Do new weight loss drugs work? There are several FDA approved weight loss injectable drugs on the market. Here is some helpful information about them if you are considering taking one on your weight loss journey.

The New Weight Loss Drugs

There are several new drugs:
• Saxenda, is a GLP-1 receptor agonist, a class of drugs used to treat type 2 diabetes but now often marketed for weight loss — even for those without diabetes.

• A newer drug of this class is semaglutide (sold under the brand name Wegovy), which was approved in 2021 and was found, on average, to reduce weight by 15% in one clinical trial where people took the drug for 68 weeks.

• And now, a related drug called tirzepatide may be even more promising. It’s the first to activate receptors for both GLP-1 and a second molecule called GIP.

How do these drugs work?

The two molecules, GLP (glucagon-like peptide 1) and GIP (glucose-dependent insulinotropic polypeptide or gastric inhibitory polypeptide), are hormones that are released by the intestine when you eat; they stimulate insulin release, lower blood sugar, and send a signal to the body that you are full.

These medications, which mimic the hormones, can enhance insulin release, resulting in a slower digestive process and reduced appetite, thereby encouraging weight loss.

But, there’s no such thing as a magic pill, nor is there a magic injection, for weight loss. For people taking these medicines, modifications to diet and physical activity are a must.

Sides Effects and Risks

• Many have also reported rough gastrointestinal side effects. About 80% of participants in tirzepatide’s clinical trial reported a side effect, most often nausea, diarrhea, and constipation, and 4% to 7% of people had to stop taking it due to side effects.

• These drugs have also been linked to a risk of thyroid cancer in animal studies, but that has not been proven to be a risk in humans.

• They also carry a risk of causing other rare but dangerous side effects, like pancreatitis and gallbladder disease.

Do New Weight Loss Drugs Work?

But the big question is do new weight loss drugs work?

• Some people taking the weight loss drugs experience lackluster results, and no one knows exactly why.

• In the tirzepatide trial, in which about half of participants lost 20% or more of their body weight on the higher doses of the drug, but about 9% of people lost less than 5%.

The medications can be expensive

• The retail price for liraglutide (Saxenda) and semaglutide (Wegovy) injector pens is around $1,700 per month for uninsured patients in the United States.

• The type 2 diabetes formulations of these medications also have high price tags, though they are significantly lower. The retail price for Ozempic and tirzepatide is about $1,100, or about $600 less per month.

• Some insurance companies won’t cover some GLP-1 agonists.

• For example, Medicare and most insurance companies won’t cover Wegovy.

There is a Shortage of These Drugs

Irrespective of the cost, new prescriptions of Wegovy have been temporarily halted. Novo Nordisk, the manufacturer of both Wegovy and Ozempic, has had to shift its production schedule in the face of its third-party vendor’s shortage of needle pens used to deliver the medicine.

• In order to continue serving patients who are already taking Wegovy, Novo Nordisk is currently only producing the two highest doses, 1.7mg and 2.4mg, and the company has said it hopes to be able to fulfill the increasing demand for Wegovy by the second half of 2022.

It’s not clear if you need to take them indefinitely to maintain weight loss

One person’s experience in taking Saxenda was that she was better able to manage her diet without facing constant hunger. But then her weight started to plateau. Even when she was taking the highest dosage of the drug, her appetite returned, so she stopped taking the weekly injection. Soon, she returned to her peak weight.

“After I quit taking it, I stopped doing a lot of the things I should have been doing, like tracking my food and weighing myself regularly. And within a few weeks, I was back to full force,” she said. “If you don’t change your behaviors, then it’s just a short-term fix, right?”

She is trying Wegovy next. However, because of the shortage in low-dose versions of the drug, she may be more likely to experience nausea as a side effect. Her doctor prescribed an anti-nausea medication just in case, and she notes there are “not many options.”

Dr. Sean Wharton, an internal medicine physician in Toronto, believes these medicines empower people to make healthy lifestyle changes.

• But he cautions that just as with any other chronic conditions of the mind or body, people experiencing health problems related to obesity will likely always require some form of treatment.

• The drug doesn’t melt fat. All it does is allow you to change your behavior.

• But since we know that this is a chronic medical biological condition, then patients can’t come off the medication ever, just like with any other medication for any other chronic condition.

• Wharton also believes the idea that people can or should be weaned from medication is actually counterintuitive and harmful.

Dr. Cindy Duke, a reproductive endocrinology and infertility specialist based in Las Vegas, has a different perspective.

• She believes that even though her patients with obesity and/or prediabetes may take liraglutide and semaglutide, this doesn’t necessarily mean they’ll need a lifelong prescription.

• I’m not a proponent of keeping people on medicines they don’t need to be on.

• If someone can maintain their loss because they’ve learned how to manage their diet, how to exercise, how to really help their body reprogram their insulin sensitivity response, I love to see that.

• I’d like to at least see patients have an opportunity to wane their dose in the future or come off completely.

• When she has someone taking anti-obesity medication who decides they are ready to conceive, Duke tapers their dosage.

They aren’t for those with short-term weight loss goals

If hype around these medications has you wondering if perhaps this new class of drug might be the answer to your short-term plan to lose a few pounds

before an upcoming wedding, experts say these drugs are not for you.
Anti-obesity medications are not for those who might be able to modify their behaviors on their own, Wharton said.

“If someone wants to lose 10 pounds, they can do it with behavioral changes. They can exercise more or eat better. If you need to lose 10 pounds, I’m not talking to you,” he said. “But dealing with chronic obesity is a neurological science question, not a behavioral science question like everyone wants it to be.”

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