Sofia had struggled with her weight since her early teens, a condition exacerbated by high fat levels in her blood, rendering diets and exercise ineffective. Lap-band surgery initially helped, but the weight returned over time. When her doctor, Joe Proietto, a former board member of the World Obesity Federation, suggested she try Ozempic, she was hopeful. Despite initial side effects, including severe nausea and vomiting, Sofia persisted. Over six years, weight-loss drugs have helped her shed 25 kilograms, a testament to their potential efficacy.
Ozempic is part of a new class of drugs known as GLP-1 receptor agonists, initially developed for diabetes management but now widely used for weight loss. These drugs not only help regulate blood sugar and promote weight loss but are also being explored for treating conditions like Alzheimer’s and addiction. Their popularity is growing, sparking discussions about their effects and potential side effects.
The Science Behind GLP-1 Receptor Agonists
The origins of these drugs trace back to the Sonoran Desert in the United States, where the venom of the Gila monster, a poisonous lizard, was found to stimulate pancreatic cells. This discovery led to the identification of exendin-4, a peptide similar to the human hormone GLP-1, which regulates insulin and appetite. Joe Proietto, a professor emeritus at the University of Melbourne, explains that GLP-1 plays a crucial role in insulin release, slowing stomach emptying, and suppressing hunger.
Initially, GLP-1 in humans had a short lifespan, but the peptide from the Gila monster lasted longer, leading to the development of the drug Byetta for type 2 diabetes by Eli Lilly in 2005. This paved the way for further advancements, including Novo Nordisk’s development of semaglutide, the active ingredient in Ozempic and Wegovy, and Eli Lilly’s Mounjaro, which combines GLP-1 and GIP for enhanced appetite suppression.
Impact and Usage of Weight-Loss Drugs
The use of GLP-1 receptor agonists has surged, with the Pharmaceutical Benefits Scheme (PBS) in Australia recording over 2.3 million prescriptions of semaglutide in 2023-24, a 60% increase from the previous year. However, these drugs are primarily approved for type 2 diabetes, and off-label prescriptions for weight loss are common but not subsidized, making them expensive for patients without diabetes.
Doctors can prescribe these drugs to individuals with a BMI over 30 or those with obesity-related complications. Terri-Lynne South from the Royal Australian College of General Practitioners emphasizes the need for careful consideration, especially for older patients, due to potential side effects and the high cost of treatment.
Personal Stories and Efficacy
Jen, who struggled with food addiction and gained nearly 100 kilos, found success with Ozempic, losing almost 30 kilograms. These drugs help reduce “food noise,” the constant preoccupation with food, providing a sense of calm and control over eating habits.
Obesity affects about a third of Australian adults, and genetic factors significantly influence it. Joe Proietto notes the frustration in treating obesity due to weight regain but acknowledges the new tools available, despite their high cost.
In 2021, Novo Nordisk’s clinical trials showed semaglutide users lost 14.9% of their body weight after 68 weeks, compared to 2.4% in the placebo group.
Future Prospects and Research
Research into GLP-1 receptor agonists continues, with studies indicating potential benefits beyond weight loss, such as reducing heart attack and stroke risks and lowering kidney disease incidence. An Australian study in The Lancet found a 16% reduction in kidney failure risk among users of these drugs.
Endocrinologist Katherine Samaras highlights the potential for these drugs to treat Alzheimer’s, as early studies show promising results in reducing brain shrinkage and cognitive decline. The broad impacts of these medications on the brain and their potential to treat various conditions are areas of active research.
The rise of GLP-1 receptor agonists marks a significant shift in obesity and diabetes management. While promising, their high cost and potential side effects require careful consideration, especially for long-term use. As research continues, these drugs may offer new hope for treating a range of conditions, transforming how we approach chronic health issues.
