Recent Research on Anti-Obesity Medications Highlights the Growing Range of Pharmacological Options – The recognition of obesity as a major public health threat has led to the development of multiple weight management approaches. For one, obesity and cancer are closely linked, where researchers found that the joint presence of obesity and cardiovascular disease was associated with a greater risk of cancer than the sum of individual risks related to each factor alone. The difference between overweight and obese individuals is also stark in terms of risk; obese people struggle with extra fat that makes it harder for them to regulate blood sugar, raising inflammation throughout the body, which leads to over 200 obesity-associated disorders, such as fatty liver disease, stroke, type 2 diabetes, and sleep apnea. As such, the medical community has fervently studied this condition, which affects more than 40% of adults in the US.
Designed to complement lifestyle modifications and behavioral interventions, an article and recent research from The Lancet outlines the evolution of anti-obesity medications for individuals with a body mass index (BMI) of more than 30 or a BMI of more than 27 with weight-related comorbidity. These medications have been found to improve weight and metabolic parameters among obese patients. However, the degree of potency and efficacy may vary depending on the drug and its mechanism of action. This has prompted doctors and researchers to explore how different classes of anti-obesity medications contribute to weight loss and widen the range of pharmacological options available for patients with obesity.
Orlistat has shown to improve obesity and metabolic markers
Orlistat is a pill that belongs to the class of anti-obesity medications called lipase inhibitors. Also known under the brand names Alli and Xenical, it prevents dietary fat absorption by inhibiting gastric and pancreatic lipases. The undigested fat is then excreted through bowel movements.
When used in conjunction with a reduced-calorie diet like the Mediterranean diet, orlistat can significantly reduce weight, BMI, waist circumference, and abdominal circumference. Furthermore, a 2023 study published in The American Journal of Clinical Nutrition shows that on top of weight loss, orlistat can also reduce the liver fat content by 27.9% among individuals with obesity and metabolic-associated fatty liver disease (MAFLD). These findings indicate the potential of orlistat in treating both obesity and its associated metabolic syndromes like MAFLD, thereby improving not just the weight but the overall health of obese patients.
FDA approves semaglutide for weight loss
The Food and Drug Authority (FDA) has recently approved semaglutide for weight loss, an injectable belonging to a class of medications called GLP-1 agonists. The mechanism of action of GLP-1 for weight loss was initially used to treat type 2 diabetes in 2005, as it triggers insulin release to improve blood glucose levels. But in the context of obesity treatment, GLP-1 agonists also activate gut and brain receptors to curb appetite and boost satiety, thus preventing weight gain induced by overeating.
Weight loss outcomes of semaglutide are further explored in a year-long, real-world study by researchers from the Precision Medicine for Obesity Program at the Mayo Clinic. Among 305 participants, 41% lost more than 15% of their initial body weight, while 21% lost more than 20%. However, patients must remember that only the brand name Wegovy has been approved by the FDA for obesity management with a maximum prescribed dose of 2.4 mg. Other semaglutide medications like Ozempic and Rybelsus are only approved for type 2 diabetes treatment.
Tirzepatide awaits approval
Similar to GLP-1 agonists, tirzepatide is used to treat type 2 diabetes, except that it targets both GLP-1 and GIP receptors at the same time to regulate blood sugar. In April 2023, pharmaceutical company Eli Lilly released the clinical trial results of the tirzepatide injection marketed as Mounjaro, citing a 21% body weight reduction among research participants. In another study called SURMOUNT-2, Mounjaro achieved up to 15.7% weight loss among adults with type 2 diabetes and obesity.
Such findings support the company’s aim of fast-tracking its FDA approval for chronic weight management among people with obesity or overweight people with weight-related comorbidities that are not necessarily diabetes.
Overall, the various classes of anti-obesity medications boost hope for obesity patients looking to improve their weight and treat associated chronic conditions. The next step is for governments and health institutions to facilitate access to these medications in terms of cost and availability.
