A systematic review and meta-analysis of the efficacy and safety of pharmacological treatments for obesity in adults: 2026 Update
This systematic review indicates that obesity management medications, including liraglutide, are associated with significant weight loss compared to placebo, but specific numeric outcomes for liraglutide were not detailed.
Where it sits
this study against the rest of the liraglutide corpusSummary and findings
This systematic review and meta-analysis evaluated the efficacy and safety of obesity management medications (OMMs) in adults, focusing on percentage total body weight loss (TBWL%) as the primary endpoint. A total of 63,909 patients were enrolled across 66 randomized controlled trials, with liraglutide included among other medications. All OMMs demonstrated significantly greater TBWL% compared to placebo.
Abstract
This updated systematic review and network meta-analysis evaluated the efficacy and safety of obesity management medications (OMMs) in terms of reducing body weight and obesity-related complications. Medline and Embase were searched up to 21 November 2025 for randomized controlled trials comparing OMMs versus placebo or active comparators in adults. The primary endpoint was percentage total body weight loss (TBWL%) at the end of the study. Secondary endpoints were TBWL% at 1, 2 and ≥3 years, anthropometric, metabolic, mental health and quality-of-life outcomes, cardiovascular morbidity and mortality, remission of obesity-related complications, serious adverse events and all-cause mortality. Sixty-six RCTs (66 comparisons) were identified – orlistat (22), semaglutide (18), liraglutide (11), tirzepatide (8), naltrexone/bupropion (5) and phentermine/topiramate (2) – enrolling 63,909 patients (34,861 and 29,048 with active compound and placebo, respectively). All OMMs showed significantly greater TBWL% versus placebo; tirzepatide and semaglutide exceeded 10% TBWL and showed the most favourable glycaemic effects. Semaglutide reduced major adverse cardiovascular events and all-cause mortality. In dedicated complication-specific trials, semaglutide and tirzepatide showed benefit on heart-failure-related outcomes; tirzepatide was associated with improved obstructive sleep apnoea syndrome and semaglutide with knee osteoarthritis pain remission. Tirzepatide and semaglutide were associated with improvements in metabolic dysfunction-associated steatohepatitis remission, and semaglutide with improvement in liver fibrosis. No OMMs were associated with an increased risk of serious adverse events. These updated results reinforce the need to individualize OMMs selection according to weight-loss efficacy, complication profile and safety.