Weight loss
Elizabeth Briand
It is no wonder that GLP-1 receptor agonists have received so much attention in recent years with their demonstrated ability to help people shed otherwise stubborn weight. Now, a handful of recent studies offer a preview of GLP-1 variations that may make the medications even more user-friendly.
These include results from a phase 2 trial, published in NEJM on June 23, 2025, on the use of long-acting maridebart cafraglutide to treat obesity in patients with and without diabetes through once-monthly injections, as compared to the weekly injections required for Ozempic or Wegovy. Participants saw significant weight loss of up to 16.2% in body weight versus the placebo.
Another study, published June 22, 2025, in NEJM, dug into the efficacy of coadministering cagrilintide and semaglutide to help combat obesity. Combining the two medications prompted significant weight loss, with participants “more likely than those receiving placebo to reach weight loss targets,” wrote the study authors.
In addition, some research has shown that smaller doses of these medications could still elicit health-beneficial weight loss—something that could help patients avoid losing too much weight in the long term.
An oral small-molecule GLP-1 receptor agonist called orforglipron also received attention earlier this summer following a phase 3 trial in which participants with T2D took one of three doses of the medication once daily for 40 weeks. All three doses proved superior to placebo with regard to reductions in A1C as well as percent changes in body weight for participants.
Improving convenience
Making GLP-1s easier to take and tolerate may make a significant difference in helping people stay on the medications and maintain their weight reductions.
Currently, less than half of the patients who start taking GLP-1s remain on the medication after a year, said W. Timothy Garvey, MD, from the University of Alabama at Birmingham’s School of Health Professions and author of the NEJM study on cagrilintide and semaglutide.
When patients stop taking their medication, their struggle with obesity can resurface, according to Garvey.
“If you stop the medicine, the disease is still there, and the pathways [that have been disrupted by the medications] will reactivate,” he said.
Often, the patient may be back to square one.
It is important to remember as well, said Garvey, that treating obesity is not just about getting the pounds off; it is also about improving the individual’s quality of life. This includes reducing the progression of prediabetes to diabetes, improving cardiac health and heart failure outcomes, reducing BP and sleep apnea, and addressing osteoarthritis.
Positive progress for patients
GLP-1s are here to stay, said Garvey.
“We’re in a remarkable era in the history of medicine. We have medications of unprecedented efficacy treating a very harmful disease,” he said.
To further improve these medications, researchers are continuing to work on ways to improve tolerability, especially with regard to GI adverse effects. When there are adverse effects, “people don’t adhere to the medications,” Garvey said. “Better tolerability is important—why should patients have to get sick to their stomach to treat their disease?”
In the meantime, as researchers continue to develop new medications and combinations, pharmacists can work with their patients to feel better and keep their weight off longer while taking current iterations of GLP-1s.
“Pharmacists can be very helpful in mitigating side effects and helping patients with adherence,” said Garvey.
They also can be advocates for lower doses, which can help ease adverse effects while still providing significant weight loss.
And, Garvey said, pharmacists and other health care providers can help patients understand that obesity is not their fault, that it is a disease that must be treated just like any other. ■