A ‘game changer’ for weight loss

A new generation of breakthrough drugs promises to revolutionize the treatment of obesity. But there are also concerns. Here's everything you need to know:

What's the excitement?

For decades, researchers have been searching for a drug that can significantly reduce weight without dangerous side effects. Now they say that moment has come. Two drugs, Ozempic and Wegovy — different formulations of the compound semaglutide — have shown surprising results in helping people lose weight by suppressing their appetite. In a 15-month study conducted by manufacturer Novo Nordisk, the Danish company, obese people lost an average of 15 percent of their weight, or an average of 35 pounds per person. They also lowered blood pressure, cholesterol and markers of inflammation. A new drug, tirzepatide, which Eli Lilly sells under the name Mounjaro, did even better. In one study, users lost an average of 21% of their body weight. The revolutionary nature of the non-invasive treatment, which produces results comparable to gastric bypass surgery, cannot be overemphasized, doctors say. “This is truly a transformative breakthrough,” says German physician and obesity researcher Matthias Tschöp. Doctors and weight-loss experts agree that the market for these drugs will be huge.

How many people are likely to accept them?

tens of millions. About 40 percent of Americans are obese, and another 30 percent are overweight enough to increase the risk of heart disease, cancer and osteoarthritis. Morgan Stanley expects global sales of these “blockbuster” new drugs to exceed $50 billion by 2030. Soaring demand for the drugs has led to shortages, in part due to heated discussions on social media. The hashtag #Ozempic generated over 700 million views on TikTok. So far, only Wegovy is FDA-approved for treating obesity; Ozempic and Mounjaro are currently only approved for treating diabetes, but are widely used “off-label” for weight loss.

How do the medicines work?

They self-inject weekly through a prefilled “pen,” much like insulin is used. In the body, these drugs mimic hormones naturally produced in the gut that regulate blood sugar and hunger. Semaglutide mimics a hormone called GLP-1, while tirzepatide mimics this hormone and a second hormone, GIP. By sending satiety signals to brain receptors that control appetite, they make people feel full after small meals and can make once-painful cravings go away. “It used to be that if I saw food, I wanted to eat it,” said Rachel Graham, 54, of Carlsbad, Calif., who lost 40 pounds at Mounjaro after years of dieting failures. “Now, If I take three or four bites, I won't think eat more. ”

Are there any disadvantages?

Possible side effects include nausea, vomiting, diarrhea, and rapid heartbeat. Doctors say they are uncommon and improve with time and dose adjustments, but those who have had them say they are debilitating. “I had no energy, and I was constantly nauseous, what I call force-vomiting,” says Anna Toonk, a New York City-based podcaster who gave up Ozempic. Because these drugs are new, long-term effects are unknown — and since patients who stop taking them often regain weight, they may be long-term or even life-long advice. This exacerbates another problem: cost. Wegovy is running over $1,300 a month and Mounjaro is closer to $1,000. That puts them out of reach for many consumers, and insurance often doesn't cover them.

why not?

The history of previous generations of diet pills has been spotty, with insurers long dismissing obesity as a failure of willpower rather than a health condition. The medical community is changing this view because of overwhelming evidence that weight is stubbornly resistant to change, and that, for most obese people, diet and exercise can only reduce weight temporarily. “We now understand that obesity is not a character defect,” said W. Scott Butsch, an obesity medicine specialist at the Cleveland Clinic. “It's a dysfunction of the complex system that controls weight.” He and other experts hope the new drug will lead to changes in insurance. But given the number of potential users, the price of a drug like Mounjaro could be staggering for private insurers, Medicare and Medicaid. There are other reasons why the wonder drug gave them pause, obesity experts say.

What concerns?

Doctors worry that if weekly injections can lead to weight loss, people will forego the need to exercise and improve their diet. Fat-accepting advocates worry that the drugs add to weight stigma and force overweight people to conform to punitive society's weight-loss standards. Another problem is that these drugs are already used by people who are not obese, but who already use them as an easy way to lose 5 or 10 extra pounds. However, such concerns were outweighed by excitement about the drug's transformative potential. Drugs that can help patients lose 30 to 50 pounds or more are “game changers,” says John Buse, an endocrinologist at the University of North Carolina School of Medicine. “Obesity is on the ropes.”

sweeping hollywood

The exorbitant price of new diet pills is a hurdle for many — but it hasn't slowed down an explosion of interest among celebrities and wealthy urbanites looking for shortcuts to slimming down. Ozempic is “the drug of choice for the 1 percent today,” says Paul Jarrod Frank, a dermatologist on Manhattan's Upper East Side. “Everyone is either involved or asking how to be involved.” In body image-obsessed Hollywood, Ozempic has reportedly “saturated the industry” typeInterest in it came after reports that Kim Kardashian used it to lose 16 pounds and wear it to Marilyn Monroe's dress at last year's Met Gala. She denies it, but Elon Musk says semaglutide helped him lose 30 pounds. Reality show executive producer Patti Stanger says it's ‘Hollywood drugs' millionaire matchmaker“Everyone I know is on it.” However, Ozempic use by non-obese individuals has created new side effects: Dermatologists and plastic surgeons report a spike in visits complaining of sunken and sagging cheeks due to sudden weight loss . “I see it every day,” says Frank, who coined a term for the condition: “ozone face.”

This article was first published in the latest issue Week Magazine.If you want to see more likes, you can try six issues of risk-free magazine here.

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