The effect that drugs such as Ozempic or Wegovy have had has completely transformed the treatment of obesity and they are already included in various clinical guidelines as necessary measures to control certain pathologies. But the industry doesn’t stop there, and is already exploring more holistic therapies, as compiled in a special issue of the magazine. science which reviews the progress made so far and how we are going to overcome the constraints on the table.
There are obstacles. The recommended treatments for weight loss have problems and are not perfect. One of them is the need to inject drugs, but luckily we are already seeing more accessible oral treatments. But in addition to this difficulty, we also found gastrointestinal side effects, a highly variable response between patients, loss of muscle mass and, above all, rapid weight regain when stopping the drug.
Loses more weight. The first tests conducted on the new molecules indicate weight loss that was not seen with the classic ozempic injection, reaching results that until now were reserved for bariatric surgery. The great promise here is retatrutide developed by Lilly and which has shown amazing results in clinical trials that are already being done on humans.
To write the numbers, it was found that patients without type 2 diabetes who received the 12 mg dose lost an average of 28.3% of their body weight over 80 weeks, and almost half of the participants were able to lose at least 30% of their weight.
He is not alone. In addition to the new Lilly treatment, which we will definitely see on the market in the coming years, Novo Nordisk is testing its CagriSema combination, with which they were able to ensure an average weight loss of 20.4% in 68 weeks compared to only 3% in the placebo group.
Metabolic challenges. Rapid weight loss has a very important consequence, which is the destruction of muscle mass, which compromises long-term metabolic health. And this is something that we have measured thanks to the drug Meritide, which, after being evaluated in phase 2, showed that, despite a weight loss of up to 16%, the patients’ muscle mass decreased by up to 11.6%.
The solution. To combat this problem, the industry is testing combination therapies that act as muscle shields. In the Phase 2 BELIEVE trial, Lilly evaluated the combination of semaglutide and bimagrumab in more than 500 adults, and the results indicated that the combination produced an average weight loss of 22.1% and 92.8% of the loss was exclusively from fat.
This is important, as semaglutide alone reduced muscle mass by 7.4%, high-dose combination therapy protected muscle, resulting in only 2.9% ‘wasting’.
rebound effect. The big problem with treatments based on increasing hormone concentrations is the possibility of going back to square one while taking the medication. Here, a meta-analysis from the University of Oxford estimated that about 0.4 kg of weight is regained per month after stopping treatment, which means that a patient can return to their initial weight in about two years.
This is why the industry recommends opting for a chronic treatment that is taken throughout life. Here stands orforglipron, which can act as a maintenance treatment aimed at rapid weight gain and loss of all the work done in the previous months. The problem is that this is not going to happen now, but extensive research is needed to ensure maximum safety in the new treatments yet to come.
Through this the country
Picture | Freepik
In Xataka | Millions of people are injecting Ozempic and suddenly there is a new obsession with skin care
