New Study Shows Which GLP-1s Ranked The Highest For Metabolic Health
GLP-1 medications have become one of the most closely watched tools in metabolic health, and for good reason. These medications can help regulate appetite, improve blood sugar control, and drive levels of weight loss that were once difficult to achieve without surgery. But a new review of 19 clinical trials indicates that different GLP-1s can have different impacts on your cardiometabolic health.
Across more than 13,000 adults, different medications and doses produced distinct effects on blood pressure, cholesterol, and blood sugar. Here's what you need to know.
About the study
For this study, researchers analyzed data from 19 randomized controlled trials involving 13,117 adults with overweight or obesity, including people with and without type 2 diabetes.
They created a scoring tool called the Cardiometabolic Efficacy Index (CEI) to compare treatments across seven health markers: body weight, waist circumference, blood sugar, systolic blood pressure, triglycerides, HDL cholesterol ("good" cholesterol), and LDL cholesterol ("bad" cholesterol).
Scores closer to 1 indicated stronger overall benefits.
Higher doses delivered the broadest cardiometabolic benefits
Across all medications studied, higher-dose GLP-1s consistently delivered the strongest improvements. Injectable semaglutide at the highest dose earned the top CEI score, followed closely by orforglipron and a lower-dose injectable semaglutide.
All three produced average weight reductions of at least 10%. But there were some differences.
- Orforglipron: Showed stronger effects on blood sugar control, HDL cholesterol, and blood pressure
- Semaglutide: Showed larger effects on total body weight, waist circumference, and LDL cholesterol
The review also found that oral GLP-1 medications held their own against injectables. Among adults without type 2 diabetes, orforglipron 36 mg showed a comparable cardiometabolic profile to oral semaglutide 25 mg.
And across both medications, higher doses consistently delivered broader benefits, pointing to a clear dose-response pattern.
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What this means for your health goals
Weight loss has long been the main measure of GLP-1 success, but this research adds to the growing body of evidence for the role of GLP-1s addressing multiple health outcomes.
Someone focused on blood sugar control may do better on a different option than someone whose main concern is LDL cholesterol or blood pressure.
Your genes may also play a role in how your body responds, which is another reason a one-size-fits-all approach falls short here, and working with an informed healthcare professional is crucial for finding the best option for you.
The takeaway
If you're on a GLP-1 or thinking about starting one, bring your blood pressure, cholesterol, and blood sugar numbers to your next appointment alongside your weight goals.
The best option for you may be the one that fits your full health picture, not just the one that moves the scale the most. Oral GLP-1s are also becoming more widely available, which may make it easier to stay on treatment long-term compared to injectables.
One thing worth knowing: the CEI scores in this study reflect how medications compare across cardiometabolic risk factors, not whether they prevent heart attacks or kidney disease. They're a useful way to compare options, not a final verdict.