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The Problematic Arrival of Anti-Obesity Drugs

The success—and mushrooming popularity—of these drugs brings us to a crossroads. We can make bigger bodies smaller with them, but does that mean we should? They promise to help people whose weight poses a health risk. And by shedding more light on what drives obesity, they could also chip away at harmful stereotypes that being overweight is simply a personal failing. At the same time, framing fatness as a disease to be done away with could lead to even greater stigma—as well as turbocharging society’s obsession with thinness.

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Featured

 Are the New Weight Loss Drugs Too Good to Be True?

The real answer isn’t “yes” or “no.” Here are six things you need to know.

 GLP-1 Medications: The Good, The Bad, & The Ugly!

How these powerful medications can be used, misused, or abused!

 GLP-1 weight-loss drugs are revolutionary – and they’re exposing America’s healthcare crisis

New GLP-1 drugs – a class that includes Wegovy and Ozempic – have revolutionized our understanding of weight loss, but they have also illuminated the flaws in our healthcare delivery. People who have struggled with their weight for their entire lives are rightfully frustrated when they learn there is now a medication that can help them but they cannot access it.

 If GLP-1 Drugs Are Good For Everything, Should We All Be on Them?

Studies show that the obesity and diabetes medication also reduces heart attacks, cancer risk, migraines, and memory loss. How is that even possible? And at what point should we all be on it? Several years ago, scientists took a close look at GLP-1 drugs, such as Ozempic, and learned that they were good at helping people lose weight. Then they took an even closer look and learned the drugs are also good at just about everything else.

 Preserving muscle with GLP-1 weight loss drugs: Big deal or nothing to worry about?

In our research work, my colleagues and I use our findings to encourage everyone to exercise, and particularly to include resistance training — load-bearing exercise with the aim of gaining or at least maintaining muscle mass and strength. Losing muscle can have a significant, direct effect on our quality of life. We need strength to reduce the risk of falls and muscle to reduce the risk of metabolic diseases such as Type 2 diabetes, which in older age can have severe outcomes. So, while losing weight is an excellent way to improve our health, it should bear the caveat of not losing muscle, especially in older persons.

 Research shows GLP-1 receptor agonist drugs are effective but come with complex concerns

These drugs are extremely effective for blood glucose control and weight management, which, combined with their relatively limited side effect profile, makes them very appealing for diabetes treatment — the purpose for which they originally received FDA approval. However, off-label use fueled by celebrities and social media is a growing concern. And even when physicians are prescribing GLP-1RAs for their intended uses, it’s not a magic formula — there are complex considerations such as dosages, costs, side effects and comparisons between specific drugs. “The current fervor for GLP-1RAs in the capital markets as well as in the general public, especially in terms of weight reduction, is probably going to result in overuse,” said Chun-Su Yuan, MD, PhD, the Cyrus Tang Professor of Anesthesia and Critical Care at the University of Chicago. “This should raise a red flag.”

Previously Featured

GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus

Adverse effects of GLP-1 receptor agonists include nausea, vomiting and diarrhoea, injection-site reactions, antibody formation and increased heart rate

GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects

Glucagon like peptide-1 (GLP-1) is a 30 or 31 amino acid long peptide hormone mainly secreted by 3 tissues in the human body: enteroendocrine L cells in the distal intestine, alpha cells in the pancreas, and the central nervous system. Through its interaction with the GLP-1 receptor (GLP-1R), GLP-1 participates in the regulation of glucose homeostasis. In addition, glucagon like peptide-1 receptor agonists (GLP-1RAs) can be combined with GLP-1Rs, playing the same role as GLP-1.

Glucagon-Like Peptide 1 Receptor Agonists for Type 2 Diabetes

Administration of GLP-1 receptor agonists stimulates GLP-1 receptors, thereby increasing insulin secretion in response to oral and intravenous glucose to similar extents; this means the magnitude of the incretin effect should remain unchanged

Incretin Mimetics (GLP-1 Agonists)

The drugs, also commonly known as glucagon-like peptide 1 (GLP-1) receptor agonists or GLP-1 analogues, are normally prescribed for patients who have not been able to control their condition with tablet medication.

What is GLP-1 & Does it Affect Weight & Cognition?

Some scientists hypothesize that GLP-1 decreases appetite by acting on specific areas in the brain. One side effect of GLP-1 agonists is weight loss, which is usually desired in patients with type 2 diabetes. However, GLP-1’s effects on weight haven’t been properly verified in humans without diabetes.

Diabetes and Obesity Drugs Are Going Viral On TikTok As a Quick Way to Lose Weight

Here's why that's problematic.

Do GLP-1 Supplements Work? Doctors Set the Record Straight on ‘Nature’s Ozempic’

Brands like Kourtney Kardashian’s Lemme are claiming to provide the same benefits as GLP-1 medications like Ozempic, Wegovy, and Mounjaro. But the truth is, these supplements have little to nothing in common with the drugs.

Effects of GLP-1 on appetite and weight

GLP-1 in both physiologic and pharmacologic doses promotes satiety, affects mechanistic properties of the GI tract and results in negative energy balance. Additionally, its success in promoting weight loss makes GLP-1 agonist therapy an attractive option in the management of type 2 diabetes. What needs to be balanced against this is the reported association between GLP-1 receptor agonist therapy and pancreatitis, pancreatic hyperplasia and pancreatic neoplasia.

New drugs could spell an end to the world’s obesity epidemic

The long-term effects must be carefully studied. But the excitement is justified. A new type of drug is generating excitement among the rich and the beautiful. Just a jab a week, and the weight falls off. Elon Musk swears by it; influencers sing its praises on TikTok; suddenly slimmer Hollywood starlets deny they have taken it. But the latest weight-loss drugs are no mere cosmetic enhancements.

Patients Cut Off From Cheaper Obesity Drugs as the F.D.A. Halts Sales of Copycats

U.S. regulators are trying to shut down the industry for compounded weight-loss drugs, which could result in higher costs or suspend treatment for patients.

The benefits of GLP-1 drugs beyond obesity

The decades-long use of GLP-1 medicines, principally acylated peptides such as liraglutide and semaglutide, for the treatment of obesity and T2D has revealed that they also exert pleiotropic actions beyond glucose and weight control, such as reduction of heart and kidney diseases. There are several potential mechanisms underlying these benefits, such as reducing systemic inflammation, which have implications for future clinical applications and drug development.

The Effect of Glucagon-Like Peptide 1 Receptor Agonists on Weight Loss in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison Meta-Analysis

This review provides evidence that glucagon-like peptide-1 receptor agonist therapies are associated with weight loss in overweight or obese patients with type 2 diabetes with no difference in weight loss seen between the different types of GLP-1 receptor agonists assessed.

The therapeutic potential of GLP-1 receptor biased agonism

At present, most evidence derives from cellular and animal studies, and more human data are required to determine whether this approach represents a genuine therapeutic advance.

The unintended side effects of popular weight loss drugs

You’ve probably heard a lot about Ozempic and Wegovy, the semaglutide wonder drugs for weight loss. Their newfound popularity with prescribers and online pharmacies has sparked a global shortage. Other diabetes medications are now also being repurposed for weight loss: On Wednesday, the FDA approved Zepbound, another version of Mounjaro, for chronic weight management.

The Weight-Loss-Drug Revolution Is a Miracle—And a Menace

How the new obesity pills could upend American society.

Torrid market for copycat weight loss drugs could be short-lived

The legal copycats are compounded drugs. They’re prepared by pharmacists using ingredients bought from suppliers registered with the Food and Drug Administration. In this case, pharmacies are buying semaglutide, the active ingredient in Wegovy and Ozempic, and tirzepatide, the active ingredient in Zepbound; preparing it for consumer use; and then offering it through telehealth websites or med spas.

Wegovy works. But here's what happens if you can't afford to keep taking the drug

"What the pharmaceutical companies have done is taken this hormone that is naturally occurring and restructured it into a drug," he explains. So, it's not a surprise that when people stop taking the medicine, they start to feel hungrier, he says. "I crave sweets," Hamilton says. And her appetite has increased. She no longer feels satisfied with small meals. "I'm losing my energy" as the weight comes back, she says.

Weight-loss drugs aren't a magic bullet. Lifestyle changes are key to lasting health

The headlines are compelling, with phrases like, "The Obesity Revolution," and "A new 'miracle' weight-loss drug really works." The before-and-after pictures are inspiring. People who have struggled for decades to shed pounds are finally finding an effective strategy.

What New Weight Loss Drugs Teach Us About Fat and Free Will

The new drugs are the first to manipulate the hormonal regulatory systems governing energy balance. The drugs simulate the action of our native GLP-1 but with longer-lasting effects, amplifying the fullness signal inside the body. People who struggle to feel sated suddenly don’t, effectively giving “someone the willpower of those lucky enough to have won the genetic lottery,” said Dr. Brierley.

What You Need to Know About Compounded Versions of Popular Weight Loss Drugs

But as with many situations in which supply far exceeds demand, questionable versions of these drugs are making their way into desperate patients’ hands, and doctors are concerned about what exactly these versions contain. Some online sellers are exploiting the opportunity to cash in, selling knockoffs of Wegovy, whose active ingredient is semaglutide, that may not even contain semaglutide.

Who Deserves the New ‘Miracle’ Weight-Loss Drugs?

Injections meant to treat type 2 diabetes have been found to help people lose weight — now, TikTok has become a place of discussion and potential misinformation.

‘Robbing Peter to pay Paul’: Obesity experts debate risks of new weight loss drugs

Amid rising demand for drugs like Wegovy, Ozempic, and Mounjaro that can lead to significant weight loss, some obesity experts are concerned about the drugs’ costs — both to patients’ finances and to their health.

Resources

GLP-1 Agonists

GLP-1 agonists are used to lower blood sugar levels to treat diabetes type 2 by releasing more insulin into the bloodstream.

Non-insulin Injectable Diabetes Medications

You might be wondering why anyone would take these drugs, since they must be injected. These drugs do lower HbA1c levels, but only by 0.5% to 1.5%. They’re also only used as a second or third agent, not by themselves. One of the main draws of these drugs is that they do lead to weight loss in about 80% of users, and they seem to curb hunger, making it a good choice for people who constantly feel hungry. Weight loss eventually plateaus, however, so keep that in mind.