The Best Obesity Drugs Aren’t Even Here Yet

Ozempic is just the beginning of a new era in obesity treatment. A review published this week previews the emergence of similar experimental drugs that will likely be more effective in helping people lose weight.

McGill University researchers conducted the study, which was a review of clinical trial data surrounding GLP-1 drugs such as semaglutide (the active ingredient in Ozempic and Wegovi). Researchers have reconfirmed the safety and effectiveness of today’s drugs. But they also point to the potential superiority of new compounds currently in development, such as retatrutide, which has so far helped people lose more than 20% of their original body weight in trials.

Semaglutide A synthetic and long-lasting version of the hormone GLP-1—a hormone that regulates appetite and insulin production, among other things. Developed by Novo Nordisk, semaglutide was first approved in 2017 as Ozempic for type 2 diabetes, then in 2021 as Wegovi for obesity. The first GLP-1 drug is far from reaching the masses, but semaglutide has been a game-changer for the treatment of obesity. It helped people lose anywhere between 10% and 15% of their weight in studies, surpassing the typical success seen with diet and exercise alone and even the typical results of older GLP-1 drugs.

Semaglutide isn’t the only new kid on the block, though. Eli Lilly tirzepatide Mimics both GLP-1 and another appetite-related hormone called GIP—a potent combination that allows it to dethrone semaglutide. In clinical trials, subjects treated with tirzepatide lost up to 20% of their baseline weight. There are dozens of other related obesity treatments in the pipeline, some of which have made it into human trials and are even poised to overtake tirzepatide.

McGill researchers analyzed data from 26 randomized clinical trials of single-agent GLP-1 drugs, double agonists like tirzepatide, and even triple-agonist drugs like retatrutide, which combine synthetic versions of three appetite-related hormones: GLP-1, GIP, and glucagon. These trials involved people living with obesity but who did not have type 2 diabetes.

As expected, they found that currently approved drugs were generally safe and effective, with tirzepatide currently the best (participants lost up to 17% body weight after 72 weeks of therapy). But they identified retatrutide as performing better in the short term, with participants losing up to 22% of their body weight after only 48 weeks of therapy.

“We found that 12 GLP-1 [drugs] According to our findings, the largest mean body weight loss was reported in a randomized controlled trial of retatrutide, tirzepatide, and semaglutide,” the researchers wrote in their paper. published on tuesday History of Internal Medicine.

Retatrutide is being developed by Eli Lilly, and is currently being tested in Phase 3 trials – trials that will conclude by 2026. And it won’t be the only newcomer coming in the near future that could outperform today’s existing drugs

Last year, for example, the results of preliminary trials of the drug amicretin (made by Novo Nordisk) Recommended That it can cause more weight loss than semaglutide and tirzepatide. Other drug companies are working on their own competitors to Ozempic, such as Boehringer Ingelheim and Zeeland Pharma’s Dual Agonist. Pressure cooker. Novo Nordisk’s stock has soared actually except That’s when it announced that their drug candidate Cagrisema (a combination of semaglutide with the experimental drug Cagrilintide) helped people lose 22% of their weight in a recent trial, instead of just the 25% expected.

These drugs are certainly not free of their negatives. They usually cause gastrointestinal symptoms such as diarrhea and vomiting and are associated with rare but serious complications. Gastroparesis (abdominal paralysis). Another major concern is their cost, with semaglutide and tirzepatide often costing about $1,000 per month without insurance coverage (which private and public insurers often do not provide). That has been a fuel of spending and growing demand Gray and black markets For these drugs, people are turning to cheaper, but less safe compound and counterfeit versions.

Some experts hope that the arrival of more GLP-1 related drugs will help alleviate some of these problems, particularly cost and insurance coverage. Whether it actually happens or not, we have to see. But it’s almost certain that semaglutide and tirzepatide will have plenty of drugs to crown the current crown as the best obesity treatment around.