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S3345 Real-World Analysis of Weight Loss Medication Use (GLP-1) in Obese Patients With Celiac Disease: Effective and Safe
Abstract   Peer reviewed

S3345 Real-World Analysis of Weight Loss Medication Use (GLP-1) in Obese Patients With Celiac Disease: Effective and Safe

M. Housam Nanah, Andrew Ford, Claire Jansson-Knodell and Alberto Rubio-Tapia
The American journal of gastroenterology, Vol.121(10S1), pp.S728-S728
10/01/2026
DOI: 10.14309/01.ajg.0001222632.07458.ae

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Abstract

Introduction: Celiac disease and obesity increasingly coexist. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated efficacy in obesity treatment; however, their long-term impact in patients with concomitant celiac disease, a malabsorptive condition, and obesity is poorly characterized. We aimed to evaluate clinical outcomes among patients with celiac disease and obesity treated with GLP-1 RAs compared with matched controls not receiving GLP-1 RAs. Methods: Using the TriNetX database, adults with celiac disease were identified by ICD-10 coding plus tTG-IgA >200 or positive endomysial antibody (EMA). Patients <18 years were excluded. Patients with celiac disease and obesity receiving GLP-1 RAs were compared with matched obese celiac controls not receiving GLP-1 RAs. Propensity score matching (PSM) was performed. Outcomes included body mass index (BMI), gastrointestinal adverse effects, obesity-related complications, tTG-IgA normalization, and nutritional deficiencies, assessed at 1, 3, 5, and 10 years where available. Results: Before matching, 298 GLP-1 RA users were compared with 1,220 controls; 298 patients remained in each cohort after PSM. Baseline characteristics were balanced. Mean baseline BMI was 36.6 ± 6.5 versus 32.5 ± 6.0. GLP-1 RA users had lower BMI at 1 year (35.1 vs 33.5, P < 0.01), 3 years (34.7 vs 33.1, P < 0.01), and 5 years (34.6 vs 33.2, P = 0.03). Nausea/vomiting and constipation were similar, while bloating was less common (11.8% vs 17.9%, P = 0.04). TTG-IgA normalization was higher at 3 years (13.5% vs 6.5%, P = 0.02) and 5 years (14.4% vs 7.5%, P = 0.02). Vitamin D deficiency was more frequent (57.4% vs 43.8%, P = 0.0008), with no differences in B12 deficiency, folate deficiency, iron deficiency anemia, or osteoporosis. Conclusion: In patients with obesity and celiac disease, GLP-1 RA therapy was associated with sustained reductions in BMI. In contrast, obese patients with celiac disease not using weight-reducing therapies demonstrated increasing BMIs. GLP-1 RAs appear to be efficacious and safe with no increased gastrointestinal adverse events. Improved rates of TTG-IgA normalization suggest benefits extending beyond weight reduction alone and warrant further study to understand GLP-1 anti-inflammatory properties or other potential mechanisms.
 Obesity Body mass index Celiac disease GLP-1 receptor agonists Weight control

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