As I embark on this journey to discuss emerging treatments for the medical management of obesity, I feel that it is important to first acknowledge the widespread and devastating impact that obesity has on individuals and society as a whole. In the United States alone, over 40% of adults are classified as obese, with rates continuing to rise each year. Obesity is a leading cause of preventable death and is associated with an increased risk of numerous health conditions, including diabetes, heart disease, and some types of cancer. It is clear that treating obesity should be a top priority in public health and medical practice.
While traditional interventions, such as lifestyle modifications and dieting, can be effective for some individuals, they do not work for everyone. As a result, researchers and clinicians are constantly searching for new and innovative treatments that can help patients with obesity achieve better outcomes. I will explore three emerging treatments for obesity: Ozempic, Mounjaro, and Wegovy.
Ozempic (semaglutide) is a GLP-1 receptor agonist, a class of medications traditionally used for the treatment of diabetes. GLP-1 receptor agonists work by mimicking the effects of glucagon-like peptide-1, a hormone produced in the intestine that helps regulate blood sugar levels and appetite. By activating GLP-1 receptors in the brain, GLP-1 receptor agonists can reduce appetite and increase feelings of fullness, leading to decreased food intake and weight loss.
Semaglutide was approved by the FDA in 2017 for the treatment of type 2 diabetes. However, in 2021, it was approved as a weight loss medication for individuals without diabetes, under the brand name Ozempic. In clinical trials, Ozempic was shown to be effective for weight loss in individuals with obesity, with some studies demonstrating an average weight loss of 15% of baseline weight.
While Ozempic has shown promise as a treatment for obesity, there are some limitations to its use. First, it needs to be administered via injection, which may be a barrier for some patients. Additionally, it can be expensive, which may limit its accessibility for some patients. Finally, it is not a cure for obesity and requires ongoing use to maintain weight loss.
Mounjaro (setmelanotide) is a melanocortin-4 receptor agonist, a class of medications that target the melanocortin system, which is involved in regulating appetite and energy balance. Specifically, Mounjaro works by activating the melanocortin-4 receptor, which regulates food intake and energy expenditure.
Setmelanotide was approved by the FDA in 2020 for the treatment of genetic obesity disorders, such as POMC deficiency and LEPR deficiency. These conditions are rare and typically present in childhood, but they can lead to severe obesity and other health complications. In clinical trials, Mounjaro was shown to be highly effective for weight loss in individuals with these genetic obesity disorders, with some patients achieving weight loss of up to 30% of baseline weight.
Recently, there has been interest in exploring the use of Mounjaro for the treatment of non-genetic obesity as well. While there is not yet enough evidence to support this use, preliminary studies have shown promising results in individuals with severe obesity who do not have genetic obesity disorders.
Like Ozempic, Mounjaro has some limitations to its use. It needs to be administered via injection, which may be a barrier for some patients. Additionally, it is expensive and may not be covered by insurance for non-genetic obesity.
Wegovy (semaglutide) is another GLP-1 receptor agonist, similar to Ozempic. However, Wegovy is a higher dose formulation of semaglutide specifically designed for weight loss. It was approved by the FDA in 2021 for the treatment of obesity, under the brand name Wegovy.
In clinical trials, Wegovy was shown to be highly effective for weight loss, with some studies demonstrating weight loss of up to 20% of baseline weight. It also has a relatively low risk of side effects, with the most common adverse effect being gastrointestinal discomfort.
Like other GLP-1 receptor agonists, Wegovy needs to be administered via injection, which may be a barrier for some patients. Additionally, it can be expensive, which may limit its accessibility for some patients.
In addition to Ozempic, Mounjaro, and Wegovy, there are other emerging treatments for obesity that are currently being investigated. These include novel medications that target the gut-brain axis, such as oxyntomodulin and PYY3-36, as well as non-invasive interventions, such as transcranial direct current stimulation and vagus nerve stimulation.
While emerging treatments can be a valuable tool in the medical management of obesity, it is important to approach these options with caution and with an understanding of their risks and limitations. Ultimately, the most effective approach to treating obesity will be one that is tailored to the individual and emphasizes sustained lifestyle changes that promote overall health and well-being. As with any medical treatment, it is important to consult with a healthcare provider to determine the best course of action.
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Emerging medical treatments for obesity
Excellent review of the use of differing medications and reduction of obesity.
I certainly agree that obesity is a very serious and life-threatening issue for many. I applaud the pharmaceutical industry’s efforts to combat this condition. On the other end of the spectrum, those of us who have difficulty gaining or maintaining a satisfactory weight due to G.I. conditions are not left with a lot of options that I can see short of going on TPN. I have personal experience with this having been on TPN for 39 years and then weaning off for the past 12 months. Gaining and maintaining weight remains a full-time job. What is out there for us folks who have the opposite problem from those battling obesity?