What do you know about prescription drugs that promise weight loss

WeightWatchers, the 60-year-old diet company, announced this week that it will acquire a telehealth company whose providers prescribe anti-obesity drugs to growing numbers of eager online subscribers.

The $132 million deal with Sequence is the latest commercial push into the prescription drug market that promises significant weight loss. Months ago, the diabetes drug Ozempic was promoted on social media by celebrities even though it was not approved for weight loss. Demand for it has created a shortage.

WeightWatchers will introduce its nearly 3.5 million subscribers to a new generation of medication that goes beyond behavioral changes like exercise and diet tracking. Obesity experts say the drugs may revolutionize the treatment of the disease, which affects 42% of American adults.

Here’s a look at the promise of these new drugs and the warnings about their use.

What are these new diet drugs?

The drugs that have made the most noise are from a class of drugs called GLP-1 agonists. Two of the most popular ones, Ozempic and Wegovy, are different doses of the same drug, semaglutide.

Ozempic has been used for six years to treat type 2 diabetes and is not approved for weight loss. Wegovy was approved in 2021 to treat obesity in adults and late last year to treat children and adolescents ages 12 and older.

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Doctors prescribe the medication for people with diabetes alone, or for people who are obese or overweight with additional health problems. Most of these types of medications are given by weekly injections.

Supply issues and surging demand last year led to drug shortages, but Novo Nordisk, the manufacturer, said they have been replenished.

How do the drugs work?

They mimic the action of a gut hormone that kicks in after eating, increasing insulin secretion, inhibiting sugar production in the liver and suppressing appetite.

A newer drug, called tirzepatide, mimics the action of two hormones for greater effect. The Eli Lilly and Co. drug has been approved. , which is sold under the brand name Mounjaro, is intended for the treatment of diabetes, but the Food and Drug Administration has granted fast-track status to its review for the treatment of obesity. A decision is expected this spring.

With reduced appetite and a feeling of fullness, people using these medications eat less and lose weight.

How effective are the medications?

In a clinical trial, adults who took Wegovy saw an average weight loss of about 35 pounds, or about 15% of their initial body weight. Teens lost about 16% of their body weight.

A clinical trial of Mounjaro, which is still being studied, showed an average weight loss of 15% to 21% of body weight depending on the dose, compared to a weight loss of about 3% for people taking a placebo or placebo.

Why not just diet and exercise?

In a typical weight-loss program where participants rely solely on diet and exercise, about a third of the people enrolled will lose 5% or more of their body weight, noted Dr. Louis Aron, MD, director of the Center for Comprehensive Weight Control at Weill Cornell Medicine. .

He said most people find it difficult to lose weight because of the body’s biological reactions to eating less. There are many hormones that respond to reduced calories to increase hunger and maintain body mass.

“There is a real physical phenomenon,” he said. “There is a resistance mechanism which is a coordinated effort by the body to prevent you from losing weight.”

What are the side effects of the drugs?

The most common side effects are short-lived gastrointestinal problems such as nausea, vomiting, diarrhea, stomach pain, and constipation.

Other possible side effects include thyroid tumors, cancer, inflammation of the pancreas, kidneys, gallbladder, and eye problems. People with a family history of certain types of thyroid cancer or a rare inherited endocrine disorder should avoid the medication.

What should consumers pay attention to?

These new drugs can be an effective part of a multifaceted approach to weight loss, said Dr. Amy Rothberg, a University of Michigan endocrinologist who runs a hypothetical weight management and diabetes program called Rewind.

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But she worries that programs like WeightWatchers are primarily concerned with increasing enrollment — and profits.

“I hope they do their due diligence and have real monitoring of patients who are taking the medications,” she said.

She said it was important to make sure patients were taking the medications for their intended purpose, to make sure there was no reason why they should not take the medications and that they were being monitored for side effects.