Explained: The New Era of Blockbuster Weight-Loss Drugs

In Pakistan, as of June 22, a novel class of weight-loss medications has shown remarkable efficacy, gained significant popularity, and generated substantial profits over recent years; however, these drugs come with certain downsides.

Following Friday’s decision in France allowing all physicians, not only specialists, to prescribe certain medications, here are several important questions regarding these drugs.

How do they work?

Among the prominent members of this emerging class of medications are Novo Nordisk’s Ozempic and Wegovy from Denmark-based pharmaceutical company Novo Nordisk, along with Mounjaro from the American firm Eli Lilly.

These drugs boost the function of a hormone in the pancreas known as "glucagon-like peptide 1," referred to as GLP-1, which names this class of medication.

The hormone influences insulin secretion; therefore, it was initially focused on for developing medications to fight diabetes.

However, it was discovered that GLP-1 medications also decrease hunger by causing individuals to feel more satiated.

A revolution?

Experts in obesity now concur that these medications represent a groundbreaking milestone in the annals of weight loss efforts. In the past, surgical interventions were primarily used for severe cases where dietary changes and physical activity proved insufficient.

This is not an easy accomplishment. The global impact of obesity, affecting 900 million individuals around the world, is viewed as a significant crisis.

The new medications address a significant gap in treatment needs since obesity was among the very few long-term conditions with limited pharmaceutical options, according to French endocrinologist Emmanuel Disse who spoke to AFP.

In clinical trials, the medications have demonstrated a reduction in individuals' body weight by approximately 15 to 20 percent on average.

Limitations?

Nevertheless, these medications come with certain drawbacks, such as potential side effects.

The medication semaglutide, utilized in Ozempic, received approval for treating diabetes back in 2017; consequently, there is currently almost ten years of studies available regarding its usage.

A comprehensive study utilizing health records from hundreds of thousands of U.S. veterans, which was released in January, revealed that GLP-1 medications do not appear to increase the likelihood of cardiovascular issues or suicidal ideation, contrary to earlier concerns.

Nevertheless, there are infrequent instances of severe side effects, including potential harm to the pancreas, it stated.

They often lead to nausea, vomiting, migraines, and disrupted sleep, potentially making these medications unappealing to certain patients.

These medications may not be effective for everybody; some individuals who take them might not experience weight loss.

The impact only persists as long as individuals continue taking the medication, suggesting that they might require continuous therapy indefinitely.

They can be quite costly as well, often reaching upwards of $1,000 per month in the U.S., whereas in France they might cost around 300 euros ($340).

The medications are currently limited to injectable formats; however, pharmaceutical companies are working on daily oral tablets that have demonstrated promising results in preliminary tests.

Who should use them?

National health organizations have stressed that these medications should be prescribed solely for individuals who are overweight or obese and for whom efforts such as physical activity and dietary changes have not been effective.

Nevertheless, substantial evidence indicates that some individuals who are not obese take these medications merely to shed a few additional kilograms.

The French medication regulatory body, ANSM, stated that these drugs "should not be utilized for weight reduction with aesthetic goals." They cautioned that improper usage might subject individuals to "potentially severe adverse effects."

What next?

Steven O'Rahilly, who leads the Institute of Metabolic Sciences at Cambridge University, informed AFP that he firmly believes there will be "a swift advancement of medications that are not only more efficacious but also come with reduced side effects, lower costs, and greater ease of use."

He noted that it might pose a greater challenge to integrate all four advancements into one medication.

As trillions of dollars hang in the balance, pharmaceutical companies are competing fiercely to be the inaugural company to launch a novel therapy.

The preliminary findings of Novo Nordisk’s investigational medication, amycretin, suggest it may outperform current GLP-1 treatments, as reported in The Lancet over the weekend.

Additionally, a burgeoning area of study has highlighted the possible advantages of GLP-1 medications extending beyond weight management.

They've been associated with enhancements across various health issues, such as dementia and addiction. However, it remains uncertain whether these benefits stem directly from the medications or are connected to better management of conditions like obesity or diabetes.