New Weight Loss Medications Cause Excitement and Concern

A number of new weight loss medications recently approved by the FDA, including Wegovy, Ozempic and Mounjaro, are generating excitement as potential game-changers in treating obesity, but also raising concerns over side effects and access.

Surge in Demand for New Anti-Obesity Drugs

The new drugs, known as GLP-1 receptor agonists, have shown dramatic weight loss results in clinical trials.

• Wegovy led to average 15% weight loss over 68 weeks [1]
• Ozempic showed 17% weight loss compared to placebo over 56 weeks [2]

This level of weight loss, without intensive dietary and lifestyle interventions, has doctors excited about a new tool to combat obesity.

As a result, demand for the new drugs has skyrocketed since their approval. This has led to shortages as manufacturers struggle to ramp up production [3] [4]. Many doctors’ offices are flooded with requests and have long waitlists for the medications [5].

Concerns Over Safety and Access

However, despite the excitement over a new option for weight management, concerns are being raised over safety and access to the medications:

• Side Effects: Gastrointestinal side effects like nausea, vomiting and diarrhea are common with GLP-1 drugs and can be severe enough to discontinue treatment. Pancreatitis is a rare but serious risk. The long-term safety is unknown [6]

• Cost and Insurance Coverage: The medications are expensive, costing over $1000/month without insurance. Many insurers are restricting coverage due to the high costs, forcing patients to pay large out-of-pocket sums or forego treatment altogether [7] [8]

Concerns Over Long-Term Efficacy and Safety

While the weight loss seen in clinical trials is impressive, questions remain about long-term results:

• Weight loss plateaus over time for many patients on GLP-1 drugs [9]
• It’s unknown if initial weight loss can be maintained long-term once medication is stopped
• Long-term safety data is lacking as most trials only followed patients for 1 year

Doctors caution that medications should complement, not replace lifestyle interventions for sustained success.

Surge in Interest for Bariatric Surgery

With increasing attention around anti-obesity medications, interest has also surged in bariatric or weight loss surgery procedures such as gastric bypass and gastric sleeve surgery [10].

These procedures promote weight loss by physically altering digestion to limit food intake and absorption.

Advantages compared to medications:

• More weight loss on average (~25-30% body weight) [11]
• Effects sustained long-term, unlike drugs where weight may rebound once stopped

Disadvantages:

• Invasive, irreversible procedures with risks for infection, blood clots and nutritional deficiencies
• High upfront costs (~$20,000) often not fully covered by insurance [12]

Many patients are now weighing pros and cons of each option. Doctors caution surgery should only be considered for severely obese patients who have struggled to lose weight through other means.

What Does the Future Hold?

The pipeline for new anti-obesity treatments remains robust. Besides new drug formulations, research is exploring targeting gut microbes or genetics to influence weight long-term [13]:

• Adjusting gut microbes through prebiotics/probiotics
• Gene therapies to permanently alter energy balance pathways
• Implanted devices to alter neural signals between gut and brain

However, experts caution we still lack understanding of the intricate biology behind weight regulation. Moving too fast with novel but unproven approaches risks safety concerns emerging down the line.

In the meantime, lifestyle interventions targeting nutrition and physical activity remain the foundation for long-term weight management and health, with medications/surgery as potential adjuncts for selected patients. Research will continue working to uncover new pathways influencing weight – and how to durably harness them safely.

References

1. https://www.aarp.org/health/drugs-supplements/info-2024/weight-loss-medication-side-effects.html

2. https://www.sciencealert.com/your-body-has-a-built-in-weight-loss-system-you-may-not-know-about

3. https://wgntv.com/news/medical-watch/ups-and-downs-of-weight-loss-medications/amp/

4. https://wgntv.com/news/medical-watch/ups-and-downs-of-weight-loss-medications/

5. https://www.miragenews.com/uva-health-debunks-5-weight-loss-drug-myths-1158555/

6. https://www.aarp.org/health/drugs-supplements/info-2024/weight-loss-medication-side-effects.html

7. https://medicalxpress.com/news/2024-01-weight-loss-medications-quick-obesity.html

8. Dr. Rachel Goldman on the Complex World of Weight Loss Drugs

9. https://medicalxpress.com/news/2024-01-body-built-weight-loss-meds.amp

10. Bariatric Surgery vs. Weight Loss Pills – What’s Right for Me?

11. https://www.yahoo.com/lifestyle/quiz-weight-loss-drugs-130000390.html

12. https://www.yahoo.com/lifestyle/quiz-weight-loss-drugs-130000390.html

13. https://www.geo.tv/latest/527278-microbiome-in-our-gut-can-do-what-weight-loss-drug-wegovy-does

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