As obesity remains a prevalent health issue across the globe, the healthcare industry has been on the lookout for more efficient treatments aside from surgery. The recent development of a new class of drugs designed to combat obesity has stirred up a significant buzz, with industries ranging from airlines to big box chains reacting enthusiastically. These drugs, which help patients lose significant amounts of weight with considerably lower risks than surgery, have sent stock markets into a flurry of activity.
Leading the pack in this new class of drugs are Novo Nordisk A/S’s Ozempic and Eli Lilly & Co.’s Zepbound. Ozempic gained notoriety after being endorsed by Hollywood celebrities, even becoming a punchline on several occasions. On the other hand, Zepbound is making waves as the newest entry in the market. These drugs have generated a level of hype reminiscent of the excitement surrounding Viagra’s approval in 1998. However, challenges persist, including high costs, uneven insurance coverage, and the possibility of patients needing to take the drugs indefinitely to prevent weight regain.
Understanding the Mechanism of Weight-Loss Drugs
Ozempic and its higher-dose version, Wegovy, simulate a hormone called GLP-1. This hormone, produced after eating, works in the brain to reduce appetite and increase feelings of fullness. Originally developed for Type 2 diabetes, these drugs, known as glucagon-like peptide 1 receptor agonists, also prompt the pancreas to release insulin after meals, which helps regulate blood sugar levels. When it was discovered that diabetes patients taking these drugs were losing weight, their use as obesity treatments began. Eli Lilly’s Zepbound takes a slightly different approach by combining GLP-1 with another gut hormone, GIP, which helps lower blood sugar and may also boost metabolism.
Availability and Effectiveness of Weight-Loss Drugs
Currently, three GLP-1 injections have received approval for obesity treatment in the U.S.: Saxenda and Wegovy from Novo Nordisk, and Zepbound from Eli Lilly. Some doctors are also prescribing drugs approved only for diabetes, such as Ozempic and Mounjaro, as “off-label” weight-loss medications. Early versions of GLP-1 drugs only produced modest weight loss, but newer drugs have built on this. For instance, Saxenda induced a loss of about 5% of body weight, while Wegovy and Zepbound helped patients lose about 15% and 21% of their body weight, respectively. These drugs also showed improvements in patients’ blood pressure and cholesterol levels.
Safety and Limitations of Weight-Loss Drugs
Having been used to treat diabetes patients for nearly two decades, these drugs’ safety profiles are considered relatively well-established. Most of their known side effects are not serious, but can be unpleasant, ranging from nausea and diarrhea to vomiting and constipation. However, long-term studies of these treatments in patients taking them for obesity are still lacking. Experts have also raised concerns that the loss of muscle from GLP-1 drugs could pose a risk for older patients.
Another significant limitation of these drugs is that patients who stop taking them tend to regain most of their lost weight. This is a common issue with almost all weight treatments, with dieters regaining more than 80% of their lost weight within five years, sometimes even gaining more. A quarter of those who undergo bariatric surgery also experience significant weight regain.
Despite these challenges, the success of these drugs has triggered a surge in research, with more than 50 anti-obesity drugs currently in clinical development. The global sales of anti-obesity drugs, which hit $6 billion in 2023, could reach over $100 billion by 2030, according to Goldman Sachs Group Inc.
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