Trulicity (dulaglutide) in the treatment of obesity

What is Trulicity?

Dulaglutide belongs to the group of medicines known as GLP-1 receptor agonists. These improve the body’s ability to regulate blood glucose while also influencing appetite and satiety (2–4).

How Trulicity works

GLP-1 receptor agonists mimic the natural hormone GLP-1 (glucagon-like peptide-1). GLP-1 is normally released from the small intestine after a meal and affects several key functions involved in appetite regulation, satiety and blood glucose.

By enhancing these processes, Trulicity can contribute to several effects:

• Improved blood glucose control: The treatment stimulates insulin secretion at elevated blood glucose levels and suppresses glucagon production, helping to maintain more stable glucose levels.
• Reduced appetite and increased satiety: The medicine affects the brain’s appetite centre, causing satiety to occur more quickly and to last longer. This reduces energy intake and may therefore contribute to weight loss.
• Slower gastric emptying: Gastric emptying is delayed, which helps stabilise post-meal blood glucose levels and enhances satiety.

Trulicity is administered as a subcutaneous injection once weekly. The injection can be given in the abdomen, thigh or upper arm. It must not be administered intravenously or intramuscularly (1,5).

Who may use Trulicity?

Trulicity is not approved for the treatment of obesity but may in some cases be used off-label following a thorough medical assessment. Such use should always occur under medical supervision and as part of a structured treatment programme (1).

When used off-label, similar medical criteria to those for medicines approved for weight management are often applied, for example:

• BMI ≥ 30 kg/m², or
• BMI ≥ 27 kg/m² with weight-related comorbidity such as type 2 diabetes, hypertension, dyslipidaemia or obstructive sleep apnoea.

Patients should always discuss treatment options with their doctor and undergo regular follow-up to evaluate effectiveness and safety, as well as to receive guidance on how to use the medicine correctly. Individuals with increased risk — such as those with underlying health conditions — should discuss with their doctor whether Trulicity is the right treatment.

Healthy weight and weight loss

Combining medication with lifestyle changes, such as healthier eating habits and physical activity, helps patients achieve a healthy weight and reduces the risk of complications associated with type 2 diabetes and obesity (5).

Other factors supporting health and weight loss

For treatment to provide the best possible results, a comprehensive strategy is required. This means the medicine should be combined with healthy changes such as improved eating habits, regular physical activity, stress management and good sleep — ideally with support from healthcare professionals (5).

Diet for healthy weight loss with Trulicity

Weight loss requires a calorie deficit — that is, energy intake must be lower than energy expenditure (5). Medication can help by increasing satiety and reducing hunger, which often becomes more pronounced when calories are restricted.

When energy intake is lower, it is especially important that the diet remains nutrient-dense to meet the body’s needs for vitamins, minerals and protein. Adequate protein intake supports improved satiety, preservation of muscle mass during weight loss and improved body composition — particularly when combined with strength training.

Dietary advice should always be individualised to the patient’s current eating habits, preferences and circumstances.

The importance of regular physical activity and training

Physical activity is a central component of comprehensive weight-loss treatment. It can enhance the effect of medication, improve overall wellbeing, and prevent or reduce side effects. Activity helps preserve muscle mass, improves metabolism and promotes mental wellbeing. Regular movement can also reduce stress, improve sleep quality and lower the risk of related conditions (5).

Recommended forms of physical activity (6):

• Everyday movement: such as taking the stairs, walking, cycling or standing more often
• Cardiovascular exercise: such as brisk walking, swimming or cycling
• Strength training: 2–3 times per week, particularly important for preserving muscle mass and supporting healthy body composition

Recommendations should always be adapted to the individual’s abilities, limitations, health status and personal goals.

How sleep helps with weight loss

Adequate sleep is essential for regulating healthy body weight. Lack of sleep affects several hormonal systems involved in appetite, satiety and energy balance. Good-quality sleep in sufficient amounts is recommended to support optimal weight regulation (7).

Stress and its impact

Chronic stress can raise cortisol levels, which negatively affect appetite regulation and metabolism. The experience of stress is highly individual and influenced by personality, life circumstances and previous experiences. Support and treatment must therefore be tailored to each person’s needs.

For some, this may involve reducing external stressors; for others, strengthening recovery and developing coping strategies is more appropriate. Regular movement, adequate sleep and stress-reduction techniques can all be valuable tools (8).

Common side effects

The most common side effects of Trulicity are gastrointestinal (1). These are usually mild to moderate and often subside after the first weeks of treatment.

Common side effects include:

• Nausea
• Diarrhoea
• Vomiting
• Constipation
• Gas or bloating

Nausea is the most frequently reported side effect and occurs mainly during the first weeks as the dose is gradually increased. For many people, symptoms lessen once the body has adjusted to the treatment.

How gastrointestinal symptoms can be relieved

These side effects are usually mild and pass after a few weeks. To help relieve symptoms, patients may:

• eat smaller portions
• eat slowly and stop when feeling full
• avoid fatty, spicy or fried foods
• drink water frequently in small amounts
• avoid carbonated drinks
• engage in regular physical activity

If symptoms do not improve or significantly affect daily life, patients should contact healthcare services for assessment, advice and support.

The importance of support and follow-up

To achieve the best possible results with Trulicity, patients benefit from support from healthcare professionals. Various tools and counselling options can help make changes in diet and physical activity. Regular follow-up helps adapt the treatment to the patient’s needs and ensures that weight loss progresses appropriately.

Common questions about losing weight with Trulicity

How long does it take to see weight-loss results?

This varies, but many people notice weight loss within a few weeks to months. It is important to combine the medicine with healthy lifestyle habits for the best results.

Can you eat normally while taking Trulicity?

To achieve weight loss, a calorie deficit is required. Medication can support this by increasing satiety and reducing hunger. When energy intake is reduced, it is particularly important to ensure the diet remains nutrient-dense and contains sufficient protein, vitamins and minerals.

What should a patient do if they experience side effects?

Contact a doctor for advice. In some cases, the dose may be adjusted or the medicine changed.

Summary – Trulicity

Trulicity (dulaglutide) is a GLP-1 receptor agonist primarily used for the treatment of type 2 diabetes but may also support weight loss by influencing appetite and satiety.

The treatment is administered as a once-weekly injection and should be seen as part of a comprehensive programme including diet, physical activity and support for long-term lifestyle change.

When used correctly and combined with regular follow-up, Trulicity can contribute to improved metabolic control, reduced body weight and enhanced quality of life.

References

1. European Medicines Agency (EMA). Trulicity – Summary of Product Characteristics (SmPC). https://www.ema.europa.eu/en/medicines/human/EPAR/trulicity
2. Wong, H.J., Sim, B., Teo, Y.H., Teo, Y.N., Chan, M.Y., Yeo, L.L.L., Eng, P.C., Tan, B.Y.Q., Sattar, N., Dalakoti, M. & Sia, C.H. (2025). Efficacy of GLP-1 Receptor Agonists on Weight Loss, BMI, and Waist Circumference for Patients With Obesity or Overweight: A Systematic Review, Meta-analysis, and Meta-regression of 47 Randomized Controlled Trials. Diabetes Care, 48 (2): 292–300. https://doi.org/10.2337/dc24-1678
3. Bonora, E., Frias, J.P., Tinahones, F.J. et al. (2021). Effect of dulaglutide 3.0 and 4.5 mg on weight in patients with type 2 diabetes: Exploratory analyses of AWARD-11. Diabetes, Obesity & Metabolism, 23 (10): 2242–2250. https://doi.org/10.1111/dom.14465
4. Mirabelli, M.; Chiefari, E.; Tocci, V.; Caroleo, P.; Giuliano, S.; Greco, E.; Luque, R.M.; Puccio, L.; Foti, D.P.; Aversa, A.; et al. Clinical Effectiveness and Safety of Once-Weekly GLP-1 Receptor Agonist Dulaglutide as Add-On to Metformin or Metformin Plus Insulin Secretagogues in Obesity and Type 2 Diabetes. J. Clin. Med. 2021, 10, 985. https://doi.org/10.3390/jcm10050985
5. Konstantinos C Koskinas, Emeline M Van Craenenbroeck, Charalambos Antoniades, Matthias Blüher, Thomas M Gorter, Henner Hanssen, Nikolaus Marx, Theresa A McDonagh, Geltrude Mingrone, Annika Rosengren, Eva B Prescott, the ESC Scientific Document Group , Obesity and cardiovascular disease: an ESC clinical consensus statement, European Heart Journal, Volume 45, Issue 38, 7 October 2024, Pages 4063–4098, https://doi.org/10.1093/eurheartj/ehae508
6. World Health Organization (WHO). (2020) WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240015128
7. Chaput JP, McHill AW, Cox RC, Broussard JL, Dutil C, da Costa BGG, Sampasa-Kanyinga H, Wright KP Jr. The role of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol. 2023 Feb;19(2):82-97. doi: 10.1038/s41574-022-00747-7. Epub 2022 Oct 24. PMID: 36280789; PMCID: PMC9590398.
8. Lengton R, Schoenmakers M, Penninx BWJH, Boon MR, van Rossum EFC. Glucocorticoids and HPA axis regulation in the stress-obesity connection: A comprehensive overview of biological, physiological and behavioural dimensions.
   https://pubmed.ncbi.nlm.nih.gov/39623561/

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