Losing Weight… and OTHER GOOD THINGS

By Dave Trecker

Who would have thought GLP-1 would become the hottest abbreviation around? It means glucagon-like peptide 1, a hormone that regulates blood sugar in Type 2 diabetics.

And it helps people lose weight!

GLP-1 drugs are in the headlines these days, as Oprah and a clutch of soap-opera actresses praise the miraculous effects of these skinny-down pharmaceuticals, spurring sales at Novo Nordisk and Eli Lilly and making a bundle for their shareholders.

It’s quite a phenomenon.

Turns out weekly injections of these drugs can lead to all kinds of good things.

I’m talking about Novo Nordisk’s Ozempic (semaglutide) and Eli Lilly’s Mounjaro (tirzepatide) for treating Type 2 diabetes and Novo’s Wegovy (semaglutide) and Lilly’s Zepbound (tirzepatide)for treating obesity.

The drugs are costly (listed at about $1,000 per month, $250 per shot) and in short supply as the companies struggle to keep up with the explosive demand.

And they’re in demand for good reason. Results from clinical trials have been astonishing.

Dr. Angela Fitch, president of the Obesity Medicine Association, reports treatment with tirzepatide yielded a 20% weight reduction in an unprecedented 60% of the trial participants. Earlier clinical testing with semaglutide delivered an average 16% weight loss. Those results, she says, are life-changers. They give hope to the 750 million people worldwide that are living with obesity, many having exhausted all other ways of slimming down.

Does the GLP-1 effect last? Yes. Although these are early days, tests show that as long as you continue the weekly shots, the weight stays off. Stop the shots and the weight eventually comes back.

How do these miracle drugs work? They activate the GLP-1 and/or GIP hormone receptors in the body. That does several things. It signals the pancreas to produce insulin and it mimics hormones the body releases when we eat, curbing appetite.

These effects are not new. Neither is the tie-in of obesity to Type 2 diabetes. And GLP-1 drugs have been around for almost two decades. The problem was that early versions were not very effective, providing weight loss of only about 8%.

Ozempic, which hit the market in 2019, followed by Wegovy in 2021 changed all that and kicked off what some enthusiasts call a “paradigm shift” in obesity treatment.

But weight loss may be just the tip of the iceberg. These drugs also do other things. A recent 17,000-patient semaglutide trial revealed a stunning 20% reduction in heart attacks among patients with a history of cardiovascular disease. FDA approval is being sought. Early results suggest the drugs may also be effective against chronic kidney disease and reduce craving for alcohol as well. Pretty impressive.

Food companies are getting on the bandwagon to treat obesity. Because weight loss is often accompanied by loss of muscle mass, a boost in protein is sometimes recommended. Nestle, Abbott Labs, General Mills and other food companies are cashing in with an array of high-protein supplements.

But nothing is ever straightforward. There are always caveats. Medical and nutritional experts agree the GLP-1 effect isn’t a standalone solution to anything, but rather one of a number of weapons that physicians can employ. And that certainly applies to treating obesity.

Dr. Evelina Grayver, a woman’s heart care specialist, says, “There is no such thing as a miracle drug … Lifestyle is the foundation of it all.” Stay active, she says, exercise, watch your diet, refrain from smoking and get plenty of rest.

GLP-1 drugs, she says, are no more than maintenance tools –although pretty darned good ones at that.

Dr. Trecker is a chemist and retired Pfizer executive living in Naples.