Wegovy can result in vital weight reduction however could must be taken long run
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Ozempic and Wegovy are model names for the drug semaglutide. Many international locations have accepted Wegovy for weight reduction in people who find themselves overweight or obese and Ozempic for individuals with sort 2 diabetes.
How do these medication work?
Medicine corresponding to semaglutide mimic the actions of a hormone known as glucagon-like peptide-1, or GLP-1. These so-called GLP-1 analogues have a number of results, together with slowing abdomen emptying, performing on the mind to cut back urge for food and boosting the discharge of insulin, which helps to manage blood sugar ranges.
For greater than a decade, GLP-1 analogues have been used to assist individuals with sort 2 diabetes management their blood sugar and a few customers skilled modest weight reduction. “These drugs augment a system that already exists within the human body, whose role it is to suppress appetite following meal ingestion,” says Simon Cork at Imperial School London.
Why are they making headlines now?
GLP-1 analogues have began to be prescribed for weight reduction in individuals with out sort 2 diabetes. They’ve additionally change into obtainable in formulations which are stronger and simpler to make use of.
Initially GLP-1 analogues have been accepted to be used at a decrease dose and wanted to be given by twice-daily injections. Within the newest formulations they’re once-weekly injections, with Wegovy’s full dose being 2.4 milligrams for weight reduction and Ozempic getting used at a most dose of two milligrams for sort 2 diabetes.
How extensively obtainable are they?
In 2021, Wegovy was accepted for weight reduction in a number of international locations, together with the US and Canada. Reward from some superstar customers introduced it widespread publicity.
Manufacturing issues meant its producer, Novo Nordisk, had bother assembly world demand, so some medical doctors began prescribing Ozempic, which had been accepted for individuals with sort 2 diabetes in sure international locations a number of years earlier. This led to shortages for individuals who required it for diabetes management.
Within the UK, Wegovy was accepted in 2021, however solely obtained the nod from England’s medical tips physique the Nationwide Institute for Well being and Care Excellence in March 2023, when it mentioned the drug needs to be given by weight reduction clinics throughout the nation’s nationwide well being service. Wegovy is predicted to change into obtainable within the UK this 12 months, whereas Ozempic has been obtainable for sort 2 diabetes since 2019.
In June 2023, the UK authorities introduced the introduction of a two-year pilot that offers individuals with weight problems entry to new medication, corresponding to Wegovy, exterior of a hospital setting.
How efficient are they?
Very. It’s a cliche however weight problems medical doctors are speaking a couple of paradigm shift within the discipline of weight problems administration. Beforehand, a lack of about 5 per cent of physique weight can be thought-about a very good end result for any weight reduction intervention exterior of abdomen surgical procedure and is taken into account a benchmark in weight problems drug trials.
Wegovy results in a couple of 15 per cent discount in physique weight over a 12 months, when mixed with train and consuming healthily.
The truth is, some individuals appear to really feel that the GLP-1 analogues have precipitated them to change into too gaunt, as mirrored within the rise of the search phrases “Ozempic face” and “Ozempic butt”. “Ozempic doesn’t do anything specific to the skin,” says Alexander Miras at Ulster College, UK. It’s the weight reduction that causes these obvious negative effects, with related outcomes typically additionally occurring after weight reduction surgical procedure, he says.
Do the medication have any negative effects?
Unwanted effects may be gentle, corresponding to nausea, constipation and diarrhoea, which are likely to happen as individuals get used to the drug. Extra worrying negative effects embody irritation of the pancreas, though that is comparatively uncommon.
How about hair loss?
Hair loss has been reported by some semaglutide customers. That is additionally generally seen after vital weight reduction from different causes, corresponding to abdomen surgical procedure, says Miras.
Hair loss following weight reduction surgical procedure is regarded as because of physiological stress on the physique inflicting an elevated variety of hair follicles to enter their “resting” section, which results in the hairs falling out a number of months later. It stops when the burden loss stabilises, nevertheless, the hair doesn’t all the time develop again, says Miras.
Do these medication trigger suicidal ideas?
GLP-1 analogues – corresponding to Ozempic and Wegovy – are being investigated by the European Medicines Company (EMA) after latest reviews that they might trigger ideas of suicide or self-harm. This was after Iceland’s well being regulator acquired three such reviews concerning semaglutide and one other drug known as liraglutide, which is an earlier GLP-1 analogue.
The EMA says it’s analysing about 150 reviews of doable circumstances of self-injury and suicidal ideas. This doesn’t imply the medicines precipitated these results, nevertheless, solely that folks reported these experiences after beginning to take them. “More work is needed to determine if a causal link exists,” says Michael Schwartz on the College of Washington in Seattle.
A spokesperson at Novo Nordisk, the producer of liraglutide and the semaglutide medication Ozempic and Wegovy, advised New Scientist: “GLP-1 receptor agonists have been used to treat type 2 diabetes for more than 15 years and for treatment of obesity for eight years. The safety data collected from large clinical trial programmes and post marketing surveillance have not demonstrated a causal association between semaglutide or liraglutide and suicidal and self-harming thoughts.”
Want a listening ear? UK Samaritans: 116123; US 988 Suicide & Disaster Lifeline: 988; hotlines in different international locations.
Do these medication assist with addictions?
Maybe. There have been many anecdotal reviews of individuals taking these medicines for diabetes or weight management who lose their urge to drink alcohol or see waning of different habits that could possibly be described as “behavioural addictions”, corresponding to compulsive buying.
That is supported by analysis in animals that discovered the GLP-1 analogues decrease consumption of alcohol and addictive medication. A small trial in individuals has hinted at an analogous impact from a GLP-1 analogue known as exenatide, which lowered heavy consuming, however solely in individuals who have been overweight.
The reason could possibly be linked with the way in which the medication act on the mind to cut back meals cravings, however the precise mechanism is unclear. We’re solely firstly of understanding how these remedies may help individuals with alcohol and drug additions, says Daniel Drucker at Sinai Well being in Toronto, Canada. “The clinical trial data is not yet in to substantiate the anecdotes.”
What occurs to a person’s weight long-term?
In an aforementioned research, taking semaglutide as soon as every week led to individuals shedding about 15 per cent of their physique weight, in contrast with 2 per cent for these taking a placebo. Carried out in 2022, this two-year trial checked out individuals who have been overweight or obese, however didn’t have diabetes.
In most international locations, Wegovy has been accepted to be used for 2 years, but when individuals cease taking the drug, they typically regain the misplaced weight – two-thirds of it after one 12 months, based on one trial.
However in 2024, Donna Ryan on the Pennington Biomedical Analysis Middle in Louisiana and her colleagues discovered that taking the identical dose of semaglutide as soon as every week for 4 years led to reductions in weight that have been maintained for the whole interval.
The workforce in contrast greater than 17,000 adults in 41 international locations who have been overweight or obese and didn’t have diabetes, however did have a type of coronary heart illness. Amongst these taking semaglutide, weight reduction continued to week 65 and was sustained over the trial, with the individuals’ shedding on common 10.2 per cent of their physique weight, in contrast with 1.5 per cent within the placebo group.
“Our long-term analysis of semaglutide establishes that clinically relevant weight loss can be sustained for up to four years in a geographically and racially diverse population of adults with overweight and obesity but not diabetes,” mentioned Ryan in a press release.
It has been instructed that utilizing semaglutide for weight reduction must be a long-term strategy. “The weight loss is only sustained for as long as the drug is taken because as soon as you stop the drug, all of those physiological processes that are trying to get your body weight back up kick in again,” says Cork.
The outcomes have led to calls to increase Wegovy’s therapy to a minimum of 4 years. Beneath the present two-year approval, there’ll in all probability be demand from individuals for medical doctors to proceed prescribing the drug “off-label”. “I think there’ll be a big push to try to change those guidelines,” says Cork. Ozempic may be prescribed long-term for sort 2 diabetes as a result of the situation is normally life-long.
Do these medication scale back the chance of heart-related occasions?
It has been instructed that by bringing individuals’s weight in the direction of a more healthy vary, these medicines could inadvertently scale back the chance of heart-related occasions, corresponding to coronary heart assaults and strokes.
Based mostly on the identical dataset utilized by Ryan and her colleagues, a workforce at College School London examined the connection between a change in weight and cardiovascular outcomes. Presenting their outcomes on the European Congress on Weight problems in Venice, Italy, the researchers discovered that semaglutide led to a 20 per cent discount in such occasions, irrespective of individuals’s beginning weight or the quantity they misplaced.
“Our findings show that the magnitude of this treatment effect with semaglutide is independent of the amount of weight lost, suggesting that the drug has other actions which lower cardiovascular risk beyond reducing unhealthy body fat,” mentioned workforce member John Deanfield in a press release. “These alternative mechanisms may include positive impacts on blood sugar, blood pressure, or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these.”
The outcomes recommend that semaglutide may scale back the chance of heart-related occasions amongst people who find themselves simply mildly obese. Nonetheless, the research wasn’t designed to measure its impact as a preventative therapy. Additional analysis can also be required amongst an much more racially various group of individuals.
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