Effects of liraglutide on appetite, food preoccupation, and food liking: results of a randomized controlled trial

Abstract

Background: Some weight loss medications, including liraglutide 3.0 mg, are thought to facilitate weight loss by improving appetite control. However, no studies have evaluated their long-term appetitive effects.

Subjects/methods: This study examined changes in appetite in a subsample of 113 adults with obesity (76.1% female, 55.8% white, BMI = 38.8 ± 4.8 kg/m2) who participated in a 52-week trial. Participants were randomized to intensive behavioral therapy alone (IBT-alone), IBT with liraglutide 3.0 mg/day (IBT-liraglutide), or IBT-liraglutide combined with a 12-week meal replacement diet (Multi-component). Participants rated their hunger, fullness after meals, liking of meals, and food preoccupation (all as experienced over the past week) using visual analogue scales (0-100 mm). Ratings were completed at baseline and eight subsequent visits over the year.

Results: At week 52, participants treated by IBT-alone lost 6.2 ± 1.6% of baseline weight, compared with 11.8 ± 1.6% and 12.1 ± 1.5% in the IBT-liraglutide and Multi-component groups, respectively. Compared to IBT-alone, IBT-liraglutide participants reported larger reductions at week 6 in hunger (-0.3 ± 4.2 vs -16.8 ± 4.0 mm, p = .005) and food preoccupation (+0.2 ± 3.7 vs -16.3 ± 3.6 mm, p = .002) and larger increases in fullness (-5.1 ± 3.2 vs +9.8 ± 3.0 mm, p = .001). These significant differences persisted at all assessments through week 24. There were no differences between IBT-alone and IBT-liraglutide in meal liking. IBT-alone and Multi-component participants differed in hunger at week 6, and in food preoccupation at all assessments through week 24. Multi-component participants reported reduced liking of meals relative to the IBT-alone and IBT-liraglutide groups through weeks 40 and 52, respectively. There were no other differences among any groups at week 52.

Conclusions: Consistent with short-term studies, IBT-liraglutide participants reported greater improvements in hunger, fullness, and food preoccupation than those assigned to IBT-alone. Differences in appetite persisted for 24 weeks but were not maintained at week 52, despite the relatively greater weight losses in the liraglutide-treated participants at the trial's end.

Trial registration: ClinicalTrials.gov NCT02911818.

Figures

Figure 1.

Estimated mean percentage reduction in baseline weight over 52 weeks in the intention-to-treat-population for the subsample of participants included in the present study (N = 113). Values with different superscripts (a vs b) differ significantly from each other at p <0.05, and values that share a superscript do not differ significantly. At week 52, IBT-alone participants had lost less weight than IBT-liraglutide participants (p = .017) and Multi-component participants (p = .010). The IBT-liraglutide group did not differ significantly from the Multi-component group at week 52 (p = .899).

Figure 2.

Panel A shows change in VAS ratings of hunger, and panel B shows change in fullness after meals. Values are estimated modeled mean changes relative to baseline (± SE) in the intention-to-treat population (N = 113). Values with different superscripts (a vs b) differ significantly from each other at p <0.05. In panel A, the IBT-alone group differs from the IBT-liraglutide group in change in hunger at weeks 4, 6, 10, 16, 20, and 24, and IBT-alone differs from the Multi-component group at weeks 4 and 6. In panel B, the IBT-alone group differs from the IBT-liraglutide group in change in fullness after meals at weeks 4, 6, 10, 16, 20, and 24. Values that share a superscript do not differ significantly.

Figure 3.

Panel A shows change in VAS ratings of food preoccupation, and panel B shows change in craving frequency. Values are estimated modeled mean changes relative to baseline (± SE) in the intention-to-treat population (N = 113). Values with different superscripts (a vs b) differ significantly from each other at p <0.05. In panel A, the IBT-alone group differs from both the IBT-liraglutide and the Multi-component group at weeks 4, 6, 10, 16, 20, and 24. In panel B, the IBT-alone group differs from the Multi-component group at week 52. Values that share a superscript do not differ significantly. In panel B, no other pairwise comparisons were statistically significant.

Figure 4.

Change in VAS ratings of liking of meals. Values are estimated modeled mean changes relative to baseline (± SE) in the intention-to-treat population (N = 113). Values with different superscripts (a vs b) differ significantly from each other at p <0.05. The IBT-alone group differs from the Multi-component group at weeks 4, 6, 10, 16, 20, 24, and 40. The IBT-liraglutide group differs from the Multi-component group at weeks 4, 6, 10, 16, 20, 24, 40, and 52. Values that share a superscript do not differ significantly.