Comparative Weight-Loss Outcomes Following Initiation of GLP-1 Receptor Agonists Versus SGLT2 Inhibitors: A Real-World Active Comparator Study
Authors' conclusion
GLP-1RA initiators achieved greater weight loss than SGLT2i initiators, concentrated in women and patients without type 2 diabetes
Study context
- Population
- Adults aged 18 to 80 with BMI ≥27 kg/m² and available weight measurements, NIH All of Us Research Program (2018–2023), diverse US cohort
- Participants
- 2,932 vs 941
- Exposure
- GLP-1RA vs SGLT2 inhibitor (SGLT2i) initiation
- GLP-1RAn = 2,932
- SGLT2in = 941reference
- Outcome
- Percent body weight change
- Follow-up
- 12 months
Methodological detailsactive comparator new-user design, inverse probability of treatment weighting, 17-covariate propensity score model
- Active comparator new-user design
- Inverse probability of treatment weighting
- 17-covariate propensity score model
Main finding
As reported in the abstract
Each group vs SGLT2iDifference, pp (95% CI)P value
GLP-1RA
−1.20(−1.91 to −0.48)
P = 0.001Each group vs SGLT2iEstimate (95% CI)
GLP-1RA
OR 1.75(1.40–2.19)
GLP-1RA
RR 1.61(1.19–2.03)
- GLP-1RA initiators lost more weight than SGLT2i initiators; NNT
- 14
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | P value |
|---|---|---|
| Percent body weight change, obesity-only subgroup · 12 months | difference −1.96 pp | P < 0.001 |
| Percent body weight change, T2D subgroup · 12 months | difference +0.08 pp | interaction P =.006 |
| Percent body weight change by sex · 12 monthsGLP-1RA vs SGLT2i · women; P for sex effect modification | difference −1.71 pp | P = 0.017 |
| Percent body weight change by sex · 12 monthsGLP-1RA vs SGLT2i · men | difference +0.12 pp | |
| HbA1c change | difference −0.261 % | P = 0.032 |
Blood pressure change
- Blood pressure did not differ significantly
Original publication
Comparative Weight-Loss Outcomes Following Initiation of GLP-1 Receptor Agonists Versus SGLT2 Inhibitors: A Real-World Active Comparator Study. Endocr Pract. Published 29 September 2026. doi:10.
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