(1352) Liraglutide and Semaglutide in the Setting of Dietary Counseling and Personal Training: A Multidisciplinary Approach to Weight Loss

Objectives: Studies show that 25% to 33% weight loss driven by dietary restriction results in loss of lean body mass (LBM). This is undesirable, as loss of LBM has been associated with increased risk of falls, frailty, and impaired functional capacity. The most important factors related to LBM gain are strength training and a diet containing adequate amounts of protein. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are novel glucose-lowering therapeutics, and select members of the class (semaglutide and liraglutide) have gained an FDA indication for weight loss independent of type-2 diabetes mellitus. Due to their mechanism of action, GLP-1RAs effectiveness for weight loss is primarily driven by dietary restriction. The objective of this study is to determine whether semaglutide or liraglutide significantly decrease lean body mass in patients receiving dietary counseling and personal training. The objective of this study is to determine whether semaglutide or liraglutide significantly decrease lean body mass in patients receiving dietary counseling and personal training.

Methods: In this pragmatic study using a quasi-experimental design with a control group and baseline data, the team consisting of the pharmacist, resident, dietician, and personal trainer will compare loss of lean body mass among patients taking liraglutide or semaglutide for weight loss in addition to diet and exercise counseling to those receiving diet and exercise counseling alone. The study will take place at an Urban Indian Health clinic and will analyze data from patients enrolled in the clinic's multidisciplinary weight-loss initiative, which aims to reduce the burden of obesity in its population through monthly dietary counseling and personal training appointments. Upon enrollment into the weight loss program, interested patients are screened for contraindications to GLP-1RAs by pharmacists, and should medications be appropriate they may be prescribed either liraglutide or semaglutide. The primary objectives will be change in body mass index (BMI), lean body mass, and waist circumference. After gaining informed consent, patient data will be collected at baseline then for up to six months in four-week intervals through manual measurements and use of an In-Body machine during dietary counseling and physical training appointments. Patients' protected health information will be sequestered, and data will be de-identified before presentation. Statistical analysis will be performed on an intention-to-treat basis and will be compiled appropriately for the two intervention groups. This project is currently under IRB review.

Results: Data collection has not yet begun due to the "in-progress" status of the IRB approval.

Conclusions: Trials have been inconclusive as to the degree of lean body mass lost with semaglutide and liraglutide; this study will clarify the effects of GLP-1RAs used for weight loss on LBM in patients receiving counseling intended to maximize beneficial diet and exercise.