Liraglutide 3.0 mg helped adults keep off lost weight in 56-week trial

A 56-week randomized trial found that liraglutide 3.0 mg per day helped adults who had already lost weight on a low-calorie diet keep it off and lose more, compared with placebo, when both groups also received diet and exercise counseling ^[1].

The study, called SCALE Maintenance, enrolled 422 adults aged 18 and older with a body mass index of at least 30, or at least 27 with related health conditions ^[1]. Everyone first completed a low-calorie diet run-in and had to lose at least 5% of their starting weight to stay in the trial. Those who qualified lost an average of 6.0% of their screening weight during that run-in ^[1]. They were then assigned at random to daily injections of liraglutide 3.0 mg or placebo for 56 weeks, with diet and exercise counseling throughout. The trial was double-blind, and the main analysis included everyone assigned to a treatment group ^[1].

From randomization to week 56, weight fell an additional 6.2% on average with liraglutide and 0.2% with placebo — an estimated difference of 6.1 percentage points (95% class interval −7.5 to −4.6; P<0.0001) ^[1]. More participants on liraglutide, 81.4%, maintained the 5% or greater loss from the run-in, compared with 48.9% on placebo ^[1]. And 50.5% of the liraglutide group lost at least 5% of their randomization weight, against 21.8% on placebo ^[1].

The published summary reports small but statistically significant improvements in several cardiometabolic risk factors with liraglutide compared with placebo, but does not list them ^[1]. Gastrointestinal disorders were reported more often with liraglutide than placebo; most events were transient and mild or moderate in severity, according to the abstract ^[1]. The authors concluded that liraglutide plus diet and exercise maintained weight loss achieved through calorie restriction and produced further loss over 56 weeks, and that the 3.0 mg daily dose "holds promise for improving the maintenance of lost weight" ^[1].

Whether people with type 2 diabetes took part in this phase 3 trial is not stated in the published summary ^[1]. How many participants dropped out of each group, and what happened to weight after the 56 weeks of treatment ended, are not reported in the abstract either ^[1]. A correction notice for the paper was later published in the International Journal of Obesity; the abstract does not describe what was corrected ^[1].

Why it matters for patients

Regaining weight after a diet is common, and this trial tested whether a daily injectable GLP-1 drug changes that. The molecule here is liraglutide. It is not semaglutide (sold as Ozempic, Wegovy and Rybelsus) or tirzepatide (sold as Mounjaro and Zepbound), and it is not orforglipron (Foundayo). The percentages in this trial belong to liraglutide 3.0 mg and cannot be applied to those drugs ^[1].

Both groups in the study received diet and exercise counseling, not just a drug, and the placebo group stayed roughly flat rather than gaining back everything. That makes the comparison a test of the drug added to ongoing support, rather than a test of the drug alone ^[1].

The trial's main goal was maintenance of weight already lost, a different question from how much weight a drug produces in the first place. Gastrointestinal side effects were more common on liraglutide, though the abstract describes most as brief and mild or moderate ^[1].

The abstract does not report whether the drug was approved for weight management at the time of the study, what it cost, or how it compared with other options ^[1]. The trial is registered as NCT00781937 ^[1].