Weekly semaglutide injections have helped patients lose more than 15kgs. Might this be a magic bullet in the fight against obesity?
We need efficient ways to treat and prevent obesity, even as we fight COVID-19. 29% of women and 26% of men in the UK, according to NHS in data published in 2020 May, were presumed to be obese. These individuals had a body mass index higher than 30.
The situation has now gotten worse thanks to a widespread lockdown-related gain in weight. Obese patients are not only likely to die due to COVID-19; but even worse, University of Glasgow researchers’ recent estimates suggest that obesity might have overtaken smoking as a cause of ill health in Scotland and England.
A healthy balanced diet and suitable physical exercise could prevent weight gain. But this is not considered an effective treatment against obesity. Consuming a very low-calorie diet of not more than 1,000 kcal a day might result in losing about 10 to 15kgs within 12 weeks.
A more modest, cautious calorie restriction prescribed by several commercial slimming plans could cause an average annual weight loss of about 7kgs. However any weight lost through these methods can be regained. And you need another approach to keep the wright off.
To date, various drugs formulated to treat obesity are either inefficient in clinical practice or have harmful side effects like anal leakage or higher blood pressure. Bariatric surgery is the only reliable treatment for critical obesity at the moment, but long-term side effects and risks accompany it.
A series of peptide hormones regulate energy expenditure and appetite. These hormones are released in the intestine. Bariatric surgery works because it changes the gut response to food intake and how it communicates with the brain.
Specifically, glucagon-like peptide (GLP-1) is produced in the ileum in the last section of small intestines. GLP-1 responds to foods containing carbohydrates. Insulin synthesis is thereby promoted and secretion by the pancreas, but it affects the stomach by reducing the digestive system movements and secretion of acid.
The UK researchers published their findings on semaglutide in the New England Journal of Medicine led by John Wilding, in February. They found that a drug mimicking GLP-1 that was initially intended for diabetes treatment caused considerable weight loss in type 2 diabetes patients.
The researchers worked with 1,962 patients, of whom 75% were female. Of these, 13% were Asian, 6% black, and 75% white. Their average body mass index was 38. Patients were randomly divided into 2 equal groups. One group received semaglutide weekly injections, while the control group received placebo injections for 68 weeks. Both groups got lifestyle advice and diet.
The semaglutide group lost an average of 15.3kgs in contrast to 2.6 from the control group. The treatment effect difference in the two groups was 12.7kgs weight loss.
The treatment as successfully reduced blood pressure by 5.1mmHg, and the patients reported better physical functioning. The treatment’s major side effects included nausea, diarrhea, and occasional vomiting. And to those on active treatment, there were more frequent gastrointestinal disorders. Of more concern may be the accelerated danger of pancreatitis and gallbladder disease.
As these high-quality trials show, semaglutide causes remarkable weight loss compared to other drugs tested so far. What happens after the treatment ends is uncertain. Preventing the weight from piling back on is a great challenge, and the lesson learned from bariatric surgery is that patients should avoid sugar-sweetened beverages and unhealthy snacking. Smaller portions of calorie-dense foods help.
The research findings need to be confirmed with a more ethnically diverse population with a higher proportion of males. From a practical standpoint, the drug injection’s weekly requirement is more likely to curb a more significant rollout of the treatment. Oral preparations of the drug are still under trials.
While semaglutide appears promising as an obesity treatment, it is not exactly a magic bullet. We should continue to promote a healthy lifestyle as well as discourage unhealthy eating habits that lead to obesity.