We have entered a new era as far as weight loss technology is concerned, oral medication is being made redundant by the GLP-1 agonist injectables. This article describes who is at the forefront of the technology and who is leading the race.
Are New Diabetes Drugs Like Ozempic and Wegovy Safe for Weight Loss?
New injectable drugs like Ozempic (semaglutide) and Wegovy (higher-dose semaglutide) were originally developed and approved to treat type 2 diabetes. However, recent studies have shown that these medications can also lead to significant weight loss, even in people without diabetes. Ozempic is approved for weight loss and blood sugar control, while Wegovy is approved specifically for chronic weight management.
These drugs work by activating GLP-1 receptors in the body that stimulate insulin secretion and suppress appetite. By mimicking natural gut hormones, they help regulate both blood sugar and hunger. The effects on appetite lead to weight loss through reduced calorie intake, even with no change in diet or exercise. Some people lose 15-20% of their weight or more on Wegovy.
While this degree of weight loss sounds appealing, using diabetes drugs primarily for weight loss does raise some safety questions. Common side effects of GLP-1 agonists like Ozempic and Wegovy include nausea, diarrhea and low blood sugar. The risks tend to be higher at the beginning of treatment and in people without diabetes. Severe side effects are still relatively rare but can include pancreatitis, gallbladder problems, and kidney impairment.
For most patients with obesity and diabetes, the benefits of substantial weight loss and blood sugar control likely outweigh the risks when used under medical supervision. However, some experts argue that obesity on its own should not necessarily be treated with prescription drugs developed for a disease like diabetes. Lifestyle interventions should always be attempted first before medication.
If you’re interested in using Ozempic, Wegovy or other diabetes drugs for weight loss, talk to your doctor. They can determine if the potential benefits outweigh the risks in your specific situation. These medications should only be used under the guidance of a physician to ensure safety and maximum effectiveness. When prescribed and monitored properly, diabetes drugs may have an important role to play in the fight against obesity. But they are not an easy answer and should not be taken lightly.
Weight Loss Technologies Pre 2020
For over 70 years, the drug phentermine was the go-to prescription weight loss medication. Phentermine was approved in 1959 and works by suppressing appetite through its effects on the central nervous system. It stimulates the release of norepinephrine, a chemical messenger that influences appetite and mood. While phentermine before and after results were considered cutting edge back then, in 2023 they only lead to modest weight loss and not in the same class as the GLP-1 agonists. Phentermine can also cause side effects like increased heart rate, insomnia, and anxiety.
Phentermine was really the only pharmaceutical option for obesity until 2020, when GLP-1 receptor agonists like Ozempic and Wegovy were approved for weight management. Rather than targeting the central nervous system, these newer drugs work by activating natural gut hormone pathways involved in hunger and fullness. They tend to produce greater weight loss with possibly fewer side effects than phentermine alone.
However, phentermine remains on the market and is still used, often in combination with GLP-1 agonists or other obesity medications. It continues to help some people lose weight, especially when combined with diet and exercise. Phentermine can also be more affordable and accessible than newer, often expensive prescription drugs.
For now, phentermine appears here to stay as another option in the weight loss drug arsenal. But GLP-1 agonists are poised to become the dominant prescription treatment for obesity based on their superior and sustained effectiveness. They represent a new path in medical weight management – one focused on harnessing the body’s own appetite-regulating hormones. This physiologic approach may produce greater results with possibly fewer downsides than older sympathomimetic drugs like phentermine that target the central nervous system.
Weight Loss Technology 2023 and Beyond
In the coming decades, injectable weight loss drugs like GLP-1 receptor agonists are poised to become the dominant form of prescription treatment for obesity. Ozempic, Wegovy and other similar medications in the development pipeline represent the cutting edge of pharmaceutical weight management. Through mimicking natural gut hormones involved in appetite regulation, they produce significant weight loss that is both effective and potentially sustainable.
However, injectable drugs also come with downsides like high cost, fear of needles for some patients, and a risk of side effects. They will not replace the need for diet and exercise, which remain the foundation of successful long-term weight control. Lifestyle interventions should always be attempted before moving on to more intensive medical options.
Oral weight loss medications continue to improve and provide alternatives for those unwilling or unable to use injections. For example, GEP44 is an oral hydrogel capsule in late-stage clinical trials that expands in the stomach to make people feel full. If approved, it would be the first oral medication using this innovative mechanism of action. Other novel approaches in the pipeline include vagal nerve stimulation and various hormone-based therapies.
GEP44 is an investigational weight loss injection currently in clinical trials. It is a glucagon-like peptide 1 receptor agonist, similar to existing GLP-1 drugs like Ozempic (semaglutide) and Trulicity (dulaglutide). However, GEP44 is more potent and longer-acting than previous GLP-1 agonists, so it may produce greater weight loss and blood sugar control.
Clinical trials have shown potential for up to 25% weight loss over 1-2 years when used alongside diet and exercise. This degree of weight loss is greater than that seen in studies of currently approved GLP-1 drugs.
GEP44 is at least 2-3 years from potential approval and availability for obesity and diabetes treatment. If successful in ongoing trials and approved, it may become the most effective injectable weight loss drug currently on the market. However, it is still too early to know for sure.
In the future, weight loss treatment is likely to become more personalized and multi-modal. Patients may start with lifestyle counseling and medications, but quickly move on to GLP-1 injections, hormone-based drugs or other interventions based on their health needs and how much they need to lose. Combination therapies, some using both oral and injectable drugs, may also help maximize results.
Prescription drugs will continue to drive significant innovation in medical weight management over the next decade and beyond. But their role should be to support behavior changes through enhancing motivation, suppressing hunger and sustaining weight loss initiated through diet and exercise. Obesity must be treated as a chronic disease requiring constant vigilance. And while new medications buy time and opportunities, patients must stick with the hard work of long-term lifestyle transformations to achieve permanent results.