S1561 Evaluating Effectiveness and Safety of a GLP-1 Agonist in Obese Patients With Inflammatory Bowel Disease: A Systematic Review

Introduction: Obesity is rising among people with inflammatory bowel disease (IBD), complicating management and treatment response. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely used for weight loss and glycemic control, but their safety and effects on IBD are unclear. This study aims to assess the safety and efficacy of GLP-1 RAs in obese IBD patients by evaluating changes in body weight, disease activity, inflammatory markers (e.g., C-reactive protein), and adverse events. Methods: We systematically searched PubMed, Scopus, and Google Scholar for studies published up to May 2025 that evaluated the use of GLP-1 RAs in obese patients with IBD. Search terms included: “Semaglutide,” “glucagon-like peptide,” “Inflammatory Bowel Disease,” “IBD,” “ulcerative colitis,” and “Crohn’s.” We included retrospective and observational studies published in English in peer-reviewed journals that assessed the impact of GLP-1 agonists on weight change, inflammatory markers, and adverse events in the target population. Studies were included if they involved obese (body mass index [BMI] >30 kg/m²) patients with IBD receiving GLP-1-based therapies. Exclusion criteria were studies involving non-obese IBD patients, animal or in vitro models, and reviews without original data. Study selection followed the PICO framework, and all eligible articles were independently reviewed and extracted using a standardized data collection form. Results: Five studies (n = 546 patients) met inclusion criteria. GLP-1 receptor agonists were consistently associated with reductions in body weight and BMI. One study reported that 58.3% of patients achieved >5% weight loss at 6 months, while others demonstrated statistically significant reductions in weight without reporting thresholds. No study reported increased rates of IBD exacerbations, hospitalizations, or need for escalation of therapy. Improvements in CRP were noted in some cohorts. Adverse events were primarily gastrointestinal, including nausea and constipation, and were generally mild. Conclusion: This review supports the potential role of GLP-1 receptor agonists as a safe and effective treatment option for weight reduction in obese patients with IBD, without exacerbating disease activity. These agents may offer a dual therapeutic benefit by addressing both metabolic and inflammatory pathways. Future prospective studies and randomized controlled trials are needed to establish long-term efficacy, clarify their role in disease modulation, and inform clinical guidelines.