Remarkable results from a new study on a diabetes drug could be a real shot in the arm for all those struggling with obesity.
Two-thirds of Australians are overweight or obese, making us one of the fattest developed nations on Earth, and the messaging on diet and exercise is failing to find its mark.
When all else fails, the most effective means of losing weight is gastric surgery, which is invasive, expensive and confronting for most.
But a new study by US researchers has delivered substantial weight loss for its participants and could well change the way we treat obesity.
The drug, semaglutide, was discovered in 2012 by researchers at Novo Nordisk, a Danish healthcare company with a focus on chronic disease.
It was approved in 2017 by the US Food and Drug Administration as a type 2 diabetes injection treatment.
There have been smaller studies into semaglutide as a weight-loss drug, but the latest trial, funded by Novo Nordisk and run by researchers at Northwestern University in Chicago, was bigger in scope and participation.
The trial, published in the New England Journal of Medicine, involved almost 2000 participants across 16 countries. They injected themselves weekly with semaglutide or a placebo for 68 weeks.
The double-blind trial involved only people who did not have diabetes and had a body mass index (BMI) of 30 or more, putting them just in the obese range.
Participants who were given the drug lost, on average, close to 15 per cent of their body weight, compared with a weight loss of 2.4 per cent for those receiving the placebo – that equated to an average loss of 15.3kg compared with 2.6kg.
More than a third of the participants receiving the drug lost more than 20 per cent of their weight, leading to fewer pre-diabetes symptoms in many patients.
Some participants on semaglutide suffered nausea and diarrhoea, with 59 ceasing treatment. But the study authors said the side-effects typically were mild to moderate in severity and subsided with time. They were also much less concerning than other weight-loss medications such as amphetamines (addictive), fenfluramine (cardiac toxicity) and, most recently, lorcaserin (cancer risk).
Most encouraging was that the weight loss achieved using semaglutide was more than double that of the best-performing anti-obesity drug on the market, phentermine – an amphetamine that has a short-term weight loss average of 7.5 per cent.
The drug is a game-changer, said Dr Robert F. Kushner, who led the study.
“This is the start of a new era of effective treatments for obesity,” he told The New York Times.
The most effective treatment for obesity is bariatric surgery, which helps people lose 25 to 30 per cent of body weight, on average, but it is invasive, and permanently alters the digestive system.
Dr Leon Cohen, a bariatric surgeon from Western Australia, has recently begun to prescribe semaglutide to his patients, giving them less than half the dose that participants were given in the US clinical trial. He is reporting similar weight loss results.
Dr Cohen told The New Daily that the drug mimics GLP-1, a gut hormone that is released in response to undigested food hitting the distal small bowel, suppressing the appetite.
“It’s an interesting and exciting mechanism, because essentially what the body needs is a mechanism that can sense you’ve just had a large meal and there’s still a lot of undigested food that hasn’t been absorbed,” he said.
“Now it’s reaching the small bowel, so it’s time to tell the body to stop eating.”
He said that for people tipping into the obese territory, the drug has resulted in “quite respectable weight loss”.
“It doesn’t matter what treatment you give to someone with a low BMI, they get a good result,” he told The New Daily. “They only need to lose 10 kilos and you get a very respectable percentage of your weight loss.
“We know that anyone with diabetes who loses 10 per cent of their weight, it’s going to help a lot with their diabetes control.”
But most of his patients have a BMI of more than 40 and surgery remains their only viable option.
“If they lose 20 per cent of their weight it’s pretty good, but it doesn’t compare to surgery, which achieves 35 to 40 per cent loss.”
The long-term effects of semaglutide are unknown, which is a concern because as soon as patients come off the drug their weight begins to climb, so they may have to take the medication for life.
Do you struggle with your weight? Would you consider medication to suppress your appetite?
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