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How promising are new drugs to treat obesity?

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(CNN) of Pharmaceutical company Eli Lilly announced Last week, tirzepatide, a drug developed to treat diabetes, also had considerable effect in losing weight.

In a study of over 900 adults with obesity and diabetes, tirzepatide not only controlled blood sugar levels, but also helped those taking the higher doses lose an average of 34 pounds. This was almost 16% of the starting weight. news release. The participant took the drug for 1 year and 5 months.

Eli Lilly plans to apply for approval by the U.S. Food and Drug Administration to market tirzepatide for the treatment of 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.celebrity Claims to be used as a weight loss tooland its widespread use has caused a shortage of medicines.

How do semaglutide and tirzepatide work? How promising are they for treating obesity? What are the side effects? Who qualifies? What if you want to lose a few pounds for a wedding or event?

To answer these questions, we spoke with CNN Medical Analyst Dr. Leana Wen. Wen is an emergency physician and George She is a professor of health policy and management at the University of Washington’s 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. Liana Wen: Both of these injections were originally developed to treat type 2 diabetes. In the course of conducting clinical trials, studies have also found that they have a substantial effect on weight loss.

Semaglutide mimics a digestive hormone called glucagon-like protein-1 (GLP-1), which is released from the intestine during meals. This hormone stimulates insulin production, which causes cells to take up glucose and lower blood sugar levels. GLP-1 also slows gastric emptying, prolonging satiety. It also suppresses appetite, which leads to less appetite and weight loss.

Tirzepatide mimics GLP-1 and another hormone released from the intestine to stimulate insulin production called glucose-dependent insulinotropic polypeptide (GIP). GIP has been less studied than GLP-1, but appears to have similar effects. Tirzepatide has this dual effect on GLP-1 and GIP, whereas semaglutide only targets GLP-1. It is important to note that no studies have compared these two drugs side by side.

CNN: How promising are these drugs for treating obesity?

Wen: Of the two agents, semaglutide is the more well-studied agent.2022 study published in JAMA network openfound that study participants had an average weight loss of 6.7 kilograms (14.8 lbs), or a 5.9% weight loss after taking 3 months. , or 10.9%.

Another study published in New England Journal of Medicinefound a mean weight loss of 14.9% from baseline to over a year later in the semaglutide group, compared to 2.4% in the placebo group.

Semaglutide is marketed under the brand name Ozempic for the treatment of diabetes.

according to News release from Eli Lilly, the company also appears to have achieved a very high rate of weight loss. Patients taking high-dose tirzepatide lost an average of 15.6 kilograms (34.4 pounds) over 1 year of treatment, which is 15.7%. equivalent to weight loss. These results have not yet been published in a peer-reviewed publication, but if this is maintained, these will also be very good results.

An important point to emphasize here is that obesity is a chronic medical condition that increases the risk of developing many other diseases such as heart disease, diabetes, high cholesterol and various forms of cancer. Patients also have a higher incidence of sleep apnea, arthritis, back pain, depression, and an increased risk of early death. It is very important to treat obesity as a disease, and it is very important to have effective drugs for it.

CNN: What side effects should I be aware of?

Wen: Almost all drugs and treatments have side effects. These are the same.

The most common side effects are gastrointestinal discomfort such as nausea, diarrhea, vomiting and constipation. The drugs are rarely associated with pancreatitis and gallbladder problems, and some patients may experience hypoglycemia while taking them. Although not seen in humans, patients or their families medullary thyroid cancer.

Moreover, these are injectable drugs. This may cause pain, swelling, and redness at the injection site. Also, because these drugs are relatively new, we don’t know their long-term effects or how long they should be taken.

Anecdotally, many patients quickly regained their weight after discontinuation.

CNN: Who is Eligible?

Wen: Semaglutide is marketed under the brand names Ozempic for diabetes and Wegovy for obesity. Ozempic is only approved for the treatment of type 2 diabetes. For Wegovy, patients with a BMI greater than or equal to her 27 are eligible. It should be combined with lifestyle changes such as increased physical activity and improved diet.

Tirzepatide, also known by its brand name Munjaro, is only approved by the FDA for the treatment of type 2 diabetes. However, like other prescription drugs, they can be prescribed for what is called off-label use by doctors. It has not been approved by the FDA for any purpose.

CNN: Who should not take these drugs? What if you want to lose a few pounds for a wedding or event?

Wen: Now, you described the types of people who shouldn’t take these drugs. Type 2 diabetes and obesity are serious medical conditions. These drugs should be reserved for individuals with these conditions.

These are not drugs for obese, non-diabetic people to take. Additionally, individuals who are considered overweight or obese based on their BMI may not need these medications. In general, as with other chronic diseases such as hypertension and diabetes, lifestyle changes should be attempted first. Medication should be considered in consultation with your doctor only if these changes do not work. Even then, lifestyle changes should continue.

I would like to emphasize that these are not drugs to be used for vanity purposes. People trying to lose a few pounds for a wedding or event should not take them for a number of reasons. First, once the person stops taking the drug, the weight is very likely to return quickly. Second, there are better ways to lose weight and, more importantly, to stay healthy. There are better ways to do this. Third, this is not what the drug is intended for. , may deprive patients of their medical condition who really need it.

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