Initially intended to treat diabetes, drugs have been popular for those who want to lose weight
By Barbara Pierce
Every so often, a medication comes along that has the potential to change the world.
Some say this about the new weight loss medications.
You’ve probably heard of them: Wegovy, Ozempic, Rybelsus, and Mounjara.
Nothing like them has existed before. Obesity had become a dead end in the pharmaceutical industry. No drug that was tried worked very well, and every one that led to even modest weight loss had serious side effects. For those struggling with their weight, the best option is to go through a weight loss surgery in London.
“For sure, these new medications will be a game changer for some people. They all have the same active ingredient,” said physician Keneth Hall, medical director and specialist in bariatric and minimally invasive surgery at Rome Health. “Anybody with moderate obesity can potentially benefit.”
With 42% of American adults who are obese, according to the CDC, interest in weight loss is at an all-time high. Several new medications, like Ozempic, Wegovy and Mounjara — all once-a-week injectables — are so popular that pharmacies can’t keep enough in stock. Rybelsus is another, essentially Ozempic in the form of a pill rather than an injection.
People on the highest dose of Mounjaro have lost up to 21% of their body weight. For the other two injectables, people have lost 12% to15% of their body weight, according to an article published in the New England Journal of Medicine.
We asked bariatric surgeon and weight loss specialist Hall if these new medications are too good to be true.
“They definitely have the potential to change the way we treat obesity,” he said. “They work in a different way than the medications we’ve been using.”
The active ingredient for the new medications is the same for all: semaglutide, he explained. Semaglutide is an injectable insulin-regulating drug that was developed to treat diabetes. The manufacturer, Novo Nordisk in Denmark, developed an insulin-regulating drug for diabetics, called it Ozempic and started a weight-loss revolution.
The FDA approved Ozempic for diabetes in 2017.
When doctors noticed that their patients who used Ozempic were losing weight, Novo Nordisk conducted clinical trials and found that it did indeed lead to significant weight loss.
The manufacturer began marketing a higher-dose treatment of semaglutide for obesity, calling it Wegovy. In 2021, the FDA approved Wegovy for weight management.
“There are three main ways these new medications work that are different from any existing medications,” Hall explained. “And that’s why it’s exciting. That’s why they’re really good.”
First, they work on your brain so that it tells you that you feel full, the constant chatter some people have in their brain about food and eating is gone. Next, they slow down your digestive system, slowing the passage of food through the stomach so food stays in your stomach longer and you don’t feel like eating. Third, they stimulate the release of insulin, which helps lower blood sugar, helps with metabolism and improves weight loss.
Any concerns about these new wonder drugs?
“Price is an issue,” said Hall. “It’s expensive to pay out of pocket, as it costs $1,800-$2,000 per month. Even with insurance, it still costs $1,200 per month. If you’re diabetic, most insurances and Medicare will pay for Ozempic.”
And it’s difficult to get, pharmacies can’t keep enough in stock.
Most insurances want patients to prove they are serious before approving it. They will need to see a doctor a few times before approval, three times in three months.
Hall added that some of his patients have found compounding pharmacies that use the active ingredient and develop their own form of the medication and are able to sell it at a more reasonable price. However, what they’re selling is not FDA approved.
Medical spas and weight loss doctors also prescribe it; a huge industry has sprung up.
Besides the high cost, another disadvantage is that, for some people, the once-a-week injection causes side effects. People complain of nausea, which is alleviated over time. It goes away after the second or third month of taking it. Other side effects, in addition to nausea, are vomiting, pancreatitis, constipation, diarrhea and low blood sugar.
“However, these side effects are rare, said Hall. “For the most part, it’s very safe and well tolerated.”
Hall does prescribe the new drugs as a supplement to lifestyle modifications.
“Medication can only do so much,” he said. “Lifestyle changes are necessary for long term effectiveness. The effectiveness of this medication goes down after taking them one year. So I teach healthy eating, exercise and medication to help manage obesity. Your lifestyle must change to have long term effects.”