Effects of glucagon-like peptide-1 receptor agonists on anthropometric and adiposity measures in patients with antipsychotic-induced weight gain: A systematic review and meta-analysis.

BACKGROUND

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a potential treatment for antipsychotic-induced weight gain. This meta-analysis aimed to investigate the efficacy of GLP-1RAs on weight, body mass index (BMI), waist circumference, and visceral fat in patients receiving antipsychotics.

METHODS

We searched PubMed, Embase, the Cochrane Central, and APA PsycINFO through April 21, 2026, for randomized controlled trials (RCTs) of GLP-1RAs in patients treated with antipsychotics. Outcomes included weight, BMI, waist circumference, and visceral fat. Between-group mean differences (MDs) and their standard errors were used for meta-analyses. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. This study is registered with PROSPERO (CRD420251118829).

RESULTS

Nine RCTs including 595 participants were identified, of whom 294 received GLP-1RAs and 301 received placebo. Four studies reported visceral fat outcomes. GLP-1RAs significantly reduced body weight (MD -6.82 kg (95% confidence interval; CI -9.66 to -3.97), p < 0.0001), BMI (-2.23 kg/m2 (95% CI -3.15 to -1.30), p < 0.0001), waist circumference (-4.94 cm (95% CI -6.92 to -2.96), p < 0.0001), and visceral fat (-0.37 kg (95% CI -0.69 to -0.05), p = 0.0255) compared with placebo. The certainty of evidence was rated as moderate across all outcomes.

CONCLUSION

This meta-analysis demonstrates the benefit of GLP-1RAs in reducing body weight, BMI, waist circumference, and visceral fat. These findings support the clinical utility of GLP-1RAs as adjunctive treatments in patients with psychiatric disease and underscore the need for further trials with adiposity endpoints.