Every so often, a groundbreaking drug emerges with the potential to revolutionize the world. According to medical experts, the latest contenders in this category are the new obesity drugs such as Ozempic, Wegovy, and Mounjaro that could soon hit the market. These drugs are unlike anything that has ever existed before.
Describing these drugs as “game changers,” Jonathan Engel, a medical historian and health care policy expert at Baruch College, acknowledges the unprecedented impact they could have. For years, obesity has plagued almost 42 percent of American adults, leaving medical professionals feeling powerless. Attempts to find effective medical treatments for obesity had been met with failures and disinterest from pharmaceutical companies. Many believed that obesity was a moral failing, rather than a chronic disease.
Unlike the logical process that led to the discovery of drugs for diseases like cancer, heart disease, and Alzheimer’s, the journey to develop obesity drugs has been quite different. The details surrounding these drugs remain shrouded in mystery. Researchers stumbled upon the idea of exposing the brain to abnormally high levels of a natural hormone, resulting in weight loss. However, the exact mechanism behind this phenomenon remains unknown.
Dr. David D’Alessio, an endocrinologist at Duke University, explains that scientists would love to establish a logical explanation or order that could predict the efficacy of these drugs. However, such an explanation has not yet been found.
While the safety of these drugs appears to be promising, caution is still urged by obesity medicine specialists. Similar to cholesterol or blood pressure medications, obesity drugs must be taken consistently to prevent weight regain. Dr. Susan Yanovski, co-director of the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases, warns about the need to monitor patients for potential rare but serious side effects, especially since the mechanism of action behind these drugs remains unclear. However, it’s important to prioritize the serious diseases and increased mortality associated with obesity.
Patients using these drugs may experience temporary symptoms such as nausea and diarrhea. However, the main effect is profound and transformative. Patients report a significant reduction in cravings and find themselves satisfied with smaller portions. The weight loss is attributed to natural appetite suppression, rather than increased calorie burning. Additionally, recent clinical trial results suggest that Wegovy may offer protection against cardiac complications, including heart attacks and strokes. The reasons behind this protective effect, however, remain poorly understood.
Dr. Daniel Drucker, a diabetes and obesity researcher at the Lunenfeld-Tanenbaum Research Institute, points out that pharmaceutical companies prefer not to admit to trial and error processes and instead portray their drug development as clever and deliberate. However, luck has played a significant role in the success of these obesity drugs.
The origin of these drugs can be traced back to the 1970s when Dr. Joel Habener, an endocrinologist at Harvard Medical School, was initially focused on diabetes research. He discovered a hormone called GLP-1, which regulates blood sugar levels. This hormone appeared to be a promising targeted treatment for replacing insulin injections. Dr. Jens Juul Holst at the University of Copenhagen made a similar discovery independently.
The challenge, however, was to make GLP-1 last longer in the body. Dr. John Eng, a researcher at the Veterans Affairs medical center, found a variant of GLP-1 in the venomous Gila monster that remained stable for an extended period. The success of this discovery eventually led to the development of exenatide (Byetta), which was approved for the treatment of diabetes in 2005. Byetta had the unintended side effect of causing slight weight loss.
For years, obesity had been a frustrating dead end in the pharmaceutical industry. No drugs had proven to be significantly effective in combating obesity, and those that did have modest effects came with serious side effects. The discovery of hormones such as leptin and ghrelin, which were believed to have potential for weight loss, yielded disappointing results.
Despite the challenges, progress has been made in the development of obesity drugs. These new drugs offer hope for the millions suffering from obesity and its associated health problems. While much remains unknown about their mechanisms of action, their potential to transform lives is undeniable.
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