Weight maintenance on cost-effective antiobesity medications after 1 year of GLP-1 receptor agonist therapy: a real-world study

Objective

The high cost of novel glucagon-like peptide-1 receptor agonist (GLP-1 RA) class agents often limits access and creates barriers to care. This real-world study evaluated the efficacy of older-generation generic antiobesity medications (AOMs) for weight maintenance after 1 year of GLP-1 RA therapy in patients who had achieved successful weight loss.

Methods

We prospectively followed patients (N = 105) who had completed 12 months of therapy and were part of a “medical weight loss bundle,” which included 12 months of GLP-1 RA therapy followed by 6 months of transition care. The baseline mean BMI was 36.4 kg/m². Body weight outcomes were measured at 6, 12, 18, and 24 months.

Results

After the medical weight loss bundle, 40 patients transitioned to generic AOMs. At 12 months, this cohort lost an average of 18.3%, 95% CI [13.0%, 23.6%] body weight from baseline, with a mean BMI of 27.9 kg/m². At 18 months, they maintained the weight loss, with a mean BMI of 27.9 kg/m². Subsequent follow-up visits (average 1.5 months later) without GLP-1 RAs showed further reduction, resulting in a total average weight loss of 25.5%, 95% CI [23.1%, 27.9%] compared to the initial visit.

Conclusions

Patients successfully treated with GLP-1 RAs can maintain their weight loss using generic older-generation AOMs, suggesting potential cost savings for insurers and implications for policy regarding AOM coverage.