According to recent estimates from the Centers for Disease Control and Prevention, as many as 42% of adults and 20% of children under the age of 18 have obesity.

Adult Obesity Facts. CDC. May 17, 2022.

Childhood Obesity Facts. CDC. May 17, 2022.

 

Traditionally, many view obesity as a personal failing, assuming the condition results from poor lifestyle choices or a lack of desire to change and improve health.

 

Former diabetes drug shows obesity-fighting effects

 

In June 2021, the FDA approved a new drug, semaglutide (Wegovy), for the treatment of chronic obesity in adults, or those who are overweight, with at least one weight-related health condition, such as high blood pressure or diabetes.

FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014. FDA. June 4, 2021.

 

This injectable drug was previously only available for people living with diabetes—a glucagon-like peptide-1 (GLP-1) incretin. The medication works by stimulating pancreatic insulin and glucagon secretion, according to the authors of an article in Nutrients.

Michałowska J, Miller-Kasprzak E, Bogdański P. Incretin hormones in obesity and related cardiometabolic disorders: the clinical perspective. Nutrients. 2021;13(2):351.

(Ozempic, another brand name for semaglutide, is currently only FDA approved for people with diabetes.)

 

When injected in higher doses, and together with proper diet and exercise, GLP-1 incretins such as semaglutide stimulate distinct portions of the brain, ultimately resulting in appetite suppression and feelings of satiety, according to a report from UCLA Health.

Semaglutide for weight loss – what you need to know. UCLA Health. January 12, 2023.

Patients inject the medication subcutaneously once each week at a typical dose of 2.4 mg.

 

As demand grows, pharmaceutical companies remain hopeful they can develop the medication in different formulations to boost supply.

 

Changing the obesity conversation

 

Drugs like semaglutide are not a quick fix.

However, new medications indicated for obesity treatment show remarkable effectiveness with good safety profiles compared with older drugs.

An early study published in the New England Journal of Medicine found that patients receiving semaglutide were much more likely to lose significant amounts of weight compared with those taking a placebo.

Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021;384(11):989-1002.

At the end of the study, 86% of patients receiving the drug lost at least 5% of their baseline body weight compared with only 32% of those who received the placebo. Other improvements, such as cardiometabolic factors, inflammation markers, and physical functioning, were also noted among the benefits of semaglutide when compared to control groups.

 

First-hand reports from patients echo the benefits noted in the study. During an interview with PBS, several patients who took semaglutide to lose weight touted the drug’s effectiveness. For those patients, and for a growing number of people, using the drug wasn’t simply about losing weight.

This may help change the way obesity is viewed among medical professionals and the public—instead of seeing it as a problem to be fixed, more people view obesity as a chronic medical condition. As such, it may be important for some people to take medications like semaglutide long-term to maintain a healthy weight.

 

Prescribing considerations for semaglutide

 

New obesity management drugs are not appropriate for all patients. Doctors should consider patients’ medical history, comorbidities, and body mass index (BMI) when prescribing the drug.

Per UCLA Health, semaglutide is only appropriate for patients with a BMI of 27 or higher, with at least one other weight-related health condition, such as high blood pressure. (Patients with a BMI of 30 or higher may be prescribed semaglutide without the presence of other medical conditions.) Semaglutide is not appropriate for certain patients, such as those with a history of gallbladder disease, medullary thyroid cancer, pancreatitis, or multiple endocrine neoplasia syndrome type 2.