A comparison of Glucagon-like peptide-1 receptor agonists on weight change, side effects, and quality of life in Kuwait.
This cross-sectional study examined self-reported outcomes among 486 adults in Kuwait who were using or had previously used GLP-1 receptor agonist (GLP-1 RA) injections — Semaglutide (n=181), Liraglutide (n=152), or Tirzepatide (n=132) — for weight loss, surveyed between February and May 2024. Participants completed an online questionnaire covering demographics, weight change, side effects, and quality of life. The study found that Tirzepatide users reported the highest average monthly and annual weight loss, along with the greatest satisfaction (88%) and most frequently reported improvements in quality of life (60%) compared to the other two agents. Side-effect profiles differed across groups: Tirzepatide users more commonly reported belching, while Liraglutide users reported higher rates of anxiety and were more likely to switch medications. No statistically significant differences were observed between groups in BMI, dietary adherence, or treatment compliance. Key limitations include the cross-sectional, self-report design, recruitment via online survey (introducing selection bias), lack of clinical verification of outcomes, and the inability to establish causality. The study also does not account for differences in duration of use, dosing, or baseline characteristics across groups.
Why this grade: Cross-sectional self-report survey without randomization, clinical verification, or control for confounders; findings are associative and subject to significant selection and recall bias.
Introduction An estimated 74.6% of Kuwaiti adults are classified as overweight or obese. As a result, Glucagon-like peptide 1 receptor agonists (GLP-1 RA) injections such as, Semaglutide, Liraglutide, and Tirzepatide have become an increasingly popular intervention for weight loss. However, no research has been published on the use of GLP-1 RA injections in Kuwait. Methods A cross-sectional study using an online survey was conducted between February and May 2024. Adults in Kuwait who have taken or are currently on GLP-1 RA injections were recruited. The questionnaire collected demographic and clinical data, including weight-loss, side-effects, and quality of life. Results In this sample of N = 486, Tirzepatide users ( N = 132; 27.8%) reported significantly higher monthly and annual weight-loss (4.76 ± 2.82 kg/month; 8.48 ± 4.04 kg/year), and greater satisfaction (88%) and improved quality of life (60%) compared to both Semaglutide ( N = 181; 37.2%) and Liraglutide ( N = 152; 31.3%), respectively. Side-effects varied: Tirzepatide users experienced more belching while Liraglutide reported higher anxiety levels and switching GLP-1 RA medication. No significant differences were found in BMI, following a diet, or compliance to treatment across the different GLP-1 RA groups. Discussion This study highlights the varying effectiveness and tolerability of GLP-1 RAs for weight loss in Kuwait, with Tirzepatide showing the highest satisfaction and weight loss. Liraglutide users experienced more anxiety and medication switches, while Semaglutide users had moderate outcomes. Despite their benefits, GLP-1 RAs face challenges in long-term adherence due to side effects and cost.
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