A new ‘miracle’ weight-loss drug really works — raising huge questions : LC Research/Media Forum : Active Low-Carber Forums

#1 ^

Mon, Jul-18-22, 07:36

JLx

Senior Member

Posts: 3,199

Plan: High protein, lower fat
Stats: 000/000/145 Female 66

BF:276, 255 hi wts
Progress: 0%

Location: Michigan U.P., USA

A new ‘miracle’ weight-loss drug really works — raising huge questions

Novo Nordisk’s Wegovy uses a hormone to regulate hunger. It’s wildly effective, but is it misguided?- Financial Times https://www.ft.com/content/96a61dc0...a2-2b6a382b7a3b

This is a more thoughtful article than many others I've noticed about the new semaglutide drugs.

Quote:

When a patient stops taking Wegovy, their appetite returns within weeks and they pack on weight. In the study run by Robillard’s doctor, Domenica Rubino, the patients who came off the drug regained 7 per cent of their body weight. “We used to think that behaviour causes the weight state, but now we think the weight state actually causes the behaviour,” Rubino says. There may be even worse side effects of coming off the drug. Less than a week after Robillard stopped taking it at the end of the trial in November 2019, she started having panic attacks. “Every circuit started thinking about the cravings,” she says. She regained 20 pounds.

Novo Nordisk’s long-term ambition is to cure obesity by discovering how to stop the body bouncing back. Until then, Kurtzhals believes people should think of treating obesity as they do other chronic diseases. “For some reason, many people have an easier time understanding that your blood pressure medication is for life than understanding that your treatment of obesity is also for life,” he says. Part of that reason may be the price tag. Unlike generic blood pressure drugs that now cost $10 a month, Wegovy’s monthly list price in the US is about $1,350....

Even if Novo Nordisk and its competitors succeed in getting their drug accepted by the people who hold the purse strings, they will still face opponents who reject the whole premise that obesity should be treated with medicine. Advocates of “body positivity” and some weight management experts believe health metrics such as blood pressure or blood sugar are far more useful than body mass index. The company is hoping to sway doubters with a trial, which reports later this year, that will show whether Wegovy reduces the risk of cardiac problems.

Marquisele Mercedes, a doctoral student in public health at Brown University, is fed up hearing that Wegovy is a “miracle”....

Varady worries that it will be easier to medicate a world that she describes as “obesogenic” — tending to cause obesity. Wegovy could become a societal sticking plaster, allowing food companies to continue selling junk and pharma companies to profit from slimming people down. She believes it would be more “humane” if governments found ways “to teach people or tax them”, such as the UK levy on sugary drinks.

Mercedes believes Novo Nordisk’s efforts to counter stigma — the Queen Latifah campaign — could actually end up embedding existing bias. “They’re selling you a solution to the discrimination and stigma you face by giving you a way to be smaller,” she says. It is “literally just advertising. We’re transitioning from the personal failure, lacking willpower, lacking self-control narrative, to this narrative that says ‘Obesity is a disease, you need a prescribed cure’ . . . so we can sell weight-loss medication,” she says. “They are going to make a killing.”

What's clear is that this drug does something real.

Quote:

When we eat, cells in the small intestine secrete GLP-1....The hormone’s effect on the brain, they discovered, is to reduce appetite and create a feeling of fullness.

One patient described feeling as if her mind was "freed from its obsession with eating".

Sponsored Links

#2 ^

Mon, Jul-18-22, 07:50

JEY100 JEY100 is offline

To Good Health!

Posts: 13,439

Plan: P:E/DDF
Stats: 225/150/169 Female 5' 9"

BF:45%/28%/25%
Progress: 134%

Location: NC

JL thanks for posting this! I had suggested a friend who wants WL surgery to look into it. The link you posted was behind a paywall for me, but this one opened: https://www.ft.com/content/96a61dc0...U6EF-LmswZHiEJ8

#3 ^

Mon, Jul-18-22, 08:43

JLx

Senior Member

Posts: 3,199

Plan: High protein, lower fat
Stats: 000/000/145 Female 66

BF:276, 255 hi wts
Progress: 0%

Location: Michigan U.P., USA

Oh, sorry. I'm not a subscriber and I was able to read it so I thought it was a good link.

#4 ^

Mon, Jul-18-22, 11:07

deirdra

Senior Member

Posts: 4,328

Plan: vLC/GF,CF,SF
Stats: 197/136/150 Female 66 inches

BF:
Progress: 130%

Location: Alberta

Quote:

Originally Posted by JLx

What's clear is that this drug does something real.

One patient described feeling as if her mind was "freed from its obsession with eating".

Curiously, this is exactly the feeling I get from eating only real foods, plenty of nutrients, high protein, low net carbs and moderate fat. Do they make my small intestines secrete GLP-1? For free?

#5 ^

Wed, Jul-20-22, 07:49

WereBear

Senior Member

Posts: 14,682

Plan: EpiPaleo/Primal/LowOx
Stats: 220/130/150 Female 67

BF:
Progress: 129%

Location: USA

Quote:

Originally Posted by deirdra

Curiously, this is exactly the feeling I get from eating only real foods, plenty of nutrients, high protein, low net carbs and moderate fat. Do they make my small intestines secrete GLP-1? For free?

The drug price tag would buy a lot of real food.

Quote:

Varady worries that it will be easier to medicate a world that she describes as “obesogenic” — tending to cause obesity. Wegovy could become a societal sticking plaster, allowing food companies to continue selling junk and pharma companies to profit from slimming people down.

She's right to worry. Because they will.

#6 ^

Mon, Mar-20-23, 07:07

Ms Arielle Ms Arielle is offline

Senior Member

Posts: 19,231

Plan: atkins, carnivore 2023
Stats: 200/211/163 Female 5'8"

BF:
Progress: -30%

Location: Massachusetts

Quote:

Originally Posted by deirdra

Curiously, this is exactly the feeling I get from eating only real foods, plenty of nutrients, high protein, low net carbs and moderate fat. Do they make my small intestines secrete GLP-1? For free?

X2
My thoughts exactly.

#7 ^

Mon, Mar-20-23, 07:42

Demi

Strong Girls Rock!

Posts: 26,750

Plan: Muscle Centric
Stats: 238/153/160 Female 5'10"

BF:
Progress: 109%

Location: UK

Quote:

Weight loss jab risks creating medicated society, warns outgoing Defra advisor

Henry Dimbleby says ministers have adopted an 'ultra-free-market ideology' and are refusing to impose restrictions on junk food industry

Prescribing weight loss jabs rather than tackling the causes of obesity risks creating a medicated society, the outgoing food tsar has said.

Henry Dimbleby, who quit his role as an advisor at the Department for Environment, Food and Rural Affairs (Defra) this weekend, said ministers had adopted an “ultra-free-market ideology” and refused to impose restrictions on the junk food industry.

The restaurateur, who co-founded Leon, said he was leaving his position after five years so he could criticise the “insane” inaction by the Government against obesity.

Mr Dimbleby said there was a “feedback loop” between food companies, their commercial incentives and the public’s appetite, and “government needs to intervene” to break the cycle.

Speaking on Radio 4’s Today programme he said: “Boris Johnson was going to do it, he was going to introduce advertising restrictions, he was going to make [buy-one-get-one-free deals] on those kinds of foods illegal, and the Government has now pulled back.”

He added: “What will happen is we either hack those commercial incentives, or we hack the appetite.”

A “new wave” of appetite restricting drugs is on the way, Mr Dimbleby said, “but if the government don't act you'll have 20 million, 25 million, people in the population who are medicated for the problems that the food system is causing."

Around a quarter of adults in England are obese, and a further 37.9 per cent are overweight, according to the Health Survey for England 2021. Obesity is estimated to cost the NHS around £60bn a year, with £27 billion costs to wider society.

Wegovy, a weight loss jab, will be offered to tens of thousands a year on the NHS after it was approved by the National Institute of Health and Care Excellence (Nice) earlier this month.

Nice is currently reviewing a second similar drug, tirzepatide, which was originally developed as a treatment for diabetes.

'They are thinking about medicating 20m people'

Asked if he believes the Government is viewing these approvals and new drugs as a solution to Britain’s obesity crisis, rather than “nanny state” interventions such as banning junk food adverts, Mr Dimbleby said: "I think that is what's happening actually, I think that they are thinking about medicating 20 million people.

"The problem with that is, first of all, when you roll out... a drug that is being trialled on quite a limited number of people to that many you will get side effects that will cause problems, it will become quite political.

"Secondly, while I think it's a good thing in certain extreme cases, to me it does not feel like a society we want to create where you're just shifting the money from people selling junk food to the people making drugs, and there are quite reasonable interventions you can make to create a healthier, more pleasurable, unmedicated society."

https://www.telegraph.co.uk/news/20...warns-outgoing/

#8 ^

Mon, Jul-18-22, 11:57

JLx

Senior Member

Posts: 3,199

Plan: High protein, lower fat
Stats: 000/000/145 Female 66

BF:276, 255 hi wts
Progress: 0%

Location: Michigan U.P., USA

I have that feeling getting 130+gms of protein and lowering fat. I did not have that feeling eating the same approx amount of calories - 1500 - and the same approx amount of carbs, 100-120. So for me, it took lowering fat and increasing protein.

I fully understand people wanting to take this drug, though. Unlike the surgery where people can still manage to gain all their weight back through emotional eating or whatever reason, this sounds like as long as you take it, you have a reduced appetite. Or could emotional eaters overcome the drug too? Now that would be an interesting study.

At the end, the woman introduced in the beginning says,

Quote:

"she resents people who think it is a quick fix. She says she has to continue
watching what she eats and exercising. “It’s not like you take the drug, and then you can eat pie and cookies all day.”

implying there has to be some kind of intent to lose weight even with the drug. But otherwise, medically, once the price comes down and as long as serious side effects don't emerge, I can see the medical establishment jumping on this for this reason:

Quote:

Almost half of Americans are expected to be obese by 2030, a Harvard study found, and that could account for up to 18 per cent of healthcare spending on related conditions, ranging from heart disease and stroke to osteoarthritis. Worldwide obesity rates have tripled since 1975, with 650 million adults obese in 2016, according to the World Health Organization. In 2019, the OECD declared that developed countries’ plans to tackle the problem were largely failing.

Well, the countries with national health insurance will be interested but perhaps not the U.S. as Big Food and the weight loss industry may lobby against it. And then there's the puritanical attitude that fat people deserve their fate.

#9 ^

Tue, Jul-19-22, 12:15

Nancy LC

Experimenter

Posts: 25,865

Plan: DDF
Stats: 202/185.4/179 Female 67

BF:
Progress: 72%

Location: San Diego, CA

I get that feeling when my blood sugar is lowish.

#10 ^

Tue, Jul-19-22, 21:07

Gypsybyrd Gypsybyrd is offline

I'm good enough!

Posts: 7,035

Plan: Keto IMO Atkins 72 Induct
Stats: 283/229/180 Female 5'3"

BF:mini goal 250, 225
Progress: 52%

Location: St. Pete, Florida

But does the drug fix insulin resistance which drives obesity? Does the drug fix other medical issues that are caused by eating higher carb? It’s fixing an external issue, appearances of being obese, but it doesn’t fix the health of the person.

#11 ^

Wed, Jul-20-22, 06:24

JLx

Senior Member

Posts: 3,199

Plan: High protein, lower fat
Stats: 000/000/145 Female 66

BF:276, 255 hi wts
Progress: 0%

Location: Michigan U.P., USA

It sounds like the person taking the drug has a newfound ability to resist overeating, which includes carbs presumably. They lose weight, so that alone will address insulin resistance.

That article said they've yet to study other health effects, such as cardiac outcome, but how can major weight loss such as 70 lbs not be of benefit? Just dragging around less body mass relieves some strain on the heart.

#12 ^

Thu, Jul-21-22, 20:10

Gypsybyrd Gypsybyrd is offline

I'm good enough!

Posts: 7,035

Plan: Keto IMO Atkins 72 Induct
Stats: 283/229/180 Female 5'3"

BF:mini goal 250, 225
Progress: 52%

Location: St. Pete, Florida

Quote:

Originally Posted by JLx

It sounds like the person taking the drug has a newfound ability to resist overeating, which includes carbs presumably. They lose weight, so that alone will address insulin resistance.

...

IF they eat less carbs, then I could see it assisting with improving insulin resistance.

Just losing weight, as I understand it (not a doctor or medical professional), is not enough to fix insulin resistance. There are plenty of people who are not overweight who are insulin resistant. The number of those in my circles of friends and acquaintances keeps increasing.

#13 ^

Tue, Aug-15-23, 17:07

Calianna

Senior Member

Posts: 1,896

Plan: Atkins-ish (hypoglycemia)
Stats: 000/000/000 Female 63

BF:
Progress: 50%

Quote:

Originally Posted by JLx

~snip~

That article said they've yet to study other health effects, such as cardiac outcome, but how can major weight loss such as 70 lbs not be of benefit? Just dragging around less body mass relieves some strain on the heart.

Apparently there's been some study of the health benefits now.

This has made the major news outlets, but the study itself has not been peer reviewed yet.

Wegovy Trial Shows Incredible Results for Heart Health

Quote:

Newly-published results of a large-scale trial found Wegovy, one of the brand names of the controversial weight loss drug semaglutide, appears to have substantial heart health benefits — findings that could finally convince insurers to begin covering the injectable medication. In a press release, Danish pharmaceutical company Novo Nordisk asserted that the 2.4 mg dose of semaglutide — which differentiates Wegovy from Ozempic, its popular-yet-notorious 1 mg semaglutide counterpart that's become a household name for its weight loss effects — is associated with lowered risk of major adverse cardiovascular events in people over the age of 45 with higher body mass index (BMI) readings but no history of diabetes. Specifically, it slashed the risk of heart attacks by 20 percent, the double-blind trial found. It also, of course, assisted in weight loss among those given the active drug instead of the placebo to lose weight. The late-stage trial named SELECT began in 2018 and enrolled more than 17,000 people across six continents. While it's not the first to look into semaglutide's cardiovascular health benefits, its timing couldn't be better. The drug's popularity has soared even as insurers continue refusing to cover the $1,300-per-month medication for anything but diabetes — and some of those patients have seen their claims denied, too. In an interview with the Financial Times, BMO Capital Markets analyst Evan Seigerman argued that the findings of this landmark trial would make it "unethical" for insurers to continue refusing to cover semaglutide drugs, which include the brand names Wegovy, Ozempic, and Moujnaro. The good news comes with caveats: SELECT trial's findings have yet to be peer-reviewed, and Novo Nordisk has only published the-top line summary of its findings. And concerns remain about some of the adverse health effects of semaglutide, and its problematic adoption by the problematic weight loss industry writ large. Just a few weeks ago, CNN reported that doctors have increasingly seen patients who developed gastroparesis, a debilitating condition in which one's stomach becomes paralyzed, after they took injectable semaglutide. Even without that extreme side effect, one of the scientists who pioneered the drug warned that its main mechanism, which suppresses appetite by mimicking the gut hormones released upon eating to fullness, can also straight up remove the pleasure of food. "What happens is that you lose your appetite and also the pleasure of eating, and so I think there’s a price to be paid when you do that," Danish biomedical researcher Jens Juul Holst, a University of Copenhagen professor whose work led to the creation of semaglutide's predecessor, told Wired earlier this year. "If you like food, then that pleasure is gone. The craving for food for some people is taken away." Holst insisted that people often don't stay on drugs like Wegovy and Ozempic because it takes away food pleasure, which could, in theory, effect the continued use of semaglutide for its heart health benefits, too. Like the classic Billy Ray Cyrus meme, there's plenty more to consider regarding Wegovy than its manufacturers and proponents are letting on — but then again, anything that gets Big Pharma out from under the plausible deniability of not being able to cover patients? For anyone who doesn't work in Big Pharma: A straight-up win, caveats and all.

It'll be interesting to see what peer review eventually says about it.

I would imagine that just like JLx said, " how can major weight loss such as 70 lbs not be of benefit? Just dragging around less body mass relieves some strain on the heart."

But then is it working to reduce heart attacks and strokes better than simply losing weight, getting your blood sugar under control, and lowering your BP?

#14 ^

Fri, Aug-18-23, 07:48

GRB5111

Senior Member

Posts: 4,044

Plan: Very LC, Higher Protein
Stats: 227/186/185 Male 6' 0"

BF:
Progress: 98%

Location: Herndon, VA

Quote:

Originally Posted by Calianna

It'll be interesting to see what peer review eventually says about it.

But then is it working to reduce heart attacks and strokes better than simply losing weight, getting your blood sugar under control, and lowering your BP?

True, but this is the statement that troubles me, which you correctly put in bold:

Quote:

The good news comes with caveats: SELECT trial's findings have yet to be peer-reviewed, and Novo Nordisk has only published the-top line summary of its findings.

And this statement:

Quote:

Novo Nordisk asserted that the 2.4 mg dose of semaglutide is associated with lowered risk of major adverse cardiovascular events in people over the age of 45 with higher body mass index (BMI) readings but no history of diabetes. Specifically, it slashed the risk of heart attacks by 20 percent, the double-blind trial found.

Since there is no full RCT document to review ("Novo Nordisk has only published the-top line summary of its findings"), I'm going to presume that the 20 percent is based on relative risk as opposed to absolute risk, as this is how the pharmaceuticals present their best statistics. I'm now looking forward to reviewing the trial, but as mentioned several times on this forum, pharmaceuticals do not publish adverse event data with no legal requirement for them to do so. I'm concerned that those taking these drugs today for weight loss and in the future for heart health are the "lab mice" who will ultimately prove the effectiveness and tease out the side effects of these drugs. What a world where humans are lab rats who can perish, but the financials are too healthy to stop the machine. What's a little payoff that's a fraction of overall revenue?

The current rumblings:

Quote:

Originally Posted by JEY100

This morning Metabolic Health sent an article about GLP-1 agonists, including slowing gastric emptying.
Then later this News report of lingering side effects. Gastroparesis maybe worse than 40% loss of lean mass!
Lesson in eye-catching headline: "They took blockbuster drugs for weight loss and diabetes. Now their stomachs are paralyzed"

gravely concern me. But, the momentum has started as the current "off label" application for heart disease, regardless of how much statistical distortion is involved, is off to the races . . . . The article is written for the machine, however, as invoking the word "ethical" in the context of the pharmaceutical business is the ultimate oxymoron.

#15 ^

Wed, Jul-20-22, 13:34

Calianna

Senior Member

Posts: 1,896

Plan: Atkins-ish (hypoglycemia)
Stats: 000/000/000 Female 63

BF:
Progress: 50%

Gypsybird said:

Quote:

But does the drug fix insulin resistance which drives obesity? Does the drug fix other medical issues that are caused by eating higher carb? It’s fixing an external issue, appearances of being obese, but it doesn’t fix the health of the person.

JLx said:

Quote:

It sounds like the person taking the drug has a newfound ability to resist overeating, which includes carbs presumably. They lose weight, so that alone will address insulin resistance.

WB said:

Quote:

Wegovy could become a societal sticking plaster, allowing food companies to continue selling junk and pharma companies to profit from slimming people down.

All very good points. I tried both links to read the actual article, both came up with a paywall.

Therefore I also have no idea if it addressed the issues of what kinds of food they're being directed to eat.

Is it just eat whatever you want (candy, cake, and potato chips), and stop when you feel full?

And what of underlying emotional/compulsive eating issues? There are people who will feel full or even excessively full, but will continue to eat just because the food is there.