GLP-1 receptor agonists show greater weight loss in women than men across multiple trials

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JAMA internal medicine Published May 4, 2026 Medically reviewed May 8, 2026 Study authors: Alexander G Caleb, Xiao Xuya, Dilek Sophie, Lewis Sydney, Deng Qilin, Kim Minji, Bolanle Dami, Salda… PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that GLP-1 agonists may produce greater weight loss in women than men.

This systematic review and meta-analysis evaluated the efficacy of GLP-1 receptor agonists, including semaglutide, liraglutide, exenatide, lixisenatide, and dulaglutide, in adults with obesity, cardiovascular disease, or diabetes. The primary focus was on changes in body weight from baseline. The analysis pooled data from numerous trials involving thousands of patients to assess treatment effects across different subgroups.

The main finding was that weight loss was substantially greater among women than among men. This difference was consistent across the included studies. In contrast, the authors found no significant heterogeneity when analyzing outcomes by age, race, ethnicity, baseline body mass index, or baseline glycated hemoglobin levels. These results indicate that demographic factors other than sex did not significantly alter the observed treatment effects in this dataset.

The authors note that safety data, adverse events, and discontinuation rates were not reported in the source trials included in this review. Consequently, the full safety profile of these agents in this specific context remains unclear based on this analysis alone. The authors suggest that these findings may inform clinical decision-making but emphasize the need for cautious interpretation given the lack of reported safety information and the specific focus on weight outcomes.

Study Details

Study typeMeta analysis

Sample sizen = 906

EvidenceLevel 1

PublishedMay 2026

PMID41770554

View Original Abstract ↓

IMPORTANCE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a novel class of therapeutics approved to treat chronic conditions such as cardiovascular disease, diabetes, and/or obesity. However, whether GLP-1 RAs' efficacy varies by age, sex, race and ethnicity, baseline body mass index (BMI), and baseline hemoglobin A1c (HbA1c) is unclear. OBJECTIVE: To quantify the heterogeneity of treatment effects (HTE) of GLP-1 RAs, including semaglutide, liraglutide, exenatide, lixisenatide, and dulaglutide, by patient characteristics. DATA SOURCES: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, from inception through July 26, 2024. STUDY SELECTION: Pairs of investigators independently screened titles and abstracts and then reviewed eligible full-text articles reporting on randomized clinical trials (RCTs) that compared GLP-1 RAs to placebo or other medications. DATA EXTRACTION AND SYNTHESIS: Study design, interventions, and comparators, and patient baseline weight and weight change over time (overall and by age, sex, race and ethnicity, BMI, and HbA1c level) were extracted from the data. Risk of bias was assessed using the Cochrane risk of bias tool and meta-analyses were conducted using random-effects models. For each subgroup, RCTs were meta-analyzed where quantitative synthesis was possible, while additional relevant studies were narratively incorporated in the analysis. MAIN OUTCOMES AND MEASURES: Change in body weight measured in kg (by age, baseline BMI, baseline HbA1c) or percentage change from baseline (by sex, race and ethnicity). RESULTS: Of 7705 unique records, 41 articles representing 64 RCTs were included in the meta-analysis. Of these, 48 RCTs could be individually characterized: they had a mean (SD) study population of 1181 (2513) participants; 51 trials were parallel (98.1%); 51 multicenter (98.1%); and 21 evaluated semaglutide (43.8%) and 9, dulaglutide (18.8%). HTE was most commonly evaluated using baseline BMI (36 RCTs [75.0%]), HbA1c (24 [50.0%]), and age (21 [43.8%]), and less commonly, ethnicity (12 [25.0%]), race (11 [22.9%]), and sex (10 [20.8%]). Among 6 trials (19 906 patients) analyzed by sex, weight loss was greater among women (10.9%; 95% CI, 7.0%-14.8%) than men (6.8%; 95% CI, 4.6%-9.0%). We found no significant HTE by age (7 trials with 4314 patients), race (9 trials, 25 229 patients), ethnicity (7 trials, 8328 patients), baseline BMI (15 trials, 9473 patients across 3 analyses), or baseline HbA1c (4 trials, 1886 patients). CONCLUSIONS AND RELEVANCE: In this systematic review and meta-analysis, GLP-1 RAs produced greater weight loss among women than men; however, their efficacy was consistent across other important subpopulations. These findings may inform clinical decision-making.