Effect of GLP-1RA and Dual GIP/GLP-1 Agonist on Metabolic Parameters in Patients with Severe Obesity: Indian Real-World Evidence

Introduction and Objective: Severe obesity (BMI ≥40 kg/m²) represents a high-risk population with limited real-world comparative data on incretin-based therapies. This study evaluated metabolic outcomes of GLP-1RA and dual GIP-GLP-1 agonist therapy in routine clinical practice. Methods: This real-world observational analysis included adults with baseline BMI ≥40 kg/m² treated with incretin-based therapies. Patients received tirzepatide (dual GIP-GLP-1 agonist), oral semaglutide, or injectable semaglutide. Mean changes in body weight, BMI, and HbA1c were assessed. Results: A total of 88 patients were analyzed (tirzepatide n=36; oral semaglutide n=40; injectable semaglutide n=12). Tirzepatide demonstrated the greatest metabolic benefit, with mean weight reduction of 10.92 kg, BMI reduction of 3.58 kg/m², and HbA1c reduction of approximately 1.0%. Oral semaglutide resulted in mean weight loss of 4.25 kg, BMI reduction of 1.68 kg/m², and minimal HbA1c change (0.07%). Injectable semaglutide showed intermediate effects, with mean weight loss of 7.18 kg, BMI reduction of 1.98 kg/m², and HbA1c reduction of 0.46%. Conclusion: In patients with severe obesity (BMI ≥40 kg/m²), incretin-based therapies significantly improve metabolic parameters in real-world practice. Dual GIP-GLP-1 agonist therapy was associated with superior weight, BMI, and glycemic reductions compared with GLP-1 receptor agonists alone. Disclosure: P. Chawla: None. A. Shaikh: None. S. Gangwani: None. M. Chawla: None.