CNN
—
He pharmaceutical company Eli Lilly announced last week that a drug developed to treat diabetes, tirzepatide, also had a substantial effect on weight loss.
Among more than 900 adults with obesity and diabetes in one study, tirzepatide not only controlled their blood sugar, but also helped those taking the highest dose lose an average of 34 pounds, which was nearly 16% of its initial weight, according to one company. Press release. The participants took the drug for one year and five months.
Eli Lilly plans to apply for US Food and Drug Administration approval to market tirzepatide to treat obesity.
Another pharmaceutical company, Novo Nordisk, makes the drug semaglutide, which has already been approved by the FDA to treat diabetes under the brand name Ozempic and to treat obesity under the brand name Wegovy. Famous have claimed to use it as a weight loss tooland its widespread use has led to drug shortages.
How exactly do semaglutide and tirzepatide work? How promising are they for treating obesity? What are the side effects? Who is eligible? What if someone wants to lose a few pounds for a wedding or event? Should I accept them?
To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She was previously the Baltimore health commissioner.
CNN: Can you explain how drugs like tirzepatide and semaglutide work?
Dr. Leana Wen: Both injectable drugs were initially developed to treat type 2 diabetes. In the process of conducting clinical trials, research has also found that they have a substantial effect on weight loss.
Semaglutide mimics a digestive hormone called glucagon-like protein 1, or GLP-1, which is released in the intestines when we eat. This hormone promotes the production of insulin, which stimulates cells to take up glucose and thus lowers blood glucose levels. GLP-1 also slows gastric emptying and prolongs feelings of satiety. Additionally, it suppresses appetite, which makes people want to eat less and induces weight loss.
Tirzepatide mimics GLP-1, as well as another hormone released by the intestine to stimulate insulin production called glucose-dependent insulinotropic polypeptide (GIP). Although GIP is not as well studied as GLP-1, it appears to have a similar effect. Tirzepatide has this dual effect on GLP-1 and GIP, whereas semaglutide targets GLP-1 only. It is important to note that we do not have results from studies comparing these two drugs side by side.
CNN: How promising are these drugs for treating obesity?
Wen: Of the two drugs, semaglutide is the better studied. A 2022 study, published in JAMA Open Network, found that the average weight loss of study participants after taking it for three months was 6.7 kilograms (14.8 pounds), or a 5.9% reduction in body weight. After six months, he weighed 12.3 kilograms (27.1 lb), or 10.9%.
Another study, published in The New England Journal of Medicinefound a mean body weight loss of 14.9% from baseline to more than a year later in the semaglutide group, compared with 2.4% in the placebo group.
According the Eli Lilly press release, it appears that the company also achieved a very high rate of weight loss. For those taking the highest dose of tirzepatide, patients lost an average of 15.6 kilograms (34.4 pounds), equivalent to a 15.7% reduction in body weight, over one year of treatment . These results are yet to be published in a peer-reviewed journal, but if they hold up, those would be really great results too.
I think the key to emphasize here is that obesity is a chronic medical condition that increases the risk of developing many other diseases, including heart disease, diabetes, high cholesterol, and many forms of cancer. Obese patients also experience higher rates of sleep apnea, arthritis, back pain, and depression, and are at higher risk of early mortality. It is really important to treat obesity like the disease that it is, and it is crucial to have effective medications to do so.
CNN: What side effects should people be aware of?
Wen: Virtually all medications and therapies have side effects. These are no different.
The most common side effects are gastrointestinal upset, such as nausea, diarrhea, vomiting, and constipation. The drugs have been associated in rare cases with pancreatitis and gallbladder problems, and some patients may experience low blood sugar while taking them. Some animal studies have linked them to thyroid tumors, and although this has not been seen in humans, patients are advised against using any of these drugs if they or their relatives have had a type of thyroid cancer known as medullary thyroid carcinoma.
Also, these are injectable drugs. As such, there could also be pain, swelling, and redness at the injection site. And because these drugs are relatively new, the long-term effects aren’t known, and it’s also not known how long people should keep taking them.
Anecdotally, many patients have regained their weight soon after quitting.
CNN: Who is eligible to take them?
Wen: Semaglutide is marketed under the brand name Ozempic for the treatment of diabetes and Wegovy for the treatment of obesity. For Ozempic, it is approved only to treat type 2 diabetes. For Wegovy, patients are eligible if they have a body mass index or BMI of 27 or higher. They should use it in conjunction with lifestyle modifications, including increased physical activity and an improved diet.
Tirzepatide, also known as Mounjaro, is only approved by the FDA to treat type 2 diabetes. However, like other prescription drugs, it can be prescribed for what doctors refer to as off-label use. Some doctors prescribe Mounjaro and Ozempic for the treatment of obesity, even though they (are not) approved by the FDA for this purpose.
CNN: Who shouldn’t be taking these drugs? What if someone wants to lose a few pounds for a wedding or event? Should I accept them?
Wen: Well, you just described the type of person who should not take these drugs. Type 2 diabetes and obesity are serious medical conditions. These drugs should be reserved for people with these conditions.
These are not drugs to be taken by non-diabetics who are not obese. Also, people who are considered overweight or obese based on BMI may not need these drugs. In general, as with other chronic conditions of hypertension and diabetes, people should first try lifestyle modifications. Only if these modifications do not work should medications be considered in consultation with your doctor, and even then, lifestyle changes should continue.
I want to emphasize that these are not medicines to be used for vain purposes. Someone who is trying to lose a few pounds for a wedding or event should not take them for a number of reasons. First of all, it is very likely that once the person stops taking the medication, the weight will immediately return. Second, there are better ways to lose weight and, more importantly, to maintain good health. Third, this is not what the drug is intended for. Given the drug shortages that have occurred, a person taking them for this type of short-term use could take them away from patients who really need them for their medical conditions.
—————————————————-
Source link