DOI: 10.20935/acaddrug8360 ISSN: 3071-2521

GLP-1 therapies for obesity: mechanisms, outcomes, and regulatory challenges

Debora de Oliveira Emos, José de Jesús Martínez González, Luisa Maria Diani, Marcela Augusta de Souza Pinhel, Lígia Moriguchi Watanabe, Ana Vitória Leca, Camila Fernanda Cunha Brandão, Carla Barbosa Nonino, Natália Yumi Noronha
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Obesity is a global epidemic and a complex chronic condition associated with various noncommunicable chronic diseases (NCDs) and has a substantial economic impact. In this context, glucagon-like peptide-1 (GLP-1) analogues and polyagonists, such as liraglutide, semaglutide, and tirzepatide, emerge as pharmacological innovations. This study conducted a descriptive literature analysis focusing on the mechanisms of action and clinical impacts of these drugs in obesity management, alongside the regulatory landscape and their challenges regarding implementation, market access, and policy implications. The review demonstrated that these medications modulate the incretin axis, delay gastric emptying, and act on neural appetite centers, resulting in significant weight loss and improved cardiometabolic parameters. However, the analysis identified that treatment discontinuation is associated with substantial weight regain, highlighting that weight loss is maintained long-term only with continuous therapy and integration with lifestyle changes. Furthermore, the study emphasized that access is severely limited by high costs and by patent barriers, regulatory and policy frameworks that hinder generic competition and health system coverage. In summary, while GLP-1 analogues represent a major therapeutic advance, their broader impact on public health depends on overcoming challenges related to treatment sustainability and equity of access.

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