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By Denise Mann HealthDay Reporter
A newly approved drug for type 2 diabetes may also be a game-changer for the treatment of obesity.
Tirzepatide is given as an injection once a week and acts on two naturally occurring hormones that help the brain tell you that you are full. It can be just as effective as weight loss surgery.
“About nine out of 10 people in the study lost weight, and the average weight loss for the highest dose was 22.5%, which is something we’ve never seen before,” said study co-author Dr. Ania Jastreboff. She is an associate professor at Yale University School of Medicine and co-director of the Yale Center for Weight Management in New Haven, Conn.
“These results are an important step forward in potentially expanding effective therapeutic options for obese people,” said Jastreboff.
The new trial was aimed at people who are obese but did not have diabetes. It turned out that they lost even more weight than what was seen in the diabetes trials that led to the drug’s approval in May for this indication.
Drug maker Eli Lilly sponsored the new study.
For the 72-week study, more than 2,500 overweight or obese adults were given 5, 10 or 15 mg of the new drug or placebo every week. The average weight reduction for the highest dose was about 52 pounds, the study showed. People who took the 10 mg dose lost about 49 pounds on average, and those in the 5 mg group lost about 35 pounds. In contrast, people who received a placebo shot lost just over 5 pounds. Study volunteers were also advised on healthy eating and exercise.
Nearly everyone who took the drug saw an improvement in blood sugar, blood pressure and cholesterol levels, the study found.
The most common side effects were nausea, diarrhea and constipation, and they were generally mild to moderate, Jastreboff said.
The study participants kept the weight off for the entire 72-week study period. “Obesity is a chronic treatable disease. We need to treat obesity as we treat any chronic disease — with effective and safe approaches that target underlying disease mechanisms, and these results underscore that tirzepatide does just that,” she said.
People may need to stay on the medication indefinitely. “If we think of obesity as a chronic disease, why treat a chronic disease for only 72 weeks?” said Jastreboff.
Individuals who developed prediabetes were not included in the new analysis. They will be followed for two years to see how the new drug is doing. People with prediabetes have higher-than-normal blood sugar levels, but they don’t have full-blown diabetes yet.
The study was presented Saturday at the American Diabetes Association’s annual meeting, in New Orleans, and was published simultaneously in the June 4 issue of the American Diabetes Association. New England Journal of Medicine†
“This study is a big deal,” said Dr. Scott Kahan, director of the National Center for Weight and Wellness in Washington, DC. “Tirzepatide is the first drug of a new class of drugs that will likely become the preeminent drug for both diabetes and obesity treatment,” said Kahan, who is unrelated to the study.
“We currently have pretty good drugs available for weight management — but the magnitude of the weight loss far exceeds all other drugs,” he said. In addition, “it approaches the amount of weight loss with the most common bariatric surgical procedures,” he added.
Also, almost everyone treated with the medication lost at least a modest amount of weight, if not much more, Kahan said.
So how does this new injection compare to other prescription weight loss drugs? Kahan said it looks like a winner.
An obesity treatment approved last year called semaglutide (Wegovy) produces about 15% weight loss. It targets human glucagon-like peptide-1 (GLP-1), but the new drug targets GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), which may be why it appears to be even more effective.
“Other drugs approved in the past decade lead to an average of between 10% and nearly 15% weight loss. The most commonly prescribed weight loss drug in the United States – phentermine (Adipex-P, Lomaira), which is US-approved Food and Drug Administration in 1959 – usually leads to only 5% to 7% weight loss,” Kahan said.
If and when this drug is approved for weight loss, cost will be a consideration, he said.
For diabetes, it is estimated to cost about $800 a month, but it will likely be covered by insurance. “Weight medications are traditionally different in that they are usually not covered by insurance, so people have to pay out of pocket,” Kahan noted. It is too early to predict the cost of tirzepatide for obesity.
The US National Institute of Diabetes and Digestive and Kidney Diseases has more information about medications that treat obesity.
SOURCES: Ania Jastreboff, MD, PhD, associate professor, Yale University School of Medicine, and director, weight management and obesity prevention, Yale Stress Center, and co-director, Yale Center for Weight Management, New Haven, Conn.; Scott Kahan, MD, MPH, director, National Center for Weight and Wellness, Washington, DC; Meeting of the American Diabetes Association, New Orleans, June 3-7, 2022; New England Journal of MedicineJune 4, 2022
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