Introduction and Objective: Alopecia is a potential adverse event of anti-obesity medications (AOMs). Rapid weight loss may result in deficiencies of key nutrients and act as a physiological stressor, potentially disrupting hair growth cycles and increasing hair shedding. This study aimed to evaluate the association between AOMs and risk of alopecia.Methods: PubMed, EMBASE, Cochrane Library, and Clinicaltrial.gov were searched from inception to December 2024. Randomized controlled trials (RCTs) that compared AOMs with placebo or active controls and reported alopecia events were included. The results were computed as odds ratios (OR) with 95% confidence intervals (CI) in random-effect model. Meta-regression analyses were performed to address potential influencing factors.Results: In total, 10 RCTs with 22840 participants were included. Compared with non-users, the use of AOMs was associated with an increased risk of alopecia (OR=3.12, 95%CI, 1.90 to 5.14). The risk of alopecia was much higher in the subgroup with obesity (OR=3.89, 95%CI, 2.37 to 6.37) when compared with the subgroup without obesity (OR=0.68, 95%CI, 0.16 to 2.86, p for subgroup difference=0.02). Meta-regression analyses suggested that greater body weight reduction percentage (β=-0.13, p=0.05) and greater body weight absolute reduction (β=-0.23, p=0.03) were associated with a higher risk of alopecia. However, younger age was associated with an elevated risk of alopecia (β=-0.20, p=0.02).Conclusion: AOMs were associated with an increased risk of alopecia, and the risk of alopecia increased with greater weight reduction. Our findings highlight the need for caution regarding the effects of rapid weight loss on hair health.
R. Jiao: None. C. Lin: None. Z. Li: None. Y. Guo: None. F. Lyu: None. W. Yang: None. X. Cai: None. L. Ji: None.
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