Medications approved for the treatment of type 2 diabetes can have another amazing effect on the body: significant weight loss in obese people.
Tirzepatide injections once a week provided “significant and lasting weight loss,” the researchers wrote over the weekend in The New England Journal of Medicine.
“We need this toolbox. There is less proportionate treatment for obesity as a chronic disease than for other chronic diseases, ”said Dr. Natalie Azar, a medical assistant at NBC News.
“It’s very important and relevant. The vast majority of Americans are either overweight or obese.
In this study, 9 out of 10 people who were obese reported losing weight while taking tirzepatide. Ania Jastreboff is the lead author and director of Weight Management and Obesity Prevention at the Yale Stress Center in New Haven, Connecticut.
“I was very impressed. I think most of us did not expect such results,” Justreboff said today.
“I think (it’s) very interesting,” the doctor added. Robert Gabbay, Senior Research Fellow, American Diabetes Association.
“We’ve always known that obesity is important and has a profound effect on diabetes, and most people with type 2 diabetes become obese. But the means to deal with obesity have not been as strong as we’ve seen here.”
More than 2,500 adults with a BMI of 30 or more, or a BMI of 27 or more, and at least one weight-related complication participated in a phase 3 double-blind, randomized, controlled trial. He compared three different doses of tirzepatide with a placebo. None of the participants had diabetes.
In addition to medication, participants were given a lifestyle that included counseling sessions to help them eat a healthy, balanced diet and exercise at least 150 minutes a week with a deficit of 500 calories per day.
After almost a year and a half, the participants lost on average:
- 5 lbs on placebo
- The lowest dose of tirzepatide is 35 pounds (5 milligrams).
- The average dose is 49 pounds (10 milligrams).
- The maximum dose is 52 pounds (15 milligrams).
The results are similar to those seen by doctors with gastric bypass surgery, as noted by Azar, higher than with other drugs available in the market to treat obesity.
The clinical trial was financially supported by drug manufacturer Eli Lilly.
According to the Centers for Disease Control and Prevention, more than 40% of American adults are obese.
Treatment for obesity has traditionally been aimed at changing lifestyles, but obesity is a “complex” metabolic disease that makes it difficult to return to excess weight, such as anti-obesity drugs, the study’s authors said.
According to Jastreboff, a member of Eli Lily’s scientific council, our bodies evolved to prevent starvation. In order to avoid starvation, they do everything in their power to contain excess fat.
However, this system creates problems in the modern world, where people live a sedentary lifestyle, often suffering from stress and lack of sleep, and many delicious foods are available at all hours. He noted that obesity is caused by a lack of regulation of how much fat our body wants to carry – a point determined by our brains, he said.
“The goal of these anti-obesity drugs is to restore the threshold. So, basically, our body wants to lift less weight, especially less fat,” Jasreboff said.
The researchers added in an editorial in The New England Journal of Medicine that “the waves are moving and there is more for people who are overweight now.”
The drug tested has two important hormones that affect several areas of the body, Azar said. Increases the release of insulin in the pancreas to lower the patient’s blood sugar level. It also helps suppress the appetite and slows down the rate at which the stomach empties, so the patient feels more energized.
“One of the most important things in using medication is to pay more attention to people’s nutrition, to take some time,” Yes, I am. I don’t need to eat, “said Gabbay.
Patients inject themselves into their stomachs or arms. “It takes 30 seconds once a week … it’s very easy,” Jasreboff said.
When it comes to side effects, the drug is well tolerated, Azar said. The most commonly mentioned problems were gastrointestinal disorders such as nausea, diarrhea and constipation. There will be more tests and more work going on, Jasreboff said.
According to Justreboff, in order for patients to continue taking the medication, people who have taken antihypertensive medication should continue to take it, even if their hypertension improves.
“When he stops taking the drug, their weight will rise again and we should not be surprised, because obesity is a chronic disease like any other chronic disease. We need to treat it. We need to continue treatment,” he said.
Last month, the U.S. Food and Drug Administration approved tirzepatid as Munjaro, a treatment for adults with type 2 diabetes. It has not yet been approved as a treatment for obesity.
“We look forward to reviewing the data with the FDA and discussing a possible accelerated path forward, and we should have an updated schedule by the end of the year,” said Maggie Pfeiffer, Lilli Diabetes Deputy Director of Strategy and Operations.
But this medicine can never replace diet and exercise, Azar warned.
“We don’t have pills or injections to help people choose healthy foods or eat right or exercise more,” Justreboff said. “So as patients lose weight, it’s important that we help them emphasize the importance of choosing foods that are truly healthy and making sure they’re getting exercise into their daily lives.”
The drug can also be expensive: Tirzepatid, approved for diabetes, costs $ 1,000 a month, Azar said. Lilly is offering savings cards to reduce costs out of a patient’s pocket, Pfeiffer said.