New and more effective weight-loss drugs are on the horizon, poised to surpass current popular slimming injections like Ozempic and Wegovy. The great news is that these novel medications not only have fewer gastric side effects but some are also available in pill form, eliminating the need for injections. Wegovy (generic name semaglutide) has the potential to help obese individuals shed up to 15% of their body weight, and since its introduction for weight loss in the US in 2021, it has been hailed as a breakthrough in combating the global obesity and type 2 diabetes epidemics. Recent data from a five-year trial of Wegovy even suggests that it could reduce the risk of heart attack or stroke by 20% in obese individuals with cardiovascular disease.
Ozempic, another injection that contains the same active ingredient (semaglutide), is currently only approved by the NHS for treating type 2 diabetes and not specifically for weight loss. However, due to its effectiveness, some doctors do prescribe it off-label for obesity, with a private prescription costing around £300 a month. In March, the National Institute for Health and Care Excellence (NICE) approved the use of Wegovy alongside diet and exercise as part of NHS specialist weight-management services. It is available to individuals with a BMI of 35 and above, who also have a weight-related condition such as high blood pressure, pre or type 2 diabetes, or sleep apnea. Those with a BMI of 30 to 34 are also eligible if they meet the criteria for referral to a specialist weight-management service.
Both Ozempic and Wegovy are administered weekly using an injection pen and are associated with side effects such as nausea, diarrhea, and constipation. However, there are reportedly around two dozen second-generation weight-loss drugs in development, aiming to improve on the benefits and reduce side effects. One such drug is retatrutide, a weekly injection that led to an average weight loss of 24% (or 58 pounds) in clinical trials. This is the highest weight reduction achieved by any drug thus far. Retatrutide mimics the hormone glucagon-like peptide 1 (GLP-1), which reduces appetite and slows stomach emptying, leading to a feeling of fullness. It also targets two other hormone receptors, GIP and glucagon, further reducing appetite. Experts have called the results of the retatrutide trial “absolutely remarkable.” Another promising drug is Orforglipron, which is available in tablet form and led to an average weight loss of 14.7% in trials. It works in a similar way to GLP-1 drugs and may be preferred by individuals who are needle-phobic.
Scientists initially developed weight-loss drugs as injections to protect the active ingredients from stomach acid. However, more people may prefer taking a daily pill, especially if they have a fear of needles. Pills can also be produced at a lower cost than injections. For example, Rybelsus, an oral version of Ozempic, has been approved for treating type 2 diabetes and has the added benefit of causing weight loss. HU6 is another pill currently in development that works differently from GLP-1 drugs, using a natural process to increase the breakdown of fat and sugar in cells. The next generation of weight-loss drugs could be available within a few years, offering more options for overweight and obese individuals.
It’s important to note that weight-loss drugs should be used while under medical supervision and are most effective when combined with a healthy lifestyle. Although weight-loss drugs can yield significant results, the appetite may return once the medication is stopped. Long-term safety data is still needed, and the National Institute for Health and Care Excellence has approved Wegovy for a maximum duration of two years due to limited safety data. However, these advancements in weight-loss medications are providing hope for the treatment of obesity and challenging the notion that weight gain is solely a result of personal failures, instead positioning it as a hormonal problem that can be treated. Individuals struggling with obesity now have more viable options for improving their health and wellbeing.
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