Every so often, a drug emerges with the potential to revolutionize the world. According to medical experts, the latest contenders to hold that possibility are the new drugs designed to treat obesity, such as Ozempic, Wegovy, Mounjaro, and others that may soon hit the market. These drugs are unlike anything seen before.
According to Jonathan Engel, a historian of medicine and health care policy at Baruch College in New York, these drugs are “game changers.” Despite affecting nearly 42 percent of American adults, the treatment of obesity has been challenging. Past research into potential medical treatments for obesity failed, leading drug companies to lose interest. Many believed that obesity was a moral failing rather than a chronic disease.
Unlike other drugs discovered through a logical process with clear drug targets, the path to discovering obesity drugs was different. Much about these drugs remains a mystery. Researchers stumbled upon the idea of using a natural hormone in the brain to induce weight loss. However, they still don’t fully understand why it works.
Dr. David D’Alessio, chief of endocrinology at Duke, admits that there isn’t a logical explanation or predictable order to these drugs’ effectiveness. While these drugs appear to be safe, caution is advised by obesity medicine specialists. Similar to drugs for high cholesterol or blood pressure, obesity drugs must be taken indefinitely to prevent weight regain.
Dr. Susan Yanovski, co-director of the office of obesity research at the National Institute of Diabetes and Digestive and Kidney Diseases, warns of potential rare but serious side effects. As scientists still don’t understand fully why these drugs work, monitoring patients is crucial. However, the risks associated with obesity itself, such as diabetes, liver disease, heart disease, cancers, sleep apnea, and joint pain, cannot be ignored.
Although these drugs can cause temporary side effects like nausea and diarrhea, their main effect is what matters. Patients report reduced cravings for food, satisfaction with smaller portions, and natural weight loss due to decreased appetite. Recent clinical trials even suggest that Wegovy can protect against cardiac complications like heart attacks and strokes, but the exact mechanism remains unclear.
Dr. Daniel Drucker, an expert in diabetes and obesity, acknowledges that while drug companies prefer not to admit it, there is an element of trial and error involved. The discovery of GLP-1, a hormone that regulates blood sugar, had a lonely origin story. Dr. Joel Habener and Dr. Jens Juul Holst independently discovered GLP-1’s potential but struggled to make it last longer for effective treatment.
A chance discovery by Dr. John Eng with the Gila monster led to the identification of a GLP-1 variant that lasted longer. This became the basis for the drug exenatide or Byetta, approved for use in the United States in 2005. Further research and modification led to the creation of liraglutide or Saxenda, initially approved as a diabetes treatment but causing unexpected weight loss.
Obesity has historically been a challenging area for pharmaceutical companies, with previous drug attempts yielding poor results and serious side effects. Even promising discoveries like leptin failed to produce weight loss in humans. Attempts to target different gut hormones, such as ghrelin, also proved unsuccessful due to the complex interplay of various factors controlling weight.
Despite the challenges, new obesity drugs like Ozempic, Wegovy, Mounjaro, and others are providing hope in the fight against obesity. While many questions still remain, these drugs have the potential to change lives and improve health outcomes in a population deeply affected by obesity.