Dulaglutide reduces risk for weight gain among women who quit smoking

Key takeaways:

• Women at risk for substantial weight gain may benefit most from the drug, the researchers said.
• The treatment had no impact on quit rates, contrary to researchers’ assumptions.

Women who quit smoking and were treated with the GLP-1 receptor agonist dulaglutide were less likely to experience substantial weight gain compared with those who received placebo, according to researchers.

“Smoking cessation needs to be a priority in health care, and a special focus should be placed on females who smoke: while the smoking prevalence in men is decreasing in many places, these trends are declining slower or even rising in women,” Fabienne Baur, MD, from the department of endocrinology at University Hospital Basel in Switzerland, and colleagues wrote in BMJ Nutrition Prevention & Health.

They also noted that post-cessation weight change “is a major barrier to smoking cessation and seems to be a greater concern for women.”

The researchers explained that although a prior randomized controlled trial found significantly reduced weight in those who quit smoking after treatment with dulaglutide — which is marketed in the United States as Trulicity by Eli Lilly — it remains unclear whether these reductions are gender specific.

Baur and colleagues reanalyzed the study, which included 255 adults (155 women) who had either received a weekly treatment of 1.5 mg dulaglutide or placebo — in addition to standard smoking cessation care — over 12 weeks.

Substantial weight gain was defined as an increase of more than 6% in weight.

Overall, there were no significant gender differences in relative or absolute weight change among those on either placebo or dulaglutide.

However, the researchers found there was a lower proportion of substantial weight gain among women on dulaglutide compared with those on placebo (1% vs. 24%).

This effect was less significant in men on dulaglutide vs. those on placebo (0% vs. 5%).

Notably, the weight loss associated with dulaglutide had no effect on abstinence rates in men (65%) and women (63%), contrary to Baur and colleagues’ assumption that weight gain was a barrier to abstinence among women.

“Our findings do not support this notion — at least not with regard to short-term abstinence — and rather suggest that (gender-specific) reasons for successful quitting are multilayered and more complex,” they wrote.

They suggested future research should analyze the drug’s impact on both men and women who have had several failed cessation attempts.

Ultimately, “the possibility of personalized weight control treatment with GLP-1 [receptor agonists] in the smoking cessation setting is of great interest, and our data suggest that women at greater risk of substantial weight gain may benefit most,” the researchers concluded.

References:

• Baur F, et al. BMJ Nutr Prev Health. 2023;doi:10.1136/bmjnph-2023-000781.
• Diabetes drug may significantly lower women’s risk of substantial weight gain after giving up smoking. https://www.eurekalert.org/news-releases/1011426?. Published Dec. 19, 2023. Accessed Dec. 19, 2023.