Effectiveness of Liraglutide in Patients With Obesity Who Are Early Non‐Responders to Lifestyle Intervention: A Real‐World Study

Objective: This prospective, observational study examined the efficacy of liraglutide in subjects with obesity who did not experience early weight loss during a behavioral intervention in a real-world setting. Methods: The weight loss intervention lasted for 12 weeks, and at Week 6, we offered liraglutide to subjects who had lost less than 2.5% of their body weight (early unresponder (eUR)). Before and after the intervention, anthropometry, body composition, blood pressure, level of physical activity, nutrition knowledge, quality of life, and daytime sleepiness were assessed. Results: Of 174 participants, 78 subjects were classified as early unresponders: 21 (27%) agreed to start liraglutide therapy (eUR-LT), and 57 declined (eUR-NLT), primarily due to the out-of-pocket cost. Liraglutide was well tolerated. Four subjects complained of nausea and two of epigastralgia. During the 6–12-week period, the weight loss was −3.5 ± 1.8 kg (−3.2%) in the eUR-LT group and −1.3 ± 1.6 kg (−1.4%) in the eUR-NLT, p < 0.001. Using liraglutide therapy, baseline body mass index, sex, age, and weight change at 6 weeks as independent variables, the multivariate regression analysis found that only liraglutide therapy was significantly associated with weight loss from Week 6 to Week 12 (p < 0.001). After 12 weeks, total weight loss was −6.0 ± 2.4 kg (−5.3%) in group eUR-LT, −2.4 ± 1.9 kg (−2.4%) in group eUR-NLT, and −6.2 ± 2.3 kg (−6.3%) in group eR. In the eUR-LT group, 66.7% lost ≥ 5% of the initial weight; in group eUR-NLT, 14%; and in group eR, 72.9%. Conclusion: Liraglutide therapy is beneficial for individuals with obesity who do not respond early to lifestyle intervention. However, the high cost of the drug remains a barrier to its use.