Pros & cons of new weight loss drug

This December, Science magazine declared that drugs that mimic a gut peptide, GLP-1 (glucagon-like peptide-1), were the scientific breakthrough of 2023. These drugs were first used to treat diabetes but were soon found to cause weight loss and have other beneficial health effects. While there are a number of these drugs, the most well-known and heavily advertised on TV is semaglutide, marketed by Nova Nordisk in various formulations and dosages as Ozempic, Rybelsus and Wegovy.

Benefits beyond diabetes

Last month, in my column on female scientists and major awards, I mentioned the work of Svetlana Mojsov. She did some of the early work on GLP-1, determining its role in our gut and that it controls insulin release from the pancreas, but until recently, her work was ignored. Now she is one of Nature’s top ten scientists of 2023.

What makes this class of drugs attractive is their multiple benefits. Initially limited to use for diabetes, it now appears that drugs that mimic GLP-1 can do more in the body. In diabetes patients, semaglutide delays kidney disease progression. It also reduced body weight by as much as 15 percent in clinical studies. In a large study, the risk of heart attacks and strokes for those taking the drug fell by about 20 percent. Currently, trials are looking at the use of these drugs to deal with various addictions, as they seem to reduce food cravings. But there are also adverse side effects – nausea and other gastrointestinal effects – that may prevent use for some people.

Costs and concerns

Semaglutide, in its various formulations, is expensive, costing more than one thousand dollars a month. But these drugs have become so attractive to people with resources (or insurance) that Nova Nordisk has a market value higher than the gross domestic product of its home country, Denmark. This pricing raises significant concerns about who can take advantage of these drugs and their benefits. Another issue is how these drugs are administered; early versions required injections, but now there are also pill versions that can be taken daily. Hopefully, in the future, this class of drugs will become more affordable and easier to administer. There are also concerns about how long these drugs need to be taken to maintain benefits; it looks like they may need to be taken perpetually, but their long-term effects are still unknown.

Great things are possible

Despite these questions, a few comments can be made. First, obesity, while complicated, may not simply be a matter of lack of willpower; it may have a biological basis, and so medication may be the best solution for those in need of one. Second, we are still learning many things about the bodies God has given us, as these new medications show. Third, we should work to make these drugs available more readily to those who need them. Finally, while these drugs may make a big difference for some individuals, other medical conditions still need scientific attention. As with the recent rapid development of Covid-19 vaccines, great things are possible with sustained work and our Lord’s blessing.