{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:40:43Z","timestamp":1792726843248,"version":"4.5.0"},"reference-count":12,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare changes in body mass index (BMI) categories after sustained versus minimal glucagon\u2010like peptide\u20101 receptor agonist (GLP\u20101 RA) exposure in older adults with obesity and without diabetes. A secondary aim was to compare changes in glycated haemoglobin (HbA1c) categories among those with paired HbA1c measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective cohort study within Clalit Health Services, Israel. Adults aged \u2265\u200965\u2009years without diabetes, with baseline BMI \u2265\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and paired BMI measurements, were classified as minimal (1\u20132 dispensations) or sustained (\u2265\u20093) exposure. The primary outcome was BMI category improvement. Secondary outcomes were relative BMI change, HbA1c category change in the paired\u2010HbA1c subset, and incident diagnosed diabetes. BMI improvement was modelled by logistic regression adjusted for age, sex, socioeconomic status and comorbidity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 13\u2009387 patients (69% female), 11\u2009121 (83%) had sustained and 2266 (17%) minimal exposure. BMI category improved in 55% of the sustained versus 30% of the minimal group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; median change \u22128% vs. \u22122%). Among 7392 with paired HbA1c, HbA1c improved in 34% versus 20% (sustained vs. minimal;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and 65% versus 37% of those with prediabetes became normoglycaemic. Diabetes diagnosis was less frequent with sustained exposure (2.5% vs. 5.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Adjusted for measured confounders, sustained exposure was associated with BMI improvement (OR: 2.77, 95% CI: 2.51\u20133.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among older adults with obesity and without diabetes, sustained versus minimal GLP\u20101 RA exposure was associated with greater improvement in BMI and HbA1c categories and a lower incidence of diabetes. These findings describe observed changes after treatment initiation, not a proven causal treatment effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71473","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:25:17Z","timestamp":1792725917000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sustained Versus Minimal\n                    <scp>GLP<\/scp>\n                    \u20101 Receptor Agonist Exposure and Metabolic Outcomes in Older Adults Without Diabetes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0100-1528","authenticated-orcid":false,"given":"Reuven","family":"Zaritsky","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Jerusalem District Clalit Health Services  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6393-0859","authenticated-orcid":false,"given":"Nili","family":"Elior","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Tel Aviv District Clalit Health Services  Tel Aviv Israel"},{"name":"Department of Family Medicine, Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talish","family":"Razi","sequence":"additional","affiliation":[{"name":"Clalit Health Services Community Medical Services Division  Tel Aviv Israel"},{"name":"School of Industrial and Intelligent Systems Engineering Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2728-5379","authenticated-orcid":false,"given":"Naama","family":"Sitry","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, North District Clalit Health Services  Nazareth Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9815-1875","authenticated-orcid":false,"given":"Alexander","family":"Lustman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Jerusalem District Clalit Health Services  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6021-5634","authenticated-orcid":false,"given":"Sophia","family":"Eilat\u2010Tsanani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Bar\u2010Ilan University  Ramat Gan Israel"},{"name":"Emek Medical Center Clalit Health Services  Afula Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadar","family":"Shahaf","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Tel Aviv District Clalit Health Services  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3529-2874","authenticated-orcid":false,"given":"Idan","family":"Barzilay","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Sharon\u2010Shomron District Clalit Health Services  Herzliya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4665-6837","authenticated-orcid":false,"given":"Belle","family":"Tamir\u2010Brahms","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Sharon\u2010Shomron District Clalit Health Services  Herzliya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shani","family":"Afek","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Sharon\u2010Shomron District Clalit Health Services  Herzliya Israel"},{"name":"Reichman University  Herzliya Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6282-5116","authenticated-orcid":false,"given":"Naama","family":"Katz Hanein","sequence":"additional","affiliation":[{"name":"Clalit Health Services  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6058-8665","authenticated-orcid":false,"given":"Ronen","family":"Arbel","sequence":"additional","affiliation":[{"name":"Clalit Health Services  Tel Aviv Israel"},{"name":"Sapir College  Sderot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1209-6201","authenticated-orcid":false,"given":"Michal","family":"Shani","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Department of Family Medicine, Central District Clalit Health Services  Rehovot Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"4","key":"e_1_2_14_2_1","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1159\/000549751","article-title":"European Association for the Study of Obesity Position Statement on the Diagnosis and Management of Obesity in Older Adults","volume":"19","author":"Di Vincenzo O.","year":"2026","journal-title":"Obesity Facts"},{"issue":"3","key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1038\/s41366-024-01529-z","article-title":"Obesity Pharmacotherapy in Older Adults: A Narrative Review of Evidence","volume":"49","author":"Henney A. 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