It’s no secret that developed nations are in the midst of an obesity epidemic. In the U.S., it is estimated that nearly 70% of adults are either overweight or obese. As a result, secondary conditions related to obesity are on the rise, including several that negatively affect the heart. Such developments have encouraged researchers to investigate obesity in greater detail. These efforts are now proving to be quite beneficial as new obesity drugs have since emerged. But in addition to reducing weight, there are also additional health benefits of obesity drugs that were unexpected. And these discoveries are further showing that the condition of obesity is much more complex than previously thought.
The group of new obesity drugs fall under the category of glucagon-like peptide-1 (GLP-1) medicines. As such, the act on the brain to suppress appetite in addition to other effects that reduce weight. These types of medications were pursued as scientists began to suspect obesity wasn’t simply a matter of poor willpower. Instead, it seems some people are prone to gaining weight and storing calories. This new concept identifies obesity as a disease rather than simply a behavior and lifestyle issue. But while this shift in perspective is notable, additional findings now suggest obesity as a disease has far-reaching effects. And the health benefits of obesity drugs are providing some additional clues in this regard.
“Obesity is associated with 200 other obesity-related diseases. If we treat this one disease, we can potentially impact the health of so many patients in many different ways, and this is yet another important example.” – Dr. Ania Jastreboff, Endocrinologist and Obesity Medicine Specialist, Yale University
How the New Obesity Drugs Work
In the past, the main approach to managing obesity was encouraging dieting and exercise. But for millions, such a strategy was both impractical and unproductive. New perspectives, however, believe there are genetic aspects to obesity risks. This does not mean there is a single obesity gene but instead an interaction among a variety of genes. While these interactions have yet to be defined, it now appears that appetite suppression offers new treatment options. And the new obesity drugs being developed mimic endocrine hormonal effects at the brain level to accomplish this. Specifically, Semaglutide manufactured by Danish pharmaceutical company Nova Novartis has shown remarkable weight loss effects.
In essence, Semaglutide is a GLP-1 analog drug that works within the brain to reduce appetite and cravings. However, it also is known to slow stomach emptying, which also reduces appetite and hunger. Though the same drug, Semaglutide is branded as three different new obesity drugs. Wegovy is the most noted one, which is approved for obese individuals with at least one obesity-related condition. Ozempic is approved for obese diabetics with Type 2 diabetes. And Rybelsus, which is the only tablet formulation, is also used among obese patients with diabetes. Each of these medications reduce body mass by about 12% and improve diabetes and other health conditions. And it’s the other health benefits of obesity drugs that is attracting more attention as of late.
“This is a huge patient population that is extremely symptomatic, for which we’ve had very few if any treatment options, and in which obesity is highly prevalent.” – Dr. Mikhail Kosiborod, Cardiologist, Saint Luke’s Mid America Heart Institute, Kansas City
The Latest Obesity Drug Research
Prior research concerning the health benefits of obesity drugs had primarily focused on weight loss effects. These studies are what led to the FDA approval for these medications in those with obesity-related conditions. But a recent study extended this research by exploring these drugs’ effects on quality of life and heart failure. Specifically, it is known that obesity often causes congestive heart failure and reduced flexibility of heart muscles. By losing weight, it was anticipated that this might improve. But in the latest research, the health benefits of obesity drugs in improving heart failure symptoms exceeded weight loss gains. This again highlights the complexity of obesity as a condition overall.
Obesity is related to many secondary conditions. This includes chronic illness like hypertension, diabetes, elevated cholesterol, and heart disease. Likewise, losing weight is known to reduce severity of blood pressure elevations and high blood sugar levels. However, the latest research showed that Wegovy reduced the number of heart failure admissions by 12-fold when compared to placebo. It has also been linked to a 20% reduction in cardiac complications overall. And it also was associated with less fatigue, reduced shortness of breath, and an 8% improvement in quality of life. Based on this, it is believed that Wegovy has some additional anti-inflammatory effects and cardiac influences beyond weight loss alone. Researchers note that additional studies are needed, but the results are quite promising for overall health gains.
“It’s a short [obesity drug] trial, and so we can’t say much about long-term sustained benefits, but I think the magnitude of the benefit is impressive relative to what other interventions have shown in the same population.” – Dr. Daniel Drucker, Senior Researcher, Lunenfeld Tanenbaum Research Institute, Mt. Sinai Hospital, Toronto
Challenges Amidst the Advances
The discovery of the added health benefits of obesity drugs is exciting and encouraging in addressing the global obesity epidemic. But at the same time, there are challenges that must be addressed. For one, the cost of these new obesity drugs is substantial, and insurance companies often to not cover their expense. This has not stopped others with adequate financial resources to secure the medications for weight loss purposes. But in the process, it is clear this is contributing to healthcare inequities. However, the latest research showing additional health benefits of obesity drugs could convince insurers to change their stance. This is particularly true of costs of conditions like heart failure among these patients could be substantially reduced.
Other risks related to side effects also exist with new obesity drugs. Those that are most common involve gastrointestinal side effects. Nausea, vomiting, diarrhea, constipation, bloating, and cramps can occur in some patients. In addition, there is a threefold increased risks of retinopathy on these new obesity drugs. These are notable adverse effects that can develop and must be closely monitored by patients and providers alike. But fortunately, these risks are small, and severity of side effects often mild. As a result, these new obesity drugs will continue to be popular for weight loss effects. But it will likely be the additional health benefits of obesity drugs that drive their use forward. And simultaneously teach us much more about the complexity of obesity overall.