GLP ‐1 Receptor Agonist Therapy for Obesity Under Japan's Optimal Use Guideline: A Prospective Real‐World Study of Lifestyle Pre‐Treatment, Time‐Limited Treatment Cap, and Post‐Cessation Regain
Authors' conclusion
Under Japan's current regulatory framework, GLP-1 RAs produced comparable weight loss in primary and rescue cohorts sharing the same eligibility criteria.
Study context
- Population
- Patients with obesity without T2D (BMI ≥ 27 kg/m² with obesity-related comorbidities) treated with semaglutide or tirzepatide under Japan's optimal use guidelineor tirzepatide 61
- Participants
- 104 patients
- Exposure
- Primary vs rescue cohorts treated with GLP-1 RA
- Primaryn = 45reference
- Rescuen = 59
- Outcome
- % body weight change on GLP-1 RA, primary vs rescue cohort
- Follow-up
- Month 6
Methodological detailsreal-world
- Real-world
Main finding
As reported in the abstract
% body weight change at month 6 (cohorts as printed, order not assigned)
−11.8% vs. −10.8%
Observational data: associations, not effects.
Further findings
| Outcome | Primary | Rescue | P value |
|---|---|---|---|
| Weight change during mandated lifestyle phase · 6 months before drug initiationMean, kg | −0.65 (SD 5.51) | +2.28 (SD 4.16) | P = 0.004 |
| Gained weight | — not stated in the abstract | 69% |
— not stated in the abstract
Aggregate % body weight change on treatment · months 10-14; month 16
- Partial plateau by months 10-14
- −16.3%, −16.1%, −15.5%
- At treatment endpoint (month 16, n = 30, all semaglutide-treated)
- −16.0%
Weight regain after mandated cessation · 2 and 6 months after cessation
- Regained weight by 2 months
- 95% (21/22)
- Regained weight by 6 months
- 83% (10/12)
- Mean change indexed to month −6: month 16 vs month 22
- −14.4% vs −7.0%
Original publication
GLP ‐1 Receptor Agonist Therapy for Obesity Under Japan's Optimal Use Guideline: A Prospective Real‐World Study of Lifestyle Pre‐Treatment, Time‐Limited Treatment Cap, and Post‐Cessation Regain. Diabetes Obes Metab. Published 4 August 2026. doi:10.
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