- What is Retatrutide? The new ‘Godzilla’ weight-loss injection Dazed
- Is the ‘Godzilla’ weight loss jab REALLY the best? MailOnline’s graphic reveals all… and how it truly compar Daily Mail
- ‘Godzilla’ of weight-loss jabs could be ‘best so far – helping slimmers shed 30% body weight’… The Sun
- Patients losing 25% of their bodyweight with King-Kong of weight loss medicines Yahoo News UK
- ‘Godzilla’ slimming jab is even better than Ozempic: Trial finds metabolism-boosting retatrutide helps users s Daily Mail
Tag Archives: weightloss
Weight-loss drug Wegovy offers benefits for people with diabetes and common form of heart failure, study finds – CNN
- Weight-loss drug Wegovy offers benefits for people with diabetes and common form of heart failure, study finds CNN
- Novo’s Wegovy Aids Heart Failure Patients With Diabetes in Study Bloomberg
- Wegovy’s heart benefits are not just linked with weight loss, new study suggests MarketWatch
- Study shows Wegovy easing heart failure symptoms for patients with diabetes—helpful to Novo Nordisk as it makes case insurers should pay for the weight-loss medication Fortune
- Positive trial results set up obesity drug Wegovy for use against heart failure STAT
Ozempic, the happy drug? Study suggests weight-loss medications could reduce depression, anxiety – Fox News
- Ozempic, the happy drug? Study suggests weight-loss medications could reduce depression, anxiety Fox News
- Can Ozempic Treat Depression? Obesity Drugs May Help Mental Health Bloomberg
- Weight-Loss Drugs Like Wegovy Now Linked to Lower Depression Risk Healthline
- Exploration of the potential association between GLP-1 receptor agonists and suicidal or self-injurious behaviors: a pharmacovigilance study based on the FDA Adverse Event Reporting System database – BMC Medicine BMC Medicine
- Popular weight loss drugs connected with lower rates of anxiety, depression TMJ4 News
Step aside Ozempic and Wegovy — ‘landmark’ trial results for weight-loss drug Mounjaro just dropped, and they – Business Insider India
- Step aside Ozempic and Wegovy — ‘landmark’ trial results for weight-loss drug Mounjaro just dropped, and they Business Insider India
- Lilly’s SURMOUNT-2 results published in The Lancet show tirzepatide achieved a mean weight reduction of 15.7% at the highest dose (15 mg) in adults with obesity or overweight and type 2 diabetes | Eli Lilly and Company Investors | Eli Lilly and Company
- ADA 2023 – Toxicity undermines Boehringer and Zealand’s incretin Evaluate Pharma
- Lilly’s phase 2 results published in the New England Journal of Medicine show orforglipron, a once-daily oral nonpeptide GLP-1 receptor agonist, achieved up to 14.7% mean weight reduction at 36 weeks in adults with obesity or overweight Yahoo Finance
- Lilly’s Mounjaro Gives Positive Results in Obese Diabetic People Bloomberg
Weight-loss diets boil down to one thing, and it’s not science jargon
Let’s be clear: You absolutely, positively can lose weight on a crank diet. If you have lost weight on a diet eliminating fat, or carbs, or gluten, or plants, or meat, or sugar, you’re not alone. But the dirty little secret is that, if you’ve lost weight at all, it’s because you’ve found a way to eat fewer calories than you expend. Eliminating categories of food is one way to do that. A good way, for lots of people, at least for a while.
Okay, so now maybe you’re thinking that, if those diets work, why write a whole column about their crankness?
Truth, justice and the American way, of course. But also maybe empowerment. Because people should know when they’re being sold a bill of goods.
Let’s look at some fun examples of diets that fit the crank model:
- The grain-free diet, a la “Wheat Belly,” holds that wheat digestion yields polypeptides that bind with opioid receptors in the brain, which makes wheat an appetite stimulant.
- The carnivore diet claims to decrease hormonal fluctuations, because the insulin spikes associated with carbohydrates create a “cascade of other imbalances” of hormones associated with hunger and fat storage.
- Intermittent fasting holds that restricting intake for an extended period of time gives your body no choice but to tap fat stores, so you lose more than if your body has continuous access to blood sugar.
- The blood type diet says that your blood type tells you your ancestry, and we thrive on the food our ancestors ate. And there are plenty of other ancestral diets that double down on this idea.
- And of course low-carb/keto, which holds that, because insulin is key to fat storage, if you don’t eat carbs, you don’t release insulin and you store less fat.
To be fair, there are a couple of diets that tell you flat-out they’re essentially a strategy to eat less. A primary rationale of the low-fat diet is that one 1 gram of fat has 9 calories and 1 gram of carbohydrate or protein has 4, so if you sub in more lower-calorie macronutrients, you consume fewer calories overall. And the Volumetrics diet posits that if you eat food that’s less calorie-dense, you end up consuming fewer calories.
While some diet rationales are pretty silly, they’re not all false. Insulin, for example, really does facilitate fat storage. But there’s one nutrition fact that trumps all the others, and it’s really the only thing you need to know about food and health: What we know is absolutely dwarfed by what we don’t know.
Remember the parable of the blind men and the elephant? Six blind men got to “see” an elephant by feeling a part of it, and they each came away with vastly different ideas of what an elephant was. The guy holding the tusk thought it was like a spear; the guy with the trunk thought it was like a snake. You get the idea. They came away with inaccurate ideas because they couldn’t feel the whole thing.
That’s what’s going on with diets. Nobody can see the whole elephant. Science hasn’t painted it (yet). So each diet guru latches onto some piece of human metabolism and decides that it’s the key to health and weight loss — but really, it’s just the toenail. Sure, digesting wheat yields polypeptides! But there’s so much else going on in the human body that it’s very hard to know how that plays out.
There’s one way to find out, of course: actual trials. And — surprise, surprise — the ones we have (and we have a lot) show that, long-term, no diet works for weight loss. The trajectory — subjects lose weight for a while, even up to two years, and then regain — is similar for all.
But let’s go back to that part where people actually lose weight on crank diets. Why is that? Because, after we peel back the sciency stuff, there are usually some pretty decent strategies for doing that thing that’s at the heart of weight loss — eating less.
So how about this: Ignore the sciency and cut right to the strategies. Sure, intermittent fasting doesn’t outperform other diets, but that doesn’t mean closing the kitchen after dinner is a bad idea. In fact, it’s a damn good idea.
Then look at low-carb. No, insulin doesn’t correlate cleanly with subsequent eating and weight gain, but that doesn’t mean cutting out sugar and refined grains is a bad idea. In fact, it’s a damn good idea.
To lose weight, you don’t have to understand the nitty-gritty of human metabolism; diet isn’t a knowing problem. You just have to figure out workable strategies to eat less; diet is a doing problem. So think of the onslaught of crank diets as a smorgasbord of strategies, and pick and choose the ones that can fit your lifestyle.
I’ve been overweight, but I’m not now, and I’ve used ideas from different diets to keep it that way. I don’t do intermittent fasting, but I close the kitchen after dinner and put off breakfast until I’m quite hungry. I don’t follow a low-fat diet but limit added fats in dishes I make. I’m not low-carb, but I don’t eat many refined grains. I bulk up dishes with vegetables (Volumetrics). I eat almost no ultra-processed foods (every diet known to man). I don’t keep easy-to-eat foods that call to me in the house (common sense), and when we have to buy Girl Scout cookies for neighborhood harmony, I make my husband stash them somewhere (okay, nobody recommends that, but it works for me because Thin Mints call my name).
What I hate most about crank diets is that they prey on people who want, often desperately, to make a change. The metabolic rationales offer a lifeline — all I have to do is this one thing! — and then the ultimate failure feels like your failure. But anyone who’s ever tried it knows that weight loss is hard. There is no one thing. And only you know where your diet goes off the rails, which foods are your undoing, how changes fit, or don’t, in your life.
My hat is off to the people who are comfortable at whatever weight they are and focus on other aspects of their health. Unfortunately, I’m not one of them; being fat made me unhappy. And maybe that’s why the false hope that crank diets traffic in drives me nuts. But I also think weight loss is not just possible but completely straightforward — at least in principle.
It’s not a knowing problem, so forget about the polypeptides. It’s a doing problem, and only you know what to do.
Everything to Know About the New Weight-Loss Drug
- The FDA is expected to approve tirzepatide for weight loss this year.
- Clinical trials found patients lost an average of 22.5% of their body weight on the drug.
- The drug is not expected to be affordable for most.
A drug currently approved to improve blood sugar regulation in adults with type 2 diabetes is expected to be approved by the Food and Drug Administration (FDA) for weight loss this year—and there are plenty of concerns about who will be able to afford it.
The drug, which is called tirzepatide (or its brand name of Monjaro), could lead to up to $48 billion in annual sales and may become the most popular drug ever once it’s approved, experts tell NBC News.
Its use is expected to expand to include weight loss treatment thanks to impressive findings in a phase 3 clinical trial. In the trial, researchers found that patients lost an average of 22.5% of their body weight (or about 52 pounds). By comparison, similar weight loss drugs Wegovy and Saxenda reduced body weight by around 15% (Wegovy) and 5% (Saxenda).
But what is tirzepatide, exactly, and how does it work? Here’s what you need to know.
What is tirzepatide?
Tirzepatide is in a class of medications called GLP-1 agonists, which mimic hormones that are involved in blood sugar control and appetite. It’s taken via injection once a week and has been shown to decrease how much food people eat and increase how much energy they burn, according to a press release from drug maker Eli Lilly.
There are other GLP-1 agonists on the market—Wegovy and Saxenda—but tirzepatide has an element that mimics a hormone called GIP which can reduce appetite and improve how well your body breaks down sugar and fat, Eli Lilly explains. The elements of the drug “work together to improve how the brain sees weight, which leads to weight loss and better blood sugar regulation” says Fatima Cody Stanford, M.D., Ph.D., an obesity medicine physician and clinical researcher at Massachusetts General Hospital.
In phase 3 clinical trials, patients lost an average of 15 more pounds with tirzepatide than with a placebo and an average of 23 pounds more than the placebo group when they used tirzepatide and insulin.
“Currently the GLP-1 agonists are very popular for weight loss,” says Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University. “It is anticipated that this drug is going to be much more beneficial.”
“This is another tool to help with weight loss,” says Mir Ali, M.D., bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, Calif. “But if it’s not used properly—with lifestyle modifications—it will eventually not work.”
What is tirzepatide used for?
Tirzepatide is currently approved by the FDA to help improve blood sugar regulation in adults with type 2 diabetes as an addition to diet and exercise (as of May 2022). The medication specifically helps control blood sugar and is also injected under the skin once a week. The dose is adjusted as people meet their blood sugar goals, the FDA explains.
What does tirzepatide cost?
As of right now, GoodRx says that tirzepatide costs in the mid-$900 to about $1,200 range for four pens without health insurance. However, the cost of the drug “is going to vary depending on insurance,” Alan says.
Stephanie Field, director of pharmacy operations at Corewell Health West, says that patients with type 2 diabetes who qualify for co-pay assistance through Eli Lilly can pay as little as $25 a month. However, that’s for patients who are taking the drug for diabetes—not weight loss.
Is it covered by insurance?
Right now, the drug “is only covered for patients with type 2 diabetes,” Field says, noting that “utilization for weight loss is considered off-label and not covered by a patient’s insurance.” (However, that may change once the drug receives FDA approval for weight loss.)
Once tirzepatide is FDA approved, Dr. Ali says it’s “not likely” to be approved by most insurance companies. “If it is, it will be quite expensive for most patients,” he says. “Hopefully, that will change with time.”
Field says patients can expect the cost of tirzepatide for weight loss to be similar to that of other similar medications on the market. “There are two GLP-1 medications with weight loss indications approved by the FDA—Saxenda and Wegovy,” Field says. “Cash prices for patients can vary depending on the pharmacy, but averages around $1,000 for a month of medication.”
However, if you have a high level of insurance coverage, Dr. Stanford says the drug may be more affordable. “If not, this would be cost prohibitive,” she adds.
Who can afford tirzepatide?
It depends. “It depends on your insurance. It also depends on your own personal finances and how important this medication is for you,” Alan says. Once the drug is approved by the FDA, “some insurances might cover it for diabetes or pre-diabetes and not cover it for weight loss,” Alan says.
How safe is tirzepatide for weight loss?
In general, the drug is “fairly safe,” Alan says. However, she adds, “we will know more as more people take this drug.” Currently, the FDA lists the following as potential side effects of tirzepatide:
- nausea
- vomiting
- diarrhea
- decreased appetite
- constipation
- upper abdominal discomfort
- abdominal pain
Nausea is a common side effect, Alan points out, but tirzepatide is still generally is considered a safe option. “Always talk to your doctor to see whether this drug is safe for you,” Alan says.
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more. She has a master’s degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.
Ozempic, Wegovy Hit Big on TikTok as ‘Miracle’ Weight-Loss Trend – Rolling Stone
Kaitlyn Wade, 30, has struggled with her weight her entire life. Since she was 19 years old, she’s tried every dieting fad that’s splashed across women’s social-media feeds: Hydroxycut, Skinny Wraps, phentermine and topiramate. They all offered temporary but not long-term effects.
“I’ve realized it’s a lot about the science of your body,” she says. “It’s mental and physical. There’s no quick fix to this.”
Wade worried about her weight as she was preparing for the birth of her son in 2021, but after he came, postpartum depression increased her eating habits and a sharp spike in her blood-sugar levels that made her officially pre-diabetic. By September, she reached the heaviest she’s ever been: 403 pounds. “That almost feels like a death,” she says.
Scrolling through TikTok, Wade came across creators who were trying out a new drug called Tirzepatide, sold under the brand name Mounjaro. Like recently popular semaglutide medications (sold under brand names Ozempic and Wegovy), Mounjaro is an injectable drug originally intended for treatment of type 2 diabetes. These drugs are meant to improve blood sugar control by increasing insulin production in the pancreas and delay food leaving your stomach, which decreases the patient’s appetite. The websites for both Ozempic and Mounjaro clearly state that while they may help with weight loss, they are not meant for this purpose. Wegovy, however, does promote itself as a weight loss medication for those with a BMI of 27 or above.
After getting her prescription for Mounjaro, Wade, a swim teacher, started documenting her journey on TikTok as @mermaidkait1. Now, her 63,000 followers have watched her share weigh-ins, tips, and “what I eat in a day” food diaries, documenting how she lost 35 pounds over 11 weeks.
Over the past year, the drugs have become increasingly popular for non-diabetic patients to lose weight: Variety recently reported that semaglutides have become Hollywood’s secret weight-loss weapon; Elon Musk tweeted about using Wegovy in October; while entirely unfounded, speculation that Kim Kardashian used a semaglutide to fit into the Marilyn Monroe dress at the Met Gala gave the drugs an extra spike. On TikTok, the hashtag for Ozempic has nearly 300 million views, while the one for Mounjaro has 200 million. The videos under both are overwhelmingly positive: creators and “obesity experts” giving rave reviews and advice to tens or hundreds of thousands of followers.
The intense interest in what some see as a quick-fix for weight loss has its drawbacks — not only can there be severe side effects, like nausea and vomiting, but the popularity of the drugs has meant a shortage of Ozempic specifically among type-2 diabetics who need it to live.
Online, a different discourse has emerged. In contrast to the overwhelmingly positive videos that fill the hashtags, the backlash has been minor, but enough to get under the skin of some of the content creators. Commenters have derided non-diabetic users for creating shortages while others have complained about the hefty price tag and laundry list of potential symptoms. In response, some of the people seeking a weight loss “miracle” and the “experts” encouraging them have rebranded the use of these injections into a form of self-care and wellness, arguing that chronic obesity should be taken as seriously as diabetes as if a century’s worth of diet culture has not built its brand on celebrating extreme weight loss at all costs.
Of course, the uptick in prescriptions doesn’t just fall on the creators’ heads. There has been a large marketing push for both the injections and the weight loss-specific telehealth platforms that offer quicker access to prescriptions. (The rise in popularity of numerous telehealth platforms have become increasingly popular in the Covid era, and they were most recently linked to a shortage of generic brand Adderall across the U.S. as well.) Advertisements have inundated the Instagram and Facebook algorithms while also being rolled out heavily on TV as well.
What the online conversation loses are the real and dire issues obese patients face in medicine. Extreme weight loss has always been widely celebrated, but obese patients have often struggled to get proper medical attention from providers who can’t see past their weight. While obesity can put patients at higher risk for chronic diseases like heart disease or diabetes, there are numerous other factors, genetic and otherwise, that can affect patients no matter what their size is. As obese patients are flippantly instructed to lose pounds in order to get essential care, they often turn to dangerous solutions in order to be seen and heard by their care providers.
April, a registered nurse known as @thatnurseapril on TikTok, has been struggling with her weight for a decade, but was never able to lose more than 14 pounds. She was fed up with how her weight had made it difficult to do even simple tasks, like vacuuming without feeling out of breath. Combined with her mom and sister’s diagnoses as type 2 diabetics, April was looking for a way to put herself at a lower risk. When she heard about Mounjaro this summer, she first went to her primary care physician for a prescription, and was surprised to be met with hesitation. Her physician instead encouraged her to go the old-fashioned route of diet and exercise. Frustrated, she joined a Telehealth program, and was able to get a prescription; she has since lost 62 pounds.
Like Wade, April has documented her journey on TikTok from the beginning, amassing over 60,000 followers who have viewed her success story. In November, she met with her primary care physician for the first time since she had been told to not take these injections, and her PCP was supportive.
Both Wade and April have reported minimal side effects from Mounjaro, but that’s not the case for most patients. The nausea, vomiting, and sometimes diarrhea can be a daily burden, often spurred by an increase in dosage or fatty foods lingering in the stomach for too long due to the delayed gastric emptying. It can also be triggering for patients with histories of disordered eating habits.
“You have to be careful with people that have a history of eating disorders and of people that are going too low with their blood sugar,” says Laura Cipullo, a registered dietitian, certified diabetes educator and certified eating disorder specialist, who has not worked with Wade or April. “Is this causing any kind of malnutrition, especially in a person that wasn’t over-nourished? It’s something that has to be really monitored closely.”
Cipullo’s practice has seen a rise in requests for Ozempic, and she worries that not enough patients are prepared for the physical and psychological changes that happen with these drugs, noting that regular visits with a physician, dietitian, and therapist are highly recommended to monitor a person’s physical and mental well-being.
“If it’s somebody that’s saying, ‘Listen, this is what happens when I take it, and I’m looking for support’ and it’s just support, great. But the thing is, the typical Instagram user that’s trying to get support from another layperson isn’t necessarily receiving correct information,” Cipullo explains.
TikTok and Facebook groups have created grassroots digital support groups. Various videos under the Mounjaro and Ozempic tags provide advice on a suite of over-the-counter medications to offset heartburn, constipation, and migraines. Commenters celebrate new milestones for their favorite creators or complain about the drug not yet working as quickly for them. Not nearly as many videos detail what happens when you quit taking the drug. Given how recently its popularity has spiked for non-diabetic patients, there is very little information on what happens after a patient wants to conclude their journey. The reality is that like diabetic patients, those who are on these drugs will likely have to be on them for a lifetime or they run a high risk of gaining back most of the weight they lost.
“Nothing is permanent,” says Dr. Azza Halim, an anesthesiologist and physician with expertise in aesthetic medicine, anti-aging, and regenerative medicine who aslo does not work with Wade or April. Dr. Halim has prescribed semaglutides for weight loss purposes to patients at her practice. “I tell my patients there is no magic pill. You still have to do the effort. All the studies have shown that once you do stop the semaglutide, people regain up to two-thirds of the weight they lost. Unless you do behavior modification, you will regain some of that weight.”
On top of practical advice for the usage of these injections, many more videos offer advice on how to not only get a prescription but not pay full price for it. Currently, the average cost for Ozempic for people without insurance is around $2,500 annually. Pharma company Eli Lilly offered a coupon for Mounjaro that lowered its price to around $25 a month for 12 months, though there were growing concerns for patients who could not afford its usual price after the coupon expired.
“If there’s a higher demand, it’ll make it that much more expensive for those who really need it,” Cipullo warns.
As someone who both works in the medical field and is a Mounjaro patient with a large following, Nurse April has been combating comments similar to Cipullo’s on her page.
“I get pretty heated,” she says, noting she tries not to respond to many of them. “It’s usually persons that are diabetic and are running into prescribing issues, which we’ve seen with Ozempic,” she says.
Her defense echoes that of numerous other creators: “The [commenters will] say ‘Well, this is a diabetic medication, and now I can’t get it because you’re only taking it to lose weight or to drop a few pounds. It’s aesthetic for you.’ So I just try to educate by saying that obesity is a chronic disease and a chronic condition like any other chronic conditions such as diabetes, and it deserves to be treated in the same manner.”
While there are many users of Mounjaro, Ozempic and Wegovy who have turned to them to subside obesity-related health risks and warnings like Wade and April, there is also a risk of these drugs being re-shaped as quick fixes for those who want to shed a small amount of weight. The last several decades have seen fad diets become a cultural norm promoted on talk shows and lifestyle magazines with flippant ease. Social media, and TikTok in particular, have unearthed new, alarming concerns for rises in body and facial dysmorphia for younger generations.
An increasing number of Gen Z users have chosen TikTok as their primary search engine and the app’s opaque and mysterious personalized algorithm has certainly gotten flack for pushing weight loss products, “thinspo” aesthetic videos, dangerous diets like intermittent fasting and other unverified medical advice. It would not be surprising if the algorithm had pushed all of the above to people who simply wanted to know more about what these injections could do for them.
“The pressures of diet culture and the societal expectations to look a certain way perpetuate body dissatisfaction, which we know is a leading risk factor in the development of an eating disorder,” says Elizabeth Altukara, director of education for the National Eating Disorder Association. “It’s time to stop body shaming and move toward body acceptance — for physical and mental health reasons.”
To counter the dangers of diet culture over the last decade, the body positivity movement has made strides in fat liberation and representation in all forms of media. There has been more on-screen and cultural body diversity as well as allowing many to see that health is not restricted to a number on a scale. Still, those figures have become targets for virulent hatred on-line, like their existence is not only offensive but a problem to be solved.
Both Wade and April have, at times, wondered what it would be like to let go of their desire to be thinner, and to embrace their body no matter how their weight fluctuates. In the end, their personal choices to turn to Mounjaro were not for aesthetic purposes but rather to stave off real health risks they have faced in recent years, whether from family histories or warnings from their doctors. They were both tired of hoping for the best.
“I still want to embrace my body and know that I’m beautiful at every size,” says Wade, “but it needs to be healthy so that I can live a long, beautiful life and not be held back.”
Why You Can’t Find Wegovy, the Weight-Loss Drug
Novo Nordisk
NVO 0.61%
A/S flubbed the launch of its buzzy new weight-loss drug Wegovy, missing out on hundreds of millions of dollars in sales and squandering a head start before a rival could begin selling a competing product.
Wegovy is among a new class of drugs that health regulators have approved to cut the weight of people who are obese, a goal long sought by doctors and patients. Their weight-dropping potential became a viral sensation on social media. Elon Musk tweeted about Wegovy in October. And a related drug for diabetes, Ozempic, is a hot topic in Hollywood among celebrities seeking to stay thin, according to doctors.
SHARE YOUR THOUGHTS
Will Novo Nordisk A/S be able to retain its competitive edge with its weight-loss drug? Why or why not? Join the conversation below.
Yet Denmark-based Novo underestimated how big demand for the drug would be, and wasn’t ready to make enough to fill the prescriptions that flooded in after U.S. approval last year. Then a contract manufacturer halted production to address inspection issues.
“We should have forecasted better, which we did not,” Novo Chief Executive
Lars Fruergaard Jørgensen
said. “Had we forecasted that, we would have built a different supply chain.”
The missteps have proven costly for Novo, which was forced to ration Wegovy to patients who already had started taking it. The company has recorded around $700 million in sales to date, well short of the $2 billion in 2021 and 2022 sales that some analysts had projected before supply issues hit.
Novo Nordisk Chief Executive Lars Fruergaard Jørgensen admits the drug company misjudged how popular Wegovy would be.
Photo:
Carsten Snejbjerg/Bloomberg News
Amber Blaylock, a music teacher from Springfield, Mo., said she has been trying to get Wegovy to help her reduce weight since hearing about the drug on TikTok and YouTube. She asked her doctor in September to prescribe it, but hasn’t been able to find it.
“Frustrated and impatient for sure,” said Ms. Blaylock, 29 years old.
To turn things around, Mr. Jørgensen said Novo has increased its capacity to make Wegovy and plans a “relaunch” early next year, which should fulfill all orders.
Novo, however, lost valuable time establishing a beachhead in the lucrative obesity-drug market before rival
Eli Lilly
LLY 1.20%
& Co. can enter. Lilly is expected to launch a similar, competing drug named Mounjaro late next year or in early 2024.
The market for anti-obesity drugs, now worth $2.4 billion worldwide, could reach $50 billion in 2030, Morgan Stanley estimates.
“Novo has left the door open for Lilly,” said BMO Capital Markets analyst Evan David Seigerman.
Mr. Jørgensen said the company can regain lost ground because of high demand for Wegovy and the large potential for what is still a mostly untapped market. He said he was unconcerned with the looming competition with Lilly’s drug, because there is room for both products.
“We disappointed physicians and patients in the first round,” he said. “The company wants to be better prepared for the second round.” Novo lists Wegovy at $1,349 a month. Some commercial insurers cover the drug.
Wegovy works by imitating a hormone called GLP-1, which occurs naturally in the body and suppresses appetite, among other effects.
Novo developed GLP-1 drugs to treat diabetes. In 2017, the company began selling semaglutide, the active ingredient in Wegovy, under the brand name Ozempic to treat diabetes.
During the drug’s development, Novo found that weight loss was a side effect, prompting the company to probe using semaglutide to treat obesity. A key trial found that Wegovy helped people with a high body-mass index shed up to 15% of their weight, surpassing the results for older obesity drugs like Novo’s Saxenda.
Saxenda and other older weight-loss drugs had sold modestly, partly due to their limited weight loss, as well as some unpleasant side effects and the refusal of many health insurers to pay up.
Novo worked with Catalent to fill its Wegovy weight-loss drug into syringes.
Photo:
yara nardi/Reuters
Given the experience, Novo figured Wegovy sales would increase gradually. To augment its own production, Novo contracted with a single manufacturer,
Catalent Inc.,
to fill the drug into syringes. Novo said it thought it would have time to add manufacturing capacity to meet a gradual increase in demand.
Wegovy may be superior to older drugs, but “we thought it would still be a journey to open up the market,” Mr. Jørgensen said.
When Novo started selling Wegovy in the U.S. in June last year, however, demand took off. Doctors with large followings on social media touted Wegovy as groundbreaking, while users posted photos holding injection pens and shared their progress losing weight.
“Demand for these new agents has been unlike anything I’ve ever seen in my time in medicine,” said Dr. Michael Albert, a physician specializing in weight-loss treatment at telehealth provider Accomplish Health who has consulted for Novo. Many of his patients began asking about Wegovy, he said, after they heard about it in Facebook groups or on TikTok.
It took only five weeks for doctors to write new prescriptions for Wegovy at the same weekly volume that Saxenda took four years to reach, according to Mr. Jørgensen. “It’s a completely different ballgame that we’re in,” said Ambre Brown Morley, the company’s vice president of media and digital global communication.
Within weeks, supplies were strained. Novo warned that patients might experience delays in receiving their prescriptions. Then in December 2021, Catalent temporarily stopped deliveries and manufacturing at its plant after Food and Drug Administration inspections found faulty air filters and damaged equipment.
To date, Novo has recorded around $700 million in Wegovy sales compared with the $2 billion in 2021 and 2022 sales that some analysts had projected before supply issues emerged.
Photo:
JACOB GRONHOLT-PEDERSEN/REUTERS
Many people who couldn’t get Wegovy for weight loss have sought prescriptions for Novo’s Ozempic and Lilly’s Mounjaro, according to analysts, even though the FDA hasn’t approved the latter two drugs for such use. Ozempic sales increased so much that certain doses are in short supply through at least January, the FDA said.
Lilly is studying Mounjaro, its GLP-1-containing drug for diabetes, for weight loss.
Novo and Lilly said they don’t promote their diabetes drugs for the “off-label” use treating obesity.
A Catalent spokesman said the company is still making improvements to the plant and working with customers to limit the impact of supply constraints on patients. The company restarted filling Wegovy syringes at the facility in the spring.
Novo has been amassing a sufficient inventory before the Wegovy relaunch, Mr. Jørgensen said. When Wegovy relaunches, he said, insurance coverage will be broader than when the drug first went on sale.
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A new weight-loss drug could be an obesity game-changer for Louisiana. But what will it cost? | Health care/Hospitals
When thousands of health care providers and scientists gathered earlier this month at a diabetes conference in New Orleans, one particular session stood out. Researchers described a new drug that could help someone lose more than 20% of their body weight, amounting to an average loss of 52 pounds over a year and a half.
“This is a new era for obesity treatment,” said Dr. Ania Jastreboff, one of the authors of the study, which was published in the New England Journal of Medicine. The results were met with applause and fervent questioning from attendees at the Ernest N. Morial Convention Center.
The evidence for the drug, tirzepatide, and another, semaglutide, is promising. And research shows treating obesity lowers the risk of other costly health concerns, such as diabetes, high blood pressure and stroke. But in a state where 38% of people are obese, ranking fourth in the nation, a big question looms: Who will pay for it?
“These drugs — semaglutide and tirzepatide — have given the kind of weight loss that we previously only got with bariatric surgery. The weight loss is incredible,” said Candida Rebello, a research scientist at Pennington Biomedical Research Center in Baton Rouge who was not involved with this research. “The problem is … most people cannot afford these drugs.”
While doctors are starting to treat obesity as a disease, coverage for expensive weight loss drugs has yet to catch up. Tirzepatide, manufactured by Eli Lilly, will likely cost in the range of $1,000 to $1,500 monthly, and insurance companies won’t cover most of that, if any, said Rebello.
‘The insurance companies haven’t quite caught up’
Weight loss drugs are typically classified as a higher tier drug on insurance plans, said Rebello, putting them in the company of lifestyle drugs like Viagra. Some private insurance companies may cover up to 50% of the cost, but $750 is still out of reach for people who need it most. People from lower socioeconomic backgrounds are more likely to be overweight, Rebello pointed out.
Louisiana’s Medicaid plan does not allow reimbursement for weight loss drugs, though it does cover tirzepatide for diabetes, which it is currently approved to treat.
Blue Cross Blue Shield, which provides health insurance for the majority of Louisiana group plans, said coverage for tirzepatide would be dependent on a member’s plan. But a representative also said many of the company’s health plans do not include coverage for weight loss medications or bariatric surgery. A wellness program that offers coaching and education about weight is available at no cost, the company said.
But such programs are typically not successful. Diet and exercise studies show about a 5% reduction in weight loss, rarely tipping the scales back into a target body weight for patients with obesity. Many people try and fail to lose weight, and evidence shows that it’s not just a lack of willpower that keeps them from succeeding. The pathways in the body that regulate weight loss are altered in some people in a way that makes it very difficult to lose and maintain weight.
“The insurance companies haven’t quite caught up to where the science is,” said Dr. Taniya de Silva, chief and program director of the endocrinology, diabetes, and metabolism fellowship program at LSU Health Sciences Center.
Before it happens
Drugs have historically targeted the downstream effects of obesity: diabetes and the kidney, nerve and eye damage that comes with it. But what if instead, drugs prevented a diabetes diagnosis, or even reversed it?
“Obesity is a big driver of the pathology we see in Type 2 diabetes itself, and if we can use our new agents to achieve significant weight loss, we could even potentially have remission of diabetes,” said de Silva.
Doing that would also lengthen a patient’s life span and reduce the risk of heart disease, which is the No. 1 cause of death in the country. Louisiana has the fifth-highest death rate from cardiovascular disease in the U.S., and it strikes many Louisiana residents in the prime of their lives.
Patients who took semaglutide, which was approved to treat diabetes in 2021 under the brand name Wegovy, decreased their Cardiometabolic Disease Staging score, a measure of diabetes and cardiovascular disease risk, by half, according to another study released at the conference. The trial participants also lost nearly 17% of their body weight.
The drugs work by making people feel full faster, mimicking hormones in the gut called GLP-1 and GIP. They are also thought to work in the brain, targeting receptors related to appetite, and in the pancreas, by increasing insulin secretion in relation to the amount of glucose in the body.
Right now, tirzepatide is only approved for Type 2 diabetes, sold under the brand name Mounjaro. Researchers hope to get it approved for weight loss after clinical trials showed significant results at higher doses. There were some side effects, such as nausea and diarrhea, and the drug needs to be injected once weekly even after the weight loss plateaus, researchers said at the conference. Patients can still “out-eat” the drug if they don’t make lifestyle changes, said de Silva. So it may not work for everyone.
But it is a significant tool in a state that desperately needs it — if only people can get it.
“Using these drugs in an effective way to improve outcomes for our patients, in the end, would be huge savings,” said de Silva. “But someone has to pay for it upfront.”
Weight-loss surgery linked to lower cancer death rate in large study
The results came from a long-term study of more than 30,000 Cleveland Clinic patients between 2004 and 2017. The patients all had a body mass index of 35 or greater — considered “class 2,” or “moderate risk” obesity by medical professionals.
Researchers followed up with about 5,000 patients between ages 18 and 80 who had gastric bypass or gastric sleeve surgery during the study period. None of the people studied had been previously diagnosed with cancer.
And their chances of developing, or dying of, obesity-linked cancers such as ovarian and pancreatic cancer were significantly lower. During the study, 2.9 percent of patients who had surgery developed cancer, compared with 4.9 percent of their counterparts; 0.8 percent died, compared with 1.4 percent of nonsurgical patients. The effects were seen across the board and appeared to be independent of age, sex or race.
According to the Centers for Disease Control and Prevention, more than 1.7 million new cancer cases were reported in 2019 alone. Additionally, nearly 42 percent of U.S. adults had obesity as of March 2020.
“Given the growing epidemic of obesity, obesity-associated cancers are a major public health concern,” says Ali Aminian, director of the Cleveland Clinic’s Bariatric and Metabolic Institute and the study’s lead author. “If we help patients to lose weight, we can significantly mitigate that risk.”
Bariatric surgery has gained steam as an obesity treatment in recent years, with an estimated 256,000 such procedures performed in the United States in 2019, according to an industry group. The researchers said “substantial weight loss” was required to reduce cancer risk.
Other factors might be at play — it’s unclear whether the surgical patients made healthier lifestyle choices or the nonsurgical patients were hesitant to participate in cancer screenings. Few of the patients were not Black or White, indicating a need for further research.