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Diabetes drug significantly cuts body weight in adults with obesity

Dante_80
Dante_80 Posts: 287 Member
edited February 2021 in Debate Club
Read this interesting article the other day, wanted to share. I've been prescribed a similar drug due to - now waning - type 2 diabetes (Victosa, using liraglutide instead), and I think it has also helped me somewhat curb my appetite, especially in the evenings (I've been on a weight loss journey for close to 10 months now, having shed around 125lbs so far).

Could this become another good tool in conjuction with nutrition and exercise to stem the obesity epidemic?

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Diabetes drug significantly cuts body weight in adults with obesity

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A Phase 3 clinical trial published in The New England Journal of Medicine demonstrated an average 14.9% decrease in body weight in adults with obesity or overweight who received an injectable diabetes medication, semaglutide, in addition to lifestyle interventions.

Approximately 50% of the participants in the semaglutide group achieved significant weight reductions of 15% or more, while 69% of participants achieved 10% or more, and 86% of participants achieved 5% or more.

The trial showed reductions in risk factors for diabetes and heart disease and a greater self-reported physical functioning in participants receiving semaglutide.

Obesity is a prevalent and serious health concern, both in the United States and globally. The Centers for Disease Control and Prevention (CDC) report that the prevalence of obesity in the U.S. increased substantially from 30.5% in 1999–2000 to 42.4% in 2017–2018, with severe obesity rising from 4.7% to 9.2%.


Doctors often use body mass index (BMI) — which a person can calculate by dividing their weight in kilograms (kg) by the square of their height in meters — to determine whether a person’s weight is healthy. A BMI of 25 to <30 falls within the overweight range in adults, while those with obesity have a BMI of ≥30.

A serious health concern

Obesity reduces life expectancy and is a major risk factor for cardiovascular disease, type 2 diabetes, non-alcohol-related fatty liver disease, and certain cancers, including breast, ovarian, endometrial, prostate, liver, and colon cancer.

Currently, a combination of diet and exercise is the mainstay of obesity treatment. If these lifestyle interventions prove ineffective over 6 months, clinical guidelines recommend medications for people with a BMI of ≥30 or those with a BMI of ≥27 who have other related health conditions.

Effectiveness, cost, and safety issues limit the use of currently available medications. Injectable semaglutide is a drug that the Food and Drug Administration (FDA) have approved for adults with type 2 diabetes and cardiovascular disease.

Semaglutide is an analog of the naturally occurring human glucagon-like peptide-1 (GLP-1) hormone in the body. The body releases GLP-1 from the gut into the bloodstream after meals, increasing satiety and reducing hunger and cravings.


In a phase 2 clinical trial involving adults with type 2 diabetes and obesity, injectable semaglutide treatment resulted in weight loss.

This result led investigators to conduct a global phase 3 trial called Semaglutide Treatment Effect in People with Obesity (STEP) to investigate the safety and effectiveness of semaglutide in participants aged 18 years and older.

The participants had either a BMI of ≥30 or a BMI of ≥27 and weight-related health conditions. A group of the participants received a placebo instead of the treatment.

The trial excluded people who had diabetes, had previously undergone obesity surgery, or had used medications to treat obesity in the 90 days before enrollment. However, the participants had some weight-related health conditions, including hypertension, high cholesterol, obstructive sleep apnea, and cardiovascular disease.

The researchers randomly assigned a total of 1,961 participants to receive either semaglutide (as an injection under the skin with a dose of 2.4 milligrams) or placebo, with both groups also receiving lifestyle interventions.

Over 68 weeks, 1,306 participants received semaglutide and 655 participants received the placebo on a weekly basis.

At baseline, the average body weight was 105.3 kg, the average age was 46 years, and the average BMI was 37.9. In addition, 75% of the participants had at least one coexisting condition.

‘Game-changing’ findings

On average, participants in the semaglutide group significantly decreased their body weight by 14.9% (-15.3 kg) from baseline compared with 2.4% (-2.6 kg) in the placebo group.

The trial demonstrated significant weight reductions of:

5% or more in 86.4% of participants in the semaglutide group vs. 31.5% in the placebo group
10% or more in 69.1% of participants in the semaglutide group vs. 12% in the placebo group
15% or more in 50.5% of participants in the semaglutide group vs. 4.9% in the placebo group

Study participants receiving semaglutide also had greater reductions in waist circumference, blood pressure, fasting lipid levels, and blood glucose than those receiving the placebo. In addition, they had increased self-reported physical functioning scores.

The most common adverse effects included mild-to-moderate nausea and diarrhea that usually subsided with time. More participants stopped treatment due to gastrointestinal side effects in the semaglutide group (4.5%) than in the placebo group (0.8%).

Study limitations

The trial had some limitations, including its short duration and the exclusion of people with diabetes.

The majority of the participants were white (75.1%) and female (74.1%) and, therefore, not reflective of the general population with obesity. This limits the generalizability of the findings.

Additionally, people with a phobia of needles may not wish to use an injectable drug in the long term.

One of the main authors of the study, Rachel Batterham, M.B., B.S., Ph.D., a professor of obesity, diabetes, and endocrinology at the Centre for Obesity Research at University College London (UCL) and the UCL Hospitals Centre for Weight Management, comments on the findings:

“No other drug has come close to producing this level of weight loss — this really is a gamechanger. For the first time, people can achieve through drugs what was only possible through weight loss surgery.”

Based on these trial results, Novo Nordisk, the pharmaceutical company funding the clinical trial, submitted a request for regulatory approval for injectable semaglutide to treat obesity to the FDA, the European Medicines Agency, and the National Institute for Health and Care Excellence.

Although the trial results seem promising, head-to-head trials comparing semaglutide with other standard-of-care pharmacologic and surgical treatment options will be necessary to determine its eventual role in treatment.

Dr. Batterham adds, “The impact of obesity on health has been brought into sharp focus by COVID-19, where obesity markedly increases the risk of dying from the virus, as well as increasing the risk of many life limiting serious diseases, including heart disease, type 2 diabetes, liver disease, and certain types of cancers.”

“This drug could have major implications for U.K. health policy for years to come.”

Source:. https://www.medicalnewstoday.com/articles/diabetes-drug-significantly-cuts-body-weight-in-adults-with-obesity
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Replies

  • Theo166
    Theo166 Posts: 2,562 Member
    Below is the mechanism
    Semaglutide acts like human glucagon-like peptide-1 (GLP-1) so that it increases insulin secretion, thereby increasing sugar metabolism.
  • eddycaa
    eddycaa Posts: 9 Member
    I just started Saxenda on 4/2/21. I started with blood work, doctor consultation and a health coach to get me on track to better habits 3 weeks before starting. Saxenda + lifestyle changes is working out really well for me. I'm down 4 lbs in 5 days. I know it's mostly water weight but it's a promising start.
  • Dante_80
    Dante_80 Posts: 287 Member
    I started taking metformin with the hopes of weightloss, and then got my dose doubled, and it hasn't made any difference to my weight.

    It really can't on its own. The drug helps with blood sugar regulation and satiety. It does not burn fat on its own or reduce your weight in any way.
  • cyaneverfat
    cyaneverfat Posts: 527 Member
    Dante_80 wrote: »
    I started taking metformin with the hopes of weightloss, and then got my dose doubled, and it hasn't made any difference to my weight.

    It really can't on its own. The drug helps with blood sugar regulation and satiety. It does not burn fat on its own or reduce your weight in any way.

    I feel like my appetite is smaller? I just might be eating more often.
  • shortassmax
    shortassmax Posts: 41 Member
    timpicks wrote: »
    I just started using Ozempic, which is a semaglutide, and started a group discussion on this site about experiences from the patients' perspective. I'm generally skeptical of miracle weight loss solutions, but am a pre-diabetic with cardiovascular issues and, ahem, some extra pounds due to COVID inactivity and boredom eating. My doctor recommended this and my insurance pays for it, so I'm giving it a try. We'll see. Check out my Ozempic group if you have something to contribute or want to hear more.

    Looking for your group
  • cmriverside
    cmriverside Posts: 31,921 Member
    timpicks wrote: »
    I just started using Ozempic, which is a semaglutide, and started a group discussion on this site about experiences from the patients' perspective. I'm generally skeptical of miracle weight loss solutions, but am a pre-diabetic with cardiovascular issues and, ahem, some extra pounds due to COVID inactivity and boredom eating. My doctor recommended this and my insurance pays for it, so I'm giving it a try. We'll see. Check out my Ozempic group if you have something to contribute or want to hear more.

    Looking for your group

    https://community.myfitnesspal.com/en/group/140032-ozempic-users-for-weight-loss
  • paperpudding
    paperpudding Posts: 7,282 Member
    socajam wrote: »
    1. What are the side effects of this drugs
    2. What are the side of effects of exercising and not overeating

    Although #2 is hard work, I would much prefer that to what the side effects of what #1 would be


    But that isn't the equation for people being prescribed Ozempic and co.

    The question is what are the side effects of poorly controlled blood sugar vs side effects of the drug.

    It isn't a drug for weight loss - it is a drug for type 2 diabetes that has the added benifit of weight loss.
  • paperpudding
    paperpudding Posts: 7,282 Member
    speyerj wrote: »
    My concern is what happens when you stop taking the drug? I think most of us have lost and regained at least once because we stopped doing the things that helped us lose weight in the first place. After a several weight loss attempts followed by regains, I finally came to the conclusion that I would never do anything to lose weight that I wasn't willing to maintain for the rest of my life.


    Well, you mostly don't stop taking it.

    Some people can reduce their need for medications if they lose weight and then I guess you would trial weaning down.

    But type 2 diabetes is usually a progressive disease so one continues on medication.