SUN-705 - The Growing Epidemic of Obesity and the Promise of GLP-1 and GLP-1/GIP Receptor Agonists for Treatment

Context: The global obesity epidemic fuels chronic diseases like type 2 diabetes and cardiovascular disease, burdening healthcare. GLP-1RAs and GIP/GLP-1 DAs offer a therapeutic revolution for weight management, acting centrally to promote weight loss. While effective in diabetes, their real-world impact and metabolic benefits in non-diabetic individuals with obesity require investigation.

Objective: To evaluate the real-world effectiveness of GLP-1RAs and GIP/GLP-1 DAs for weight loss and metabolic improvement in non-diabetic individuals with obesity, and to identify treatment access barriers.

Methods: Retrospective chart review of 260 patients (from 500 considered) with obesity (no diabetes) initiating GLP-1RA/GIP/GLP-1 DA therapy (Jan 2021-Dec 2024). Baseline: avg. age 44; 90% Caucasian, 80% female. Initial BMI: 36.8 ± 6.6 kg/m2; weight: 103 ± 24 kg. Medications: semaglutide (40%), tirzepatide (54%), liraglutide (5%). Data collected at 6-month intervals.

Results: Significant, sustained weight loss was observed:

· 6 months: 6.6% mean loss

· 12 months: 9.9% mean loss

· 18 months: 11.4% mean loss

· 24 months: 11.1% mean loss

Metabolic improvements included a 1.9% mean systolic BP decrease at 12 months and a 3.8% mean LDL decrease at 24 months. Discontinuation due to side effects was low (8% at 6 months, another 4% by 12 months).

Critically, 30% of the initial 500 patients lacked insurance coverage for these medications and did not initiate therapy, highlighting a significant access barrier.

Conclusions: This real-world study confirms GLP-1RAs and GIP/GLP-1 DAs deliver clinically significant weight loss and metabolic improvements in non-diabetic individuals with obesity, aligning with trial data. However, widespread insurance coverage gaps profoundly impede access to these transformative therapies. Addressing these policy-level barriers is essential to leverage these medications' full public health potential against the obesity epidemic.

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