May 2023

ENDOCRINOLOGY

GLP-1 AGONISTS FOR WEIGHT LOSS WITH ROBERT KUSHNER, MD


With obesity rates at an all-time high, scientists have been scrambling to understand and treat a disease that affects more than two-fifths of U.S. adults.

Among adults 60 and older, about 42 percent have obesity, defined as having a body mass index (BMI) of 30 or higher, according to the Centers for Disease Control and Prevention (CDC). Obesity affects roughly 44 percent of adults 40 to 59.

​Extra pounds can lead to a host of health problems, ranging from heart disease and stroke to certain types of cancer and early death. Here are a few recent findings and potential treatments that weight loss experts are paying the most attention to.

A new class of medications

​By far the most significant breakthrough in recent years has been the development of a class of injectable weight loss medications called GLP-1 agonists, experts say. The drugs mimic a naturally occurring gut hormone called GLP-1 that helps reduce food intake and suppress appetite.

A few GLP-1 medications have been approved by the Food and Drug Administration (FDA) for type 2 diabetes or weight loss. Probably the most notable is semaglutide, which is better known by its brand names Wegovy (for weight loss) or Ozempic (for diabetes).

Another GLP-1 drug getting a lot of hype is tirzepatide (Mounjaro), because research indicates it may lead to even greater weight loss than the other medications. It’s approved only to treat type 2 diabetes, but the FDA is likely to approve it for weight loss this year. It mimics GLP-1 and a second hormone.
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“We have really entered a paradigm shift in how we’re thinking about treating obesity,” says Robert Kushner, M.D., an obesity medicine specialist at Northwestern University Feinberg School of Medicine. “For the first time, we have really effective medications. In my own clinics, patients are responding. Some are achieving 20 percent or more of body weight loss after one year.” (That’s about 40 pounds for a 200-pound person.)

​The drugs aren’t covered by Medicare if used for weight loss, and they can be expensive. They are also hard to find, due to high demand, and are associated with side effects including nausea, diarrhea and an increased risk of thyroid cancer.

This article was originally published in AARP on on May 12, 2023.

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