New weight-loss drugs

You may have heard about a relatively recent weight loss and diabetes drug, Semaglutide. This drug, from Novo Nordisk, is marketed as Wegovy for weight loss and at a lower dose as Ozempic to treat Type-2 diabetes. Both are administered as a once-weekly injectable. Semaglutide works by mimicking the GLP-1 (glucagon-like peptide-1) satiety hormone in our bodies. When we eat, GLP-1 is released from our intestines and sends signals to our brain centers that control appetite. This is having remarkable weight loss results in patients taking the drug.

However, much like the speed-based weight loss drugs of the past, when patients stop taking the medicine, they start to feel hungrier and regain the weight. This is concerning because insurance coverage for semaglutide is spotty. Medicare does not cover weight loss drugs and many insurers follow Medicare's lead. The lowest price among all retailers is $1,304 per month for people paying out of pocket, which is out of reach for most people.

Another concern is long-term effects, especially if these drugs have to be taken indefinitely. There's ongoing research to evaluate the drug's effect on the cardiovascular system, and it has caused thyroid tumors in rodents. It is also important to remember that Wegovy is only recommended for people with a BMI of 30 or higher, or people with a BMI of at least 27 with weight related conditions.

Of course, exercise and diet modification are still the first strategies to try. But given that about 70% of Americans are overweight or obese, nearly half of adults in the U.S. have hypertension and more than 1 in 3 have pre-diabetes, doctors' groups cite an urgent need to layer on more interventions.

I think these medications can be used to help people who qualify for whom diet and exercise alone hasn't helped. Semaglutide can work together with exercise and diet modifications to help those with obesity and diabetes. I do wonder whether the drugs will have staying power or if they'll fall out of favor, like their predecessors, either from side effects or decreased effectiveness.

Have you had any experience with medications for weight loss? Do you think they can be part of combating the obesity epidemic, or do you think a "magic pill" is too good to be true?