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.