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If you’ve opened a magazine in the last couple of years – anything from The New Scientist to the supermarket tabloids – you may have noticed the dizzying array of new weight loss medications on the market.
You might be familiar with the names Ozempic, Wegovy, Mounjaro, or Zepbound. Billionaire Elon Musk tweeted that he’d lost 30lbs using Wegovy, while Charles Barkley is a 60lb smaller mound of rebound due to his treatment with tirzepatide; the active ingredient of Zepbound and Mounjaro.
This new breed of medications have boomed in the US market in the 2020s. Science.org named GLP-1 drugs (as these weight loss medicines are known) their ‘2023 Breakthrough of the Year’. But where did they come from, and why are they so popular? Let’s take a look.
Origins
The story of GLP-1 drugs began in the 1980s, with the discovery that the GLP-1 hormone increased insulin production. Pharmaceutical companies sought to develop drugs that would mimic that hormone’s effect on the pancreas, to produce treatments that could help in the management of diabetes. In 2010, the Food & Drug Administration approved liraglutide for use in diabetic patients. Semaglutide (the active ingredient in Wegovy) followed in 2017.
Studies showed that patients using GLP-1 drugs tended to lose weight throughout their treatments. Liraglutide users were averaging a loss of around 8% of body mass. This led to the manufacturers trialing the medications specifically for weight loss in non-diabetic subjects. Semaglutide users lost an unprecedented 15% of body weight over the course of a 16-month trial. The FDA approved Wegovy as a weight loss aid in 2021.
Cultural context
‘Obesity’ is a word that will make many of us recoil a little. It can conjure up lurid images of people bedbound, or trundling through the supermarket on a scooter. For a long time, it was seen not as a medical condition, but rather a moral failing. However, the clinical definition of obese – those with a Body Mass Index of 30 and higher – is much more familiar to many of us. A 5’2 woman is considered obese at 164lbs. A man at the average American height of 5’9 is obese at 203lbs.
This has led to some realism being injected into the philosophy around healthcare and the overweight. For some, there’s only so much that willpower and healthier snacks will do, and if a helping medical hand can be provided, perhaps it should be. It should not go unregarded that the current cost per annum of obesity to the US healthcare system is around the $175m mark.
Personal prescriptions
Physicians are now approved to issue prescription weight loss medication to adults with a BMI of 30 or higher. Wegovy (semaglutide) is the dominant player, at around 55% of the market, however, Saxenda (liraglutide) and Zepbound (tirzepatide) can also be options depending on how much weight the individual needs to lose. All work in fairly similar ways. The medication slows the movement of food through the body – literally keeping the user fuller for longer – and works with the reward pathway in the brain to dampen the craving for unhealthy ‘quick fix’ foods.
Prescription weight loss medicines are not a magic bullet. They must be accompanied by a healthier eating plan and regular physical activity – however, the effect of slowing the food through the body means the patient is likely to eat smaller portions. The signaling of fullness to the brain also has the ‘virtuous circle’ bonus that the internal monologue – or ‘food noise’ – that thinks a coffee should be accompanied by a cookie, or that completing a task deserves a treat as a reward should also be quietened.
Prescription weight loss medication has proven wildly popular in a very short space of time. The potential of GLP-1s seems limitless – it’s recently been reported that research into semaglutide for treating dementia is underway. Less restrictive than many diet plans, they’re usually administered via a once-weekly shot, or a twice daily pill, so don’t impact on a busy schedule. You may want to speak with your physician to see if they could be right for you.
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