A new generation of weight loss drugs makes bold promises, but who really wins?
Sarah became irritated in the months following the birth of her second child. The 40-year-old Seattle resident reduced carbs and sugar from her diet and exercised regularly, but she still couldn't lose the weight she gained during pregnancy. Sarah decided to try a new weight-loss medicine called Wegovy after reading about it in an email newsletter. She's spent more than $10,000 and lost more than 60 pounds in just eight months.
Sarah, whose name has been changed to protect her identity, told Quartz, "Wegovy made losing weight nearly painless." "I'm not hungry as often as I used to be, and eating less isn't difficult. I simply don't want to eat too much."
Sarah is one of 125,000 individuals in the United States who are using Wegovy (generic name: semaglutide), a new weight-loss medicine. These medications are not like the appetite suppressants used by past generations of dieters. They're also entering the market at a unique time: one in which people are more hungry than ever for practical, science-based solutions to obesity, even as a rising number of activists and doctors question the accuracy of weight as a health indicator.
A new class of weight-loss drug
Experiments on Gila monster venom in the mid-1990s revealed that it contains hormones that could help decrease blood sugar. As a result, the diabetic medication Ozempic was developed and released in 2018. That drug's users experienced an amusing adverse effect: they lost weight.
The US Food and Drug Administration (FDA) approved the same substance under the name Wegovy in 2021 for the sole purpose of weight loss. Wavy works in a more complicated way than simple appetite suppression, and it has fewer (but not zero) negative effects.
Many of these medications, like Wegovy, were first licensed for other ailments; for example, liraglutide (brand name Saxenda for weight loss) was first approved as a diabetes drug (Victoza). In fact, semaglutide and liraglutide are GLP-1 receptor agonists, meaning they activate receptors for the glucagon-like peptide-1 (GLP-1) hormone, reducing appetite by delaying digestion and the rate at which the body absorbs glucose.
The new medications also promise significant weight loss, which is perhaps the most crucial benefit. According to John Buse, an endocrinologist at the University of North Carolina School of Medicine, "prior weight loss medicines were only marginally effective." The typical patient would lose 5% of their body weight, with some patients losing up to 8%. "We've gotten the kind of weight loss that makes people pay attention: 10-15 percent of body weight," he says of semaglutide. That's the average weight loss; half of the population loses more. It's a game-changer in the conversation...now that we have drugs that can help a large percentage of people lose 30 to 50 pounds."
Patients taking Wegovy lost 14.9 percent of their body weight in a 68-week pre-approval clinical trial.
What it takes to lose weight
This new class of medications is entering a market that appears to be ripe for disruption at first appearance. Obesity affects 42 percent of Americans, or 70 million people, according to the US Centers for Disease Control and Prevention (CDC) (having a BMI of 30 or more). Most of those folks will try a diet and exercise routine to lose weight at some point.
Diets, however, are not an effective strategy to lose weight and keep it off, according to a growing body of evidence. "Obesity is a multifaceted condition... "For most patients, lifestyle changes, food, and exercise aren't enough," says Katherine Saunders, a doctor at Weill Cornell Medicine's Comprehensive Weight Control Center and co-founder of Intellihealth, an app-based platform that connects people with their health.
A complicated picture
This new class of medications is making its way into a market that, at first appearance, appears to be saturated.
While patients' expectations are high, the realities of taking these medications can be more challenging. Side symptoms are prevalent, with diarrhea, vomiting, and nausea being the most common for semaglutide and liraglutide. Sarah says she's had diarrhea so bad on Wegovy that she's had to postpone her next dose a few times.
Those effects are occasionally glossed over or downplayed by doctors. However, a look at the dedicated Reddit boards for these treatments reveals entire communities of patients battling to stick to the routine while they're unwell and seeking support from a community to figure out if what appears to be a severe reaction is typical. (A request for comment from Novo Nordisk was not returned.)
The new generation of weight loss drugs
| Drug name | Brand names | Manufacturer | Year approved for weight loss* | Adminstration/frequency | Mechanism |
|---|---|---|---|---|---|
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