In simpler terms, obesity is the product of a body’s energy output being less than its energy input. But in reality, there is nothing simple about this complex and mysterious disease.
Obesity, which has exploded in recent decades, which now defines the body mass of more than 40 percent of adult Americans, is not only difficult for people to bear and for scientists to understand. It is also incredibly difficult to deal with.
Beyond a commitment to sustained lifestyle changes (healthy eating and exercise, effectively), there are really only two potential options that can help: bariatric surgery and weight loss medications.
The former is invasive and carries several risks and complications. As for medications, they don’t always work and they can also have their own adverse effects.
However, an experimental treatment recently tested by scientists and detailed in a study published this week could open new doors for treating obese patients with a weight-loss drug.
In the study, which involved nearly 2,000 obese adults in 16 different countries, participants took a weekly dose of a drug called semaglutide, an existing drug already used in the treatment of type 2 diabetes.
A control group took only a placebo, instead of the drug. Both groups received a lifestyle intervention course designed to promote weight loss.
At the end of the trial, the participants who took the placebo lost a small but clinically insignificant amount of weight. But for those who took semaglutide, the effects were pronounced.
After 68 weeks of treatment with the drug, which suppresses appetite due to a variety of effects on the brain, participants taking semaglutide lost an average of 14.9 percent of their body weight. And more than 30 percent of the group lost more than 20 percent of their body weight.
Overall, this makes the drug up to twice as effective as existing weight-loss drugs, the researchers say, approaching the kind of efficacy of surgical interventions.
“No other drug has come close to producing this level of weight loss – this is really a game changer,” says obesity researcher Rachel Batterham of University College London.
“For the first time, people can achieve through medication what was only possible through weight-loss surgery.”
In addition to losing weight, the participants recorded improvements in other areas, showing reductions in various cardiometabolic risk factors and reporting improvements in quality of life.
While the results are compelling, the dose of semaglutide for anti-obesity effects has some drawbacks.
Many participants reported mild to moderate effects (in the semaglutide and placebo groups), including nausea and diarrhea. While the effects were temporary, they were enough for nearly 60 of the participants to discontinue their treatment, compared with just five in the placebo group.
Currently, the drug requires a weekly injection to work, while patients likely prefer an oral form of the drug.
More significantly, we do not yet have data on what happened to the participants after the drug regimen stopped at the end of the trial.
For at least one person, however, who spoke with The New York Times, his weight began to slowly increase after the test ended.
“While drugs like this may be helpful in the short term for rapid weight loss in severe obesity, they are not a magic bullet for preventing or treating less severe degrees of obesity,” says nutritionist Tom Sanders, professor emeritus at King’s College London. , who did not participate in the study.
“Public health measures that encourage behavioral changes, such as regular physical activity and moderate energy intake from the diet, are still needed.”
No one would deny the wisdom of that, but if a more detailed analysis of semaglutide turns out to be positive, we could also be looking for an important new pharmaceutical option to help fight obesity.
And that option could come sooner than we think.
The study, funded by the pharmaceutical company Novo Nordisk, which sells semaglutide as an antidiabetic drug, is now being submitted as evidence to international health regulatory authorities, in support of a request to market the drug as a treatment for obesity.
The US FDA, together with its counterparts in the UK and Europe, is currently evaluating the data.
Findings are reported in The New England Journal of Medicine.