This is why, I was particularly interested in a study by Tom Wadden and colleagues, just published in the International Journal of Obesity, which looked at the effect of treating individuals who had already lost weight with a low calorie diet with the GLP-1 analogue liraglutide (The SCALE™ trial).
The study was conducted in 422 obese participants, who managed to first lose at least 5% of their initial weight during a low-calorie (liquid) run-in diet (LCD), after which they were randomised to either 3.0 mg of liraglutide (once daily injections) or placebo.
During the 56 week trial, the liraglutide group lost an additionl 6% of their body weight (on top of the 6% they lost on the LCD), whereas the control group essentially maintained most of their initial weight loss.
Overall, liraglutide treated participants were about five times more likely to maintain at least 5% weight loss than those on placebo and about four times more likely to lose an addition 5% from their weight at time of randomisation.
As expected, the liraglutide treated group reported the typical gastrointestinal symptoms associated with GLP-1 treatment, although most of these events were apparently transient and mild or moderate in severity.
Thus, treatment with liraglutide (3.0 mg/day, together with diet and exercise), not only helped most of the participants maintain the weight loss achieved by LCD, but even further significantly reduce their weight over the 56 weeks of the trial.
Unfortunately, as noted in an earlier post, there is currently no regulatory pathway to license a drug for “weight loss maintenance”, which is why liraglutide will need to go the usual route and file for an indication as a “weight-loss” drug.
That said, it appears that once this drug is launched, it may well find a much-needed place in helping sustain and augment what can be achieved by a low-calorie diet.
Disclaimer: I have received speaking and consulting honoraria from Novo Nordisk, the maker of liraglutide. Liraglutide is currently not indicated or licensed for the treatment of obesity.
Wadden T, Hollander P, Klein S, Niswender K, Woo V, Hale PM, & Aronne L (2013). Weight maintenance and additional weight loss with liraglutide after low-calorie diet-induced weight loss: the SCALE™ Maintenance randomized study. International journal of obesity (2005) PMID: 23812094