DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS 🎓 Expert Commentary / Peer Perspective
OBGYNs see 37% of nonpregnant privately insured women as their primary care provider, yet 52% have never prescribed antiobesity medications. This review synthesizes evidence for GLP-1 RA initiation, side-effect management, and long-term adherence in a women’s health setting.
Clinical Considerations
- Liraglutide 3.0 mg achieved 6.0%–8.0% mean weight loss at 56 weeks versus 0.2%–2.6% with placebo across SCALE trials, with 81% maintaining ≥5% loss at 1 year.
- In women with PCOS, liraglutide 1.8–3.0 mg has been associated with improved ovarian function, menstrual regularity, and reduced androgen levels beyond weight reduction.
- All antiobesity medications are contraindicated in pregnancy; effective contraception is required throughout treatment, and the agent is not recommended in nursing women.
- Treatment persistence is significantly higher with liraglutide 3.0 mg than other AOMs — 28.2% versus 9%–11% at 1 year in a 26,522-patient real-world analysis.
Practice Applications
- Recognize patients meeting criteria (BMI ≥30, or ≥27 with weight-related comorbidity).
- Integrate routine bodyweight discussions using open-ended, nonstigmatizing language.
- Monitor for the 16-week stopping rule: discontinue if <4% weight loss achieved.
- Consider slow dose escalation, dose timing adjustments, and antiemetics for transient GI side effects.
