This real-world study compared 12-month weight loss between patients starting GLP-1 receptor agonists (like semaglutide) versus SGLT2 inhibitors (like empagliflozin) in a diverse US cohort of nearly 4,000 people. After rigorous statistical balancing, GLP-1 drugs produced about 1.2 percentage points greater body weight loss overall. The advantage was concentrated in women (−1.71 pp) and patients without type 2 diabetes (−1.96 pp), while men and those with type 2 diabetes showed no meaningful difference between the drug classes. GLP-1 initiators also achieved greater HbA1c reductions. With obesity and metabolic dysfunction central to accelerated aging, these findings support personalized drug selection for weight and cardiometabolic management rather than a one-size-fits-all approach.
