A 101 Guide to New Weight Loss Drugs such as Ozempic and Wegovy
In this article, you'll get:
The weight loss medications have been explored for many decades, with various types of drugs being developed over the years. The recent frenzy in weight loss drugs is largely due to new medications that offer significant weight loss benefits with manageable side effects. These drugs, like GLP-1 receptor agonists (GLP-1 RA), have gained popularity not only for their astonishing effectiveness in reducing weight but also for their superior ability to improve health overall, such as reducing heart attack risk. Their unique mechanism, which impacts appetite regulation and glucose metabolism, has made them stand out in the weight management field.
How do weight loss drugs work?
The weight loss drugs’ effect is pretty easy to understand. Generally, they help you lose weight in three ways:
I’m not hungry: the drugs make you not feel hungry at all, or at least not that hungry. Or in a fancy way called Appetite Suppressants. Such drugs whispers to your brain, “You’ are getting full, slow down”. Usually, such drugs also come into effect with the next one—extend your stomach fullness feeling (see next bullet).
I feel full: the drugs make you digest slower; aka make you feel full longer. This effect mostly comes from some amazing stuff our intestine generates, or something called Intestinal Peptides. Typical examples include GLP-1 and GIP (which we will talk about below). Intestinal peptides are a group of small proteins in your gut with many great effects, including making your stomach empty slower. Of course, we are not farming this protein from human GIs to make a weight loss drug. Generally speaking, it is a man-made product to mimic such protein’s work and give you the same effect.
Say goodbye to fat: the drugs block you from absorbing fat, or in a jargon way called Fat Absorption Inhibitors. These drugs block the breakdown and absorption of fat in your intestines. When you eat food that contains fat, these inhibitors prevent the enzymes in your digestive system, such as lipases, from breaking down the fat. This means that the fat isn't absorbed into your body and instead passes through your digestive system. As a result, you take in fewer calories from fats, which can help with weight loss. However, because the fat passes through your system, it can sometimes lead to digestive side effects, such as (you can imagine), oily stools, oily fart, and all those you can imagine.
GLP-1, GLP-1 RAs, GIP, and GIP RAs
Now is the boring part. These G-family acronyms don't make sense at all to laypersons like you and I; but they do wonders. Bear with me, as I am going to try my best to explain them in the simplest way and they don't confuse you anymore!
GLP-1: Let’s talk about GLP-1. You may or may not have heard about this techy term before. It literally means “Glucagon-like peptide-1”, and for common folks like you and me, this still means nothing other than Martian language. So generally speaking, GLP-1 is a small protein (specifically a type of hormone), produced in your small intestine in response to food intake. GLP-1 is like your body's natural blood sugar manager. After you eat, it tells your body, "Hey, let's get that insulin flowing," which helps keep your blood sugar in check. It's also like a gentle reminder to your stomach to take it slow with the food, helping you feel full longer. It's pretty cool how your body has this built-in system for balance. Check this journal article from National Institutes of Health if you prefer some in-depth explanation regarding GLP-1.
Apparently, our body cannot generate GLP-1 as much as we want, otherwise obesity and diabetes and those related serious diseases will not be a problem at all. Plus, GLP-1 is quickly broken down in the body, which limits its duration of action. This is why medications mimicking GLP-1, like GLP-1 RAs, are developed to have a longer-lasting effect.
GLP-1 RAs: So here comes our super star: GLP-1 RAs, or again in Martian language called “Glucagon-Like Peptide-1 Receptor Agonists”. This class of medications tricks your body into thinking it’s getting the real GLP-1, helping you control blood sugar and feel less hungry, and all those good effects coming with it. A more professional explanation is that GLP-1 RAs bind to the GLP-1 receptors in the body, stimulating the release of insulin (which lowers blood sugar), reducing the production of glucagon (which otherwise raises blood sugar), and slowing gastric emptying. This also helps in reducing appetite and food intake. Check this NIH article if you want in-depth information.
GIP: Weight loss strugglers like you and me might even heard about this new term “GIP” recently. What is that? It is the abbreviation of “Glucose-Dependent Insulinotropic Polypeptide”. OMG that is even a longer jargon! Don’t worry, we as common people just need to know, this is just a GLP-1’s brother. When you eat, GIP helps tell your pancreas to release insulin, which helps lower blood sugar. It's part of your body's team of hormones that work together to keep your blood sugar levels stable, especially after meals. Check this ScienceDirect page if you want to know more.
GIP-RAs: If you followed me until here, you must learn what this phrase mean! Yes, GIP-RAs, aka Glucose-Dependent Insulinotropic Polypeptide Receptor Agonists is the copycat of GIP, and a newer class of drugs being explored for diabetes and weight managements. That’s it!
Originally, scientist and pharmacologists developed drugs using GLP-1 RAs, and though that route they explore the potential of GIP-RAs. And guess what, they combined the two, and made a new class of drug! This new class of drugs combine the effect of both with a clinically proven stronger effect.
Now we have a dual peptides drug. Are there triple, or even more combinations with better effect incoming? Yes, but that will be another topic…
Ozempic & Wegovy, Mounjaro & Zepbound
When it come to drug names, the pharmaceutical companies are more creative than the wizards and witches in Happy Potter coming up with spells! These fours drugs are hot buzz words today. You must have heard about at least one of them from somewhere. What are these?
Ozempic & Wegovy
I group these two together because:
They are from the same pharmaceutical company – Novo Nordisk.
Both of these two drugs have the same active ingredient called Semaglutide. This ingredient functions as a GLP-1 RA, and does the great stuff GLP-1 RA is supposed to do---control blood sugar, slow stomach emptying, etc.
They both use a pen for injection under the skin, typically once a week, usually in areas like your abdomen, thigh or upper arm. The dosing can vary.
Ozempic is approved for managing type 2 diabetes in adults, and got a lot of off-label uses because of its significant weight loss effect. Ozempic is the starting point of this weight loss drug frenzy (BTW, Ozempic has an sibling called Rybelsus which is a tablet for oral use).
Wegovy is approved and specifically focused on weight management, while you need to be an adult with
obesity (BMI 30 and above) or
overweight (BMI 27 or above) with at least one weight-related condition such as high blod pressure, type 2 diabetes or high cholesterol.
Munjaro & Zepbound
These two drugs are grouped similarly because:
They are from the same pharmaceutical company – Eli Lily.
They have the same active ingredient generally called Tirzepatide (I’m so curious how pharmas name their drugs…). It is unique for its dual action as both a GLP-1 and GIP receptor agonist (Yes dual function!). This dual mechanism makes it more effective in controlling blood sugar levels and promoting weight loss, offering an innovative approach in the treatment of type 2 diabetes and related weight issues.
Again, they use a pen for injection under the skin.
Mounjaro is approved to treat type 2 diabetes in adults.
Zepbound is approved very recently for weight management in adults with the same criteria as Wegovy.
Why such a market frenzy over these new weight loss drugs?
They really WORK!
And it doesn't require much efforts or cause any pain for you as what the weight loss surgery takes. Simply speaking, they really work, regardless of your willpower. Taking Wegovy as an example, research shows an average of 35 lbs weight loss over a 68-week period! It took me 8 years to lose 50 lbs, and in a bit over a year, these people can lose that much! That dual action Zepbound works even better with 15% more lost in the similar period.
I’m no expert but I don’t think a clinical trial can recruit that many iron will folks. And clinical experts also told us it is not a matter of willpower but far more powerful forces causing us to eat more and to do less activity.
Social Media and Celebrity Influencing
Social media and celebrities also played a significant role in this frenzy. Platforms like TikTok have become hotspots for sharing personal success stories and experiences with these medications. For example, Staci Rice, with over 12,000 TikTok followers, shares her experience with semaglutide, directing viewers to a telemedicine provider. Elon Musk and Oprah Winfrey have been influential in bringing weight-loss drugs into the public eye, particularly through social media. Musk, known for his high-profile presence on Twitter, mentioned using Wegovy, a weight-loss drug, which contributed to the increased public interest in these types of medications. His endorsement, considering his massive social media following, significantly raised awareness and curiosity about the drug's weight loss potential.
Similarly, Oprah Winfrey's public discussion about her use of weight loss medication has played a significant role. As a prominent media figure and an influential voice in health and wellness, her openness about using these drugs for weight management has brought further attention to them. Her involvement with WeightWatchers, which is now embracing these medications, indicates a significant shift in how weight loss and management are approached and discussed in the public domain.
Enormous market
The significant market potential for weight loss drugs like Ozempic, Wegovy, Mounjaro, and Zepbound is a key driver of the current frenzy around these medications. Obesity and overweight conditions are major health issues worldwide, with the World Health Organization reporting that in 2016, more than 1.9 billion adults, 18 years and older, were overweight, of these over 650 million were obese. The demand for effective weight loss solutions is driven by both the widespread prevalence of these conditions and the desire for weight management. This represents a substantial market opportunity for pharmaceutical companies, given the large number of people potentially seeking treatment.
The appeal of these drugs is amplified by their proven effectiveness in weight management and the growing acceptance of pharmacological interventions in obesity treatment. For instance, the success of Ozempic and Wegovy in clinical trials has led to a surge in interest. The market for anti-obesity medications is projected to grow, with a report by Allied Market Research estimating that the global anti-obesity drugs market could reach $4.40 billion by 2032. This growth potential, coupled with the chronic nature of obesity which often necessitates long-term treatment, suggests a sustained demand for these drugs. The combination of a large target demographic, effective treatment options, and shifting societal attitudes towards weight management drugs contributes to the significant market interest and investment in these medications.