Self-reported physical function improves after an intervention with weight-lowering pharmacotherapy, according to results of a systematic review and meta-analysis. “However, effects were modest and lower than those reported for other weight loss intervention studies, including diet or bariatric surgery,” the authors conclude. “Evidence surrounding physical activity, cardiorespiratory fitness, and objectively measured physical function is lacking, highlighting the need for further research investigating the effect of weight-lowering pharmacotherapies on objective measures of physical function, activity, and fitness.”
The analysis included 14 randomized controlled trials on the effects of licensed weight loss pharmacotherapies on physical activity, physical function, and cardiorespiratory fitness in individuals with obesity. “Five [trials] investigated liraglutide, four semaglutide, three naltrexone/bupropion, and two phentermine/topiramate,” write the authors. “All 14 trials included a self-reported measure of physical function, with the pooled findings suggesting an improvement favoring the pharmacotherapy intervention groups (SMD: 0.27; 95% CI: 0.22 to 0.32) and effects generally consistent across different therapies. Results were also consistent when stratified by the two most commonly used measures: The Short-Form 36-Item Questionnaire (SF-36) (0.24; 0.17 to 0.32) and the Impact of Weight on Quality Of Life-Lite (IWQOL-Lite) (0.29; 0.23 to 0.35). Meta-regression confirmed a significant association between pharmacotherapy induced weight loss and improved physical function for IWQOL-Lite (P = 0.003). None of the studies reported a physical activity outcome, and only one study reported objectively measured cardiorespiratory fitness. Improvements in self-reported physical function were observed with weight loss therapy, but the effect on physical activity or objectively measured physical function and fitness could not be determined.”