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For the first time, a drug has been shown to be so effective against obesity that patients can dodge many of its worst consequences, including diabetes, researchers reported Wednesday.
The drug, semaglutide, manufactured by Novo Nordisk, is already marketed as a treatment for type 2 diabetes. In a clinical trial published in the New England Journal of Medicine, researchers at Northwestern University in Chicago tested semaglutide at a dose much higher as an anti-obesity drug.
Almost 2,000 participants in 129 centers in 16 countries injected semaglutide or placebo once a week for 68 weeks. Those who took the drug lost almost 15 percent of their body weight, on average, compared to 2.4 percent among those given the placebo.
More than a third of the participants receiving the drug lost more than 20% of their weight. Symptoms of diabetes and pre-diabetes improved in many patients.
These results far exceed the amount of weight loss seen in clinical trials of other obesity drugs, experts said. The drug “is a game-changer,” said Dr. Robert F. Kushner, an obesity researcher at Northwestern University’s Feinberg School of Medicine, who led the study. “This is the start of a new era of effective treatment for obesity.”
Dr Clifford Rosen of the Maine Medical Center Research Institute, who was not involved in the trial, said, “I think he has tremendous potential for weight loss.” Gastrointestinal symptoms among the participants were “really marginal – nothing like weight loss drugs in the past,” added Dr. Rosen, editor of the New England Journal of Medicine and co-author of a editorial accompanying the study.
For decades, scientists have searched for ways to help a growing number of people struggling with obesity. Five currently available anti-obesity drugs have side effects that limit their use. The most effective phentermine results in an average weight loss of 7.5% and can only be taken for a short time. After it is stopped, even this amount of weight is recovered.
The most effective treatment to date is bariatric surgery, which helps people lose 25 to 30 percent of their body weight, on average, noted Dr. Louis Aronne, an obesity researcher at Weill Cornell Medicine in New York City who advises Novo Nordisk and is studying semaglutide.
But surgery is an invasive solution that permanently alters the digestive system. Only 1% of those who qualify go through the procedure. Instead, most obese people try diet after diet with disappointing results.
The semaglutide study confirms what scientists already know, said Dr Kushner: Willpower is not enough. In the new trial, participants who received the placebo and the diet and exercise counseling could not see a significant difference in their weight.
In general, insurers have refused to pay for weight loss drugs in the market. Semaglutide is likely to be expensive. The lowest dose used to treat diabetes costs an average of almost $ 1,000 per month. (Insurers typically pay for diabetes drugs, Dr. Kushner noted.)
Dr Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital and a member of the advisory board of Novo Nordisk, said the effectiveness of semaglutide was “phenomenal” and that the trial results could lead insurers to cover it. .
Semaglutide is a synthetic version of a natural hormone that acts on appetite centers in the brain and in the gut, producing a feeling of fullness. A high dose regimen of the drug has not been studied long enough to know if it has serious long-term consequences.
And it is expected that patients will have to take it all their lives to prevent the weight loss from returning.
Qiana Mosely, who lives in Chicago, has spent years trying to lose weight on diet and medication, to no avail. Then Ms. Mosely joined the semaglutide trial and lost 40 pounds, or about 15% of her weight.
Ms. Mosely did not know until recently whether she was receiving the drug or the placebo. Even though she tried to eat well and exercise, her weight “was dropping too quickly,” she says. “It must have been the drugs.”
She did not experience any side effects, she said. But when the trial ended and she no longer received the drug, the weight started to return. “I was so sad,” she says. She looks forward to getting the medicine back once it becomes available.
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