Posted on July 4th, 2022.

Date: June 12, 2022

A new class of weight-loss drugs is giving some patients with obesity new hope that they’ll be able to lose excess pounds and improve their health without experiencing the dangerous side effects of older medications. 

But despite mounting evidence that the drugs are both safe and effective, doctors say relatively few of the country’s millions of eligible patients are taking them. 

“This drug is something that transforms lives for some people,” said Thomas Wadden, the director of Penn Medicine’s weight and eating disorders program in Philadelphia. But, he said, “I don’t think any of these weight-loss medications are being prescribed as much as they should be.”

More than 70 percent of adults in the U.S. are overweight or obese, according to the Centers for Disease Control and Prevention. Obesity can lead to a variety of other medical conditions, including high blood pressure and cholesterol, Type 2 diabetes and stroke.

The drugs mimic a hormone produced in the gut called GLP-1, which tells the pancreas to secrete more insulin to control blood sugar. They’re not new to medicine; they’ve been used to treat Type 2 diabetes for years. But when doctors noticed that patients also lost weight, drugmakers got on board, offering the medications in higher dosages specifically to treat obesity. 

It’s still unclear exactly how the drugs help with weight loss. Wadden said they seem to slow down stomach-emptying so people stop eating sooner and feel full longer.

It’s also believed that the drugs target certain receptors in the brain that affect appetite. “It may be acting upon areas of reward in the brain,” Wadden said. So patients may eat less frequently for pure pleasure, which he calls “hedonic eating.” 

So far, two of the new drugs, both from drugmaker Novo Nordisk, have been approved by the Food and Drug Administration. Saxenda was approved in 2020. The most recent, Wegovy, was approved last year for patients with body mass indexes of 30 or greater or those with BMIs of 27 or greater plus at least one weight-related condition. Studies found the weekly self-injectable helped patients lose, on average, about 15 percent of their body weight over 16 months, making it twice as effective as older weight-loss drugs already on the market, such as Qsymia. 

A newer GLP-1 medication called tirzepatide, also a weekly injectable, appears to be even more effective. A study published last week in the New England Journal of Medicine found it helped patients lose more than 20 percent of their weight over 72 weeks. 

The medications do come with side effects. Most commonly, patients complained of nausea, vomiting, diarrhea and stomach pain. 

And experts emphasize the drug is not a magic bullet. 

“I don’t care how wonderful the drug is, it will not work for everyone,” said Dr. Zhaoping Li, the director of the Center for Human Nutrition at UCLA. “This is a tool, but it’s not the tool.”

Still, obesity doctors and researchers say that compared with the older class of weight-loss drugs, the new medications are impressive, especially for those whose obesity has caused other chronic conditions, such as heart disease and Type 2 diabetes.

Source: New weight-loss drugs are highly effective, so why aren’t they widely used? 

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