A study looked at people who are overweight and have inflammatory bowel disease (IBD) and took GLP‑1 drugs like liraglutide, semaglutide, or tirzepatide. Overall, these drugs didn’t change hospital stays or surgery rates, but semaglutide seemed to cut the chance of needing IBD‑related surgery. Tirzepatide didn’t show a clear benefit, likely because only a few people used it. The medicines lowered inflammation markers and were generally safe, though Black patients on GLP‑1 drugs had a higher risk of any hospital admission.

Obesity is a risk factor for relapsing inflammatory bowel disease. GLP-1 and dual GLP-1/GIP agonists may offer superior weight loss; however, their effect on inflammatory bowel disease remains unknown. In this study, we assessed outcomes in patients with IBD and obesity using these medications. A retrospective, propensity-matched analysis was conducted using data from The OneFlorida+ network. We evaluated patients with IBD and obesity prescribed GLP-1-based therapy (liraglutide, semaglutide, or tirzepatide) versus those without. 562 patients prescribed GLP-1-based therapies were matched 1:1 to controls based on demographics and comorbidities. No differences in GLP-1 users versus non-users with respect to all-cause hospitalization, IBD-hospitalization, IBD-related surgery, or pancreatitis were seen. Use of semaglutide reduced the risk of IBD-related surgery (HR 0.33, CI 0.13-0.83). Among 89 tirzepatide users, none required IBD-related surgery versus 2 matched controls. Black GLP-1 users had an increased risk of all-cause hospitalizations (HR 1.59, CI 1.11-2.29) but not IBD-related hospitalization or IBD-related surgery. Steroid use was comparable between groups. GLP-1 use significantly reduced serum CRP. Semaglutide appeared to lower the risk of IBD-related surgery. Black patients using GLP-1 therapy had an increased risk of all-cause hospitalization. Tirzepatide showed no significant difference regarding primary endpoints; however, the sample size was small. Overall, all GLP-1-based therapies were well tolerated among obese patients with IBD. Larger studies are warranted to understand the therapeutic potential of GLP-1-based treatment in this patient population.