OBJECTIVES: Liraglutide 3.0 mg is a glucagon-like peptide-1 (GLP-1) analog currently licensed for weight management in people with obesity or overweight with comorbidity. This analysis investigated the effects of liraglutide 3.0 mg versus placebo, as an adjunct to diet and exercise, on health utility in people with prediabetes and obesity or overweight with comorbidity, over 3 years. METHODS: The study was a 3-year, randomized, double-blind, placebo-controlled, parallel-group, multicenter, multinational trial (NCT01272219). Participants were ≥18 years, without type 2 diabetes but with prediabetes and obesity (BMI ≥30 kg/m) or overweight (BMI ≥27 kg/m) with hypertension or dyslipidemia. Participants were randomized 2:1 to liraglutide 3.0 mg (n=1505) or placebo (n=749). Health-related quality of life was assessed via the Impact of Weight on Quality Of Life (IWQOL)-Lite questionnaire, completed at baseline and 3 years (Week 160). IWQOL-Lite scores were mapped to the Short-Form-6D (SF-6D) health utility index using a validated algorithm. Health utility scores are constructed so that perfect health is anchored at 1.0 and death is anchored at 0. RESULTS: At Week 160 individuals on liraglutide 3.0 mg had greater weight loss from baseline (‑7.1±8.4%) compared with placebo (-2.7±7.2%); estimated treatment difference (ED) -4.3% [95%CI ‑4.9;-3.7], p<0.0001. Change in IWQOL-Lite total score was significantly higher (better) at Week 160 compared with placebo: ED 3.35 [95%CI 2.04;4.66], p<0.0001. All subscales of the IWQOL-Lite were significantly higher at Week 160 with liraglutide 3.0 mg versus placebo. IWQOL-Lite-derived utility score (mean [SD]) was 0.75 (0.09) and 0.74 (0.09) at baseline, and 0.80 (0.08) and 0.78 (0.09) at Week 160, for liraglutide 3.0 mg and placebo respectively. At Week 160, ED was 0.014 [95%CI 0.008;0.021], p<0.0001. CONCLUSIONS: Liraglutide 3.0 mg is associated with improved health utility compared with placebo in weight management of people with prediabetes over 3 years.