Each week, OMRF Chief Medical Officer Dr. Judith James opens “Adam’s Journal” to answer a medical question from Adam Cohen, OMRF’s senior vice president & general counsel.
Adam’s Journal
I’ve seen a lot of headlines recently about the new generation of weight-loss drugs. Now that their use is becoming more widespread, what are we learning about them?
Dr. James Prescribes
The latest generation of anti-obesity drugs have quickly become blockbusters, thanks to their effectiveness at reducing weight and treating diabetes. They mimic a gut hormone known as GLP-1, which controls blood sugar levels and acts on the brain to dampen appetite.
These drugs, known generally as GLP-1 agonists, are sold under brand names that include Mounjaro, Ozempic, Zepbound and Wegovy, and studies have shown that people taking them lose an average of 15% to 20% of their body weight. Increasingly, we’re also seeing new benefits.
A study sponsored by Eli Lilly found that people taking its GLP-1 agonists had lower systolic blood pressures, the pressure on blood vessels when the heart contracts. The study’s lead author, a cardiologist at the University of Texas Southwestern Medical Center, said the reduction was in the range of what would be expected from treatment with blood pressure medication.
He said the drug could be useful for people trying to control their pressure – and, as a result, reduce their risk for heart attacks and strokes. Indeed, a study from drugmaker Novo Nordisk involving more than 17,000 people found that the company’s GLP-1 agonists might prevent heart attacks, strokes and cardiovascular events among those at highest risk.
In addition, it’s recently been found that drugs in this class can help patients with heart failure. In another large study sponsored by Novo Nordisk, patients taking the company’s GLP-1 agonists had fewer symptoms of the disease and were better able to exercise.
Evidence suggests these drugs can also suppress inflammation, with studies showing positive effects in the liver, kidney and heart. They even seem to tamp down inflammation in the brain, making scientists hopeful the compounds might be useful in treating diseases like Parkinson’s and Alzheimer’s.
While all of these results are encouraging, GLP-1 agonists also present challenges. They don’t work for everyone, and they come with relatively high rates of side effects like nausea and diarrhea. The medications can also trigger muscle loss. And they’re in short supply, expensive (about $1,000 per month), and may not be covered by insurance.
Research indicates that if people want to maintain the benefits these medications provide, they may have to stay on them for the long term, potentially for the rest of their lives. Still, given the mounting evidence these drugs can be game changers for many with obesity, that may be a consequence those who use them can accept.
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James, a physician-scientist, is executive vice president and chief medical officer of the Oklahoma Medical Research Foundation. Cohen is a marathoner and OMRF’s senior vice president and general counsel. Submit your health questions to contact@omrf.org.
