Liraglutide reduces visceral, ectopic fat in obesity with hi
Adults with obesity at high cardiovascular risk saw significant reductions in visceral and ectopic fat after adding daily liraglutide 3 mg to a reduced-calorie diet and lifestyle plan, findings from a randomized controlled trial show.

Visceral and ectopic fat are key drivers of adverse cardiometabolic outcomes in obesity. Researchers aimed to evaluate the effects of injectable liraglutide 3.0 mg daily on body fat distribution in adults with overweight or obesity without type 2 diabetes at high cardiovascular disease risk.

In this randomized, double-blind, placebo-controlled, phase 4, single center trial, we enrolled community-dwelling adults, recruited from the University of Texas Southwestern Medical Center, with BMI of at least 30 kg/m2 or BMI of at least 27 kg/m2 with metabolic syndrome but without diabetes and randomly assigned them, in a 1:1 ratio, to 40 weeks of treatment with once-daily subcutaneous liraglutide 3.0 mg or placebo, in addition to a 500 kcal deficient diet and guideline-recommended physical activity counselling.

The primary endpoint was percentage reduction in visceral adipose tissue (VAT) measured with MRI. All randomly assigned participants with a follow-up imaging assessment were included in efficacy analyses and all participants who received at least one dose of study drug were included in the safety analyses.

235 participants assessed for eligibility, 185 participants were randomly assigned (n=92 liraglutide, n=93 placebo) and 128 (n=73 liraglutide, n=55 placebo) were included in the final analysis (92% female participants, 37% Black participants, 24% Hispanic participants, mean age 50.2 years, mean BMI 37.7 kg/m2). Mean change in VAT over median 36.2 weeks was ?12.49% with liraglutide compared with ?1.63% with placebo, estimated treatment difference ?10·86%. Effects seemed consistent across subgroups of age, sex, race–ethnicity, BMI, and baseline prediabetes. The most frequently reported adverse events were gastrointestinal-related (43 of 92 with liraglutide and 12 of 93 with placebo) and upper respiratory tract infections (10 of 92 with liraglutide and 14 of 93 with placebo).

In adults with overweight or obesity at high cardiovascular disease risk, once-daily liraglutide 3·0 mg plus lifestyle intervention significantly lowered visceral adipose tissue over 40 weeks of treatment. Visceral fat reduction may be one mechanism to explain the benefits seen on cardiovascular outcomes in previous trials with liraglutide among patients with type 2 diabetes.