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In obesity, bariatric surgery is effective but carries morbidity and mortality risks. In type 2 diabetes, glucagon-like peptide-1 (GLP-1) agonist therapy results in weight reduction. Randomised controlled trials show efficacy in the non-diabetes obese population. Thus we have audited GLP-1 agonist use for weight reduction in morbidly obese people without diabetes. Methods: A protocol for GLP-1 use in non-diabetes obesity (body mass index >35 kg/m2) was agreed with local clinical governance committees. After liraglutide initiation, follow up was monthly, and the dose was up-titrated to a maximal 3 mg daily if indicated. Results: Of 34 people offered treatment, 22 proceeded (age 42 ± 14 years, 17 females, 16 White Caucasians) and 14 completed 12 months of treatment. Absolute weight fell significantly from a baseline of 127 ± 19 kg (n=22) to 121 ± 19 kg (n=22), 119 ± 21 kg (n=21) and 110 ± 15 kg (n=14) kg at 3, 6 and 12 months respectively (all p<0.001 from baseline) amounting to -5.3 ± 4.4 kg, -7.4 ± 7.7 kg and -12.1± 9.6 kg at 3, 6 and 12 months respectively (all p<0.001 from baseline). Conclusions: GLP-1 agonist therapy may play a significant role in people who have failed other weight loss options and are potential candidates for bariatric surgery.

The use of GLP-1 agonist therapy, liraglutide, is associated with significant weight loss in morbidly obese people without diabetes