In the simplest terms, obesity is the product of a body’s energy production being lower than its energy intake. But in reality, there is nothing simple in this complex and mysterious disease.
Obesity, which has exploded in recent decades – now defining the body mass of over 40% of adult Americans – is not only difficult for people to bear and understand by scientists. It is also incredibly difficult to treat.
Beyond the 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 first is invasive and presents various risks and complications. As for medicines, they do not always work and can have their own side 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 from 16 different countries, participants took a weekly dose of a drug called semaglutide, an existing drug already used to treat type 2 diabetes.
One control group took only one placebo instead of the medicine. Both groups received a lifestyle intervention course designed to promote weight loss.
At the end of the study, participants taking placebo lost a small but clinically insignificant amount. But for those taking 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 in treatment with semaglutide lost an average of 14.9% of body weight. And over 30 percent of the group lost more than 20 percent of their body weight.
Broadly speaking, this makes the drug twice as effective as existing drugs for weight loss, say researchers, addressing the type of effectiveness of surgery.
“No other drug has been able to produce this level of weight loss – this really changes the game,” says obesity researcher Rachel Batterham of University College London.
“For the first time, people can achieve through medication what was possible only through weight loss surgery.”
In addition to weight loss, participants experienced improvements in other areas, showing reductions in various cardiometabolic risk factors and reporting improvements in quality of life.
Although the results are convincing, the dose of semaglutide for anti-obesity effects comes with some disadvantages.
Mild to moderate effects have been reported by many participants (both in the semaglutide and placebo groups), including nausea and diarrhea. While the effects were temporary, they were enough for almost 60 of the participants to stop treatment, compared to only five in the placebo group.
Currently, the drug requires a weekly injection to function – while an oral form of the drug would probably be preferred by patients.
More significantly, we do not yet have data on what happened to the participants after the drug regime ended at the end of the trial.
However, for at least one person he spoke to New York Times, her weight began to slip after the process.
“While such drugs may be useful in the short term for rapid weight loss in severe obesity, they are not a magic bullet for preventing or treating less severe levels of obesity,” said nutritionist Tom Sanders, professor emeritus at King’s. College of London, which was not involved in the study.
Public health measures are still needed to encourage behavioral changes, such as regular physical activity and moderation of dietary energy intake.
No one would deny the wisdom of this, but if further analysis of semaglutide proves positive, we could also be looking for an important new pharmaceutical option to help fight obesity.
And this 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 provided to international health regulators in support of a request to market the drug as a treatment for obesity.
The US FDA, along with its counterparts in the UK and Europe, is currently evaluating the data.
The findings are reported in The New England Journal of Medicine.