Patient initiation and maintenance of GLP-1 RAs for treatment of obesity: a narrative review and practical considerations for primary care providers

ABSTRACT

Obesity is a chronic, relapsing metabolic disease, linked to a number of health risks and serious complications. Although highly prevalent in adults in the United States, it is underdiagnosed and untreated. Primary care providers (PCPs) are uniquely poised to diagnose and treat patients with obesity, using a selection of treatment strategies including lifestyle modifications and pharmacotherapies. As a physiological regulator of appetite and energy intake, the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide 3.0 mg is approved for chronic weight management in individuals with overweight (pre-obesity) or obesity. In this review, we provide an overview of the clinical data supporting the use of liraglutide 3.0 mg, as well as practical advice for PCPs on the initiation and maintenance of treatment over the long term. This also covers the management of side effects and how to manage patient expectations over time.

KEYWORDS:

• Obesity
• primary care
• pharmacotherapy
• GLP-1 RA
• liraglutide

Acknowledgments

Writing and editing support was provided by Sasha Walton and Izabel James, from Watermeadow Medical, an Ashfield company, funded by Novo Nordisk Inc.

Declaration of financial/other relationships

Angela Fitch reports that she acts on the advisory board of SetPoint Health, Gelesis, and Phenomix Sciences and has previously consulted for Novo Nordisk. Amy Ingersoll has previously consulted for Novo Nordisk.

Declaration of interest

No potential conflict of interest was reported by the authors.

Author contributions

Both authors contributed to the design and scope of this review article, reviewed and commented on several drafts of the manuscript, and approved the final version for publication. Both authors take responsibility for the integrity of the work.