunity for those trying to improve care for patients with obesity, diabetes, and other conditions for which GLP-1RAs are relevant.
Reference
Alexander GC et al. Heterogeneity of treatment effects of glucagon-like peptide-1 receptor agonists for weight loss in adults. JAMA Intern Med. 2026;DOI:10.1001/jamainternmed.2025.8222.
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