Perspective on the Newly Approved Diabetes Drug for Weight Loss

Posted on: 11th Jun, 2022

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A recent headline on CNN excitedly notes that “overweight people lost 35 to 52 pounds on newly approved diabetes drug, study says.” A weekly dose of a medication, recently approved by the FDA, used to treat type 2 diabetes may also help adults without the condition lose weight. Here’s what the study revealed, plus a little perspective from Dr. Sasse on this newly approved diabetes drug for weight loss.

From the Study

According to CNN, the medication tirzepatide (sold under the brand name Mounjaro) was given to study participants in three dosages over 72 weeks. The participants were either overweight or obese, but none had diabetes. Coauthor Dr. Ania Jastreboff said that “almost 40% of individuals lost a quarter of their body weight.” Participants had an average body weight of 231 pounds and an average BMI of 38. They injected themselves with tirzepatide or a placebo weekly and received counseling sessions to help maintain a healthy diet, which included a 500-calorie daily deficit. Study participants were also getting 150 minutes of physical activity per week.

The most commonly reported side effects during the study were nausea, diarrhea, and constipation.

A Successful Outcome?

This drug is part of a wave of new medications that predominantly activate the receptor for a hormone known as GLP-1. As a group, these drugs have all shown significant promise and appear to be an improvement on the previous generation of weight-loss drugs. Tirzepatide also appears to activate a hormone receptor GIP.

Unfortunately, the new drugs are ridiculously expensive. Worse, very few health insurance plans cover these medications for the treatment of obesity, the number one root cause killer of Americans today. At our center, we frequently prescribe these medications only to be told that the patient’s insurance plan does not cover the drug, and the pharmacy would release it for a charge of $1,300 per month or something similarly impossible.

As a result, very very few of our patients are able to access the new class of medications for the treatment of obesity.

We would still like to see long-term data with use of these medications. Tirzepatide looks promising because it seems to result in more significant weight loss than prior medications, at least in small studies with relatively short term follow-up. The fact that this drug activates the receptors for two important gastrointestinal peptides might mean that its effectiveness is higher than the drugs that only activate GLP -1. This theory takes a page from metabolic surgery, which is known to create long-term favorable changes not just in GLP -1, but at least 20 other important endocrine and G.I. peptides, accounting for the large long-term  effectiveness at reversing obesity and diabetes.

Our genetics have not changed in 50 years. The epidemic of obesity is an environmental disease. Changes decades ago in the food supply and the chemical substrate we consume has caused the obesity epidemic for the most part, although some smaller influences undoubtedly play a role.

Hopefully these medications will become more available to every day people without exorbitant cost. Hopefully this research will lead to better pharmaceutical treatments that involve more of the hormones activated by metabolic surgery. But ultimately, the best outcome would be if this research leads to such a great understanding of the mechanisms of obesity that we are able to create effective prevention strategies beginning in childhood.

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