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Association between eating behavior patterns and the therapeutic efficacy of GLP-1 receptor agonists in individuals with type 2 diabetes: a multicenter prospective observational study
The efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in managing type 2 diabetes (T2D) raises pertinent questions about the role of individual eating behaviors in treatment responses. Despite the recognized benefits of GLP-1RAs for glycemic control and weight reduction, variability in patient outcomes has led to the hypothesis that dietary habits could significantly influence therapeutic effectiveness, although supporting evidence remains limited.
This multicenter, prospective observational study conducted in Gifu Prefecture, Japan, included 92 individuals with T2D who initiated GLP-1RA therapy with liraglutide, dulaglutide, oral semaglutide, or injectable semaglutide. Participants were evaluated at three time points—baseline, 3 months, and 12 months—to assess clinical parameters, dietary intake, and eating behaviors using validated instruments, including the Food Frequency Questionnaire and the Japanese version of the Dutch Eating Behavior Questionnaire (DEBQ-J). The primary focus was on changes in glycosylated hemoglobin (HbA1c), body weight, and eating behavior over the one-year period.
Results indicated that the GLP-1RA therapy led to significant reductions in HbA1c levels, body weight, and body fat percentage after 12 months. Of particular interest, the study observed a sustained reduction in external eating scores, in contrast to transient shifts in emotional and restrained eating scores. Furthermore, higher initial external eating scores correlated with more substantial weight loss and indicated a tendency towards improved glycemic control. No significant links were found between the emotional or restrained eating metrics and clinical outcomes.
In conclusion, the findings of this research provide evidence that GLP-1RAs not only enhance metabolic parameters but also positively influence external eating behaviors among individuals with T2D. The consistency of external eating as a predictive behavioral marker for treatment response underscores its potential role in personalizing GLP-1RA therapy, thereby optimizing clinical outcomes. This study advocates for the inclusion of eating behavior evaluations in clinical settings to better tailor diabetes treatments. [NPID: GLP-1 receptor agonists, eating behavior, dietary intake, DEBQ-J, external eating, personalized medicine]
Year: 2026
