ABSTRACT Objective This meta‐analysis evaluates the safety and efficacy of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RA) for the treatment of older adults with obesity compared to younger individuals. Methods A systematic review was conducted following PRISMA guidelines (PROSPERO CRD420251074381). PubMed, Embase, and Scopus were searched until May 17, 2025, for randomized controlled trials and observational studies assessing GLP‐1 RA in adults ≥ 65 years with obesity with or without type 2 diabetes. Random effects meta‐analyses calculated the log odds ratios (LOR) for dichotomous outcomes and the mean differences (MD) for continuous outcomes, with equivalence testing via two one‐sided tests (TOST) and meta‐regression for baseline adjustments. Results Five studies involving 1229 participants were included. No significant difference in serious adverse events was found between older and younger adults (pooled LOR: 0.06, p = 0.9). Older adults had a trend toward lower frequency of nausea (LOR: −0.44, p = 0.06) but higher incidence of constipation (LOR: 0.72, p = 0.02) and hypoglycemia (LOR: 0.97, p < 0.001). Efficacy in metabolic and weight control was comparable. Additionally, one study suggested that liraglutide could reduce fat mass without worsening sarcopenia. Conclusions GLP‐1 RA therapy seems to be safe and effective in older adults with obesity, achieving similar effects on weight loss and glycemic control as in younger individuals.
Figueiredo et al. (2026) studied this question.