A retrospective cohort study conducted at a Vancouver-based multidisciplinary obesity clinic revealed that female sex may be independently associated with a hyper-response to glucagon-like peptide-1 analogues for weight loss in real-world settings. The clinic aims to contribute to advancing the understanding of obesity management through ongoing patient data analysis.

The findings, published in BMJ Open, highlighted significant variations in total body weight loss (TBWL) outcomes among patients. Investigators analyzed data from 483 adult patients with a body mass index (BMI) of at least 30 kg/m² who had filled prescriptions for subcutaneous semaglutide or liraglutide, with an average follow-up of 17.3 months (520 days). Patients with previous bariatric surgery were excluded. 

The participants were categorized into three response groups based on TBWL outcomes:

• Nonresponders: Less than 5% TBWL (17.8%)
• Moderate responders: 5% to 15% TBWL (48.4%)
• Hyper-responders: Greater than 15% TBWL (33.8%).

The average TBWL across the entire cohort was 12.2%.

In the multivariable regression analysis, female sex was significantly associated with a hyper-response to glucagon-like peptide-1 (GLP-1) therapy (adjusted odds ratio = 1.92, 95% confidence interval = 1.01–3.65, P = .048).

"Being a woman may be associated with a favorable response, but other key clinical factors like diabetes, age, anthropometric characteristics, depression, anxiety and sedentary behavior do not correlate with response to GLP-1 analogue therapy," explained lead study author Peter Squire, of the Department of Medicine at the University of Alberta in Edmonton, Alberta, Canada, and his colleagues.

The investigators emphasized the clinical relevance of identifying factors linked to weight loss outcomes for more personalized obesity management.

Despite its strengths, they acknowledged limitations, including the single-center design and exclusion of patients with prior bariatric surgery. Future research is needed to identify biomarkers associated with TBWL and to further assess individual predictors of response.