GLP ‐1 Receptor Agonists for Weight Loss and Risk of Major Safety Outcomes: A Multicentre Cohort Study
Authors' conclusion
GLP-1 RA initiation for weight loss was associated with higher risks of selected psychiatric and gastrointestinal outcomes compared with non-initiators, with heterogeneity across agents.
Study context
- Population
- Adults initiating semaglutide or liraglutide for weight loss, EHRs from 13 South Korean hospitals (2018–2025), OMOP Common Data Modelmatched cohort
- Exposure
- Weight-management semaglutide or liraglutide initiation vs propensity score-matched non-initiators
- Outcome
- Ten safety outcomes
Methodological detailsnew-user design, propensity score-matched, site-specific Cox models combined via meta-analysis
- New-user design
- Propensity score-matched
- Site-specific Cox models combined via meta-analysis
Main finding
As reported in the abstract
Safety outcomes (HR vs matched non-initiators)
Hazard ratio (95% CI)
Semaglutidevs Non-initiators (semaglutide comparison)psychiatric disorders overall
2.02(1.30–3.14)
Semaglutidevs Non-initiators (semaglutide comparison)anxiety disorder
2.39(1.22–4.71)
Semaglutidevs Non-initiators (semaglutide comparison)depressive disorder
3.42(1.51–7.74)
Semaglutidevs Non-initiators (semaglutide comparison)gastrointestinal dysmotility or obstruction
3.91(1.42–10.82)
Semaglutidevs Non-initiators (semaglutide comparison)vision impairment
1.58(1.04–2.41)
Liraglutidevs Non-initiators (liraglutide comparison)psychiatric disorders overall
1.66(1.36–2.03)
Liraglutidevs Non-initiators (liraglutide comparison)anxiety disorder
1.68(1.45–1.96)
Liraglutidevs Non-initiators (liraglutide comparison)depressive disorder
1.51(1.14–2.00)
Liraglutidevs Non-initiators (liraglutide comparison)hepatic impairment
1.46(1.16–1.83)
Liraglutidevs Non-initiators (liraglutide comparison)pancreatobiliary disorder
1.33(1.09–1.63)
Liraglutidevs Non-initiators (liraglutide comparison)pancreatitis/cholangitis/cholelithiasis
1.40(1.18–1.68)
Liraglutidevs Non-initiators (liraglutide comparison)vision impairment
1.34(1.16–1.55)
Observational data: associations, not effects.
Further findings
Sensitivity analyses
- Consistent overall, although semaglutide-associated vision impairment and liraglutide-associated hepatic impairment were not significant in some analyses
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
GLP ‐1 Receptor Agonists for Weight Loss and Risk of Major Safety Outcomes: A Multicentre Cohort Study. Diabetes Obes Metab. Published 6 July 2026. doi:10.
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