SCALE Maintenance shows liraglutide holds off regained weight

A phase 3 trial called SCALE Maintenance found that liraglutide 3.0 mg, taken once daily by injection, helped people hold onto weight they had already lost through dieting, and helped many lose even more ^[1]. The results add to evidence that GLP-1 medications can play a role not just in initial weight loss, but in preventing the weight regain that often follows a diet.

The study enrolled 422 adults who were obese or overweight with related health conditions ^[1]. Before random assignment to either liraglutide or placebo, all participants first completed a low-calorie-diet run-in period, during which they lost an average of 6.0% of their starting weight ^[1]. Researchers required participants to have lost at least 5% of their initial weight during that run-in before they could join the randomized part of the study ^[1].

From that point, participants were randomly assigned to either liraglutide 3.0 mg per day or a placebo injection, both alongside ongoing diet and exercise counseling, for 56 weeks ^[1]. Those taking liraglutide lost an additional 6.2% of their body weight on average over that year, compared with just 0.2% for those on placebo, a statistically significant difference of about 6.1 percentage points ^[1].

The study also tracked whether people kept off the weight they had lost during the diet phase. Among those on liraglutide, 81.4% maintained their initial 5% run-in weight loss, compared with 48.9% of those on placebo ^[1]. Looking at further progress, 50.5% of the liraglutide group lost at least 5% more weight measured from the start of the randomized phase, compared with 21.8% on placebo ^[1]. Researchers also reported small but statistically significant improvements in several cardiometabolic risk factors, though the study abstract does not specify which measures beyond noting the improvements were modest ^[1].

Side effects followed a pattern common to GLP-1 drugs: gastrointestinal problems, such as nausea or digestive upset, were reported more often in the liraglutide group than the placebo group ^[1]. The study authors described most of these events as temporary and mild to moderate in severity ^[1]. A correction to the original paper was later published in the International Journal of Obesity, though the correction notice available does not describe what was changed ^[1].

Why it matters for patients

For people who have already lost weight through dieting, one of the hardest parts is often not gaining it back. This trial suggests that continuing a GLP-1 medication like liraglutide after a diet-driven weight loss period can help preserve those results and, for some, produce further loss ^[1]. That distinguishes this study from many other GLP-1 trials, which typically measure weight loss from a starting point without first requiring a diet-based loss.

The gap between the liraglutide and placebo groups, both in the amount of weight kept off and in additional pounds lost, was large and statistically significant ^[1]. But the study also confirms that gastrointestinal side effects are a real trade-off patients on liraglutide are likely to experience, even if usually not severe ^[1]. This is an older trial from 2013, using a formulation and dosing (3.0 mg daily) approved for chronic weight management, and it does not include long-term data beyond the 56-week study window ^[1].

What happens next

The sources provided do not include information on the drug's regulatory status following this trial, nor on any longer-term follow-up studies beyond the 56 weeks reported. It is not yet known from these sources what happened to participants after the trial period ended.