2023-12-26 10:15:08
There has been a lot of talk this year about a type of anti-obesity drug, about its effectiveness in losing weight but above all in alleviating the health problems associated with this disease. And they not only help control appetite but reduce the risk of heart failure, heart attack and stroke.
Science Magazine has designated these drugs against obesity, and the discovery that they can mitigate the health problems of the pathology, as the breakthrough of the year 2023. In this way, they have gone from “being on the covers of the tabloid press” for their use by Hollywood stars “to be on the cover of an impact scientific magazine.”
It is a statement of endocrine of the Spanish Society for the Study of Obesity (SEEDO) and the Vithas hospital in Seville, Christopher Moralesin an interview with EFEsalud in which he gives the keys to why these drugs have been a whole revolution if they are accompanied by an adequate diet and physical activity.
How do they work
They are drugs that They began to be used in 2005 to treat type 2 diabetes because they improve glucose control, but the different studies that researchers were carrying out revealed how beneficial they were for controlling appetite and, therefore, weight.
EFE/ Alejandro García
These are molecules that imitate the hormone GLP-1 secreted by the small intestine in response to food intake and which increases the feeling of fullness and satiety. The one produced by the human body disappears quickly from the blood, however, the modified ones (the drug) cause a feeling of satiety for a longer time.
Drugs for obesity
The most “famous” drug and the one that has been on everyone’s lips the most is Ozempic (from Novo Nordisk), whose active ingredient is semaglutide. In Spain it is authorized for type 2 diabetes and obesity. Public Health finances it for people with type 2 diabetes (T2DM).
For the exclusive indication of obesity in Spain, it is currently authorized only Saxenda (also from Novo Nordisk), which contains the active ingredient liraglutide. The technical sheet specifies that “it acts on the brain receptors that control appetite and make you feel fuller and less hungry. This way, it can help you eat less and reduce your body weight.” It is not financed by Public Health.
He will join them Wegs (from the same laboratory) that is not yet in Spain due to stock problems. It is the same molecule but the approval is specific for obesity, so having type 2 diabetes will no longer be a requirement for its indication.
Although the molecule being tested is the same, “there is a clinical development program for type 2 diabetes and another program for people without it,” explains Morales.
“In Europe it is approved for obesity, which happens that it has not yet been marketed in Spain because we are waiting for there to be enough stock in 2023, since we have talked so much about specific shortages,” indicates the SEEDO endocrinologist.
Supply problems
And the popularity of these drugs has caused shortage problems.
In Spain, according to the latest communication from the Spanish Agency for Medicines and Health Products (Aemps) the rise of The demand in recent months for GLP-1 analogue drugs “continues to produce tensions in the supply”.
“The increase in demand in recent months for some of the medications included in this group has caused specific supply problems since the end of 2022, so it is necessary to adjust their prescriptions to prioritize the use of these treatments for glycemic control. of patients with DM2 since the therapeutic alternatives for these patients can be more complex,” pointed out the Aemps.
Furthermore, it specified thatThe incumbent laboratories have established measures to increase their manufacturing globally and meet needs, but while this is taking place, tensions in its supply may continue to occur.
Its effects beyond weight loss
Another drug that will break into Spain in 2024 will be the antidiabetic Mounjaro (from Lilly). The active ingredient is tirzepatide. And it would have approval by the European Medicines Agency (EMA) for type 2 diabetes but also for obesity.
“With everything that is coming, the progress that is being made and the new molecules that are even more powerful, with weight loss of up to 25%, are truly outrageous,” says Morales, who describes the situation as a “pharmacological spring.”
They are drugs that this year several clinical trials have discovered that reduce symptoms of heart failure and the risk of heart attack and stroke.
Science magazine notes that the reach of these drugs is expanding “in ways their inventors could not imagine” and trials are underway to investigate why people with obesity and diabetes reported less craving for wine and tobacco during treatment. .
And others try these drugs to Alzheimer’s and Parkinson’s, because it has been shown that they act on brain inflammation.
However, Science points out, like almost all medications “These best sellers have side effects and unknowns”. Among the first, possible intestinal problems or pancreatitis.
The stigma
For Morales, the fact that Science has chosen these drugs as the breakthrough of the year highlights “all the science behind obesity.”
EPA/Britta Pedersen
“The great damage that has been done to so many people who are so stigmatized, so judged of more sole and less pot. Society has blamed the obese person, accusing them of eating a lot and dying little. As a scientist I am very happy that science advances and gives us light to see that there was a lot of genetic, biological, epigenetic, social, psychological component… around the disease of obesity,” reflects the endocrinologist.
For Morales, obesity is a disease “in capital letters, with multiple and deep roots that begin in schools, in daycare, in the womb” and with these drugs “some color” has been added to a disease in which “until now we had failed” and the only thing available was surgery.
“Another issue would be financing, which we still don’t know because in Spain unfortunately we have never obtained financing for any obesity medication,” highlights the endodrin.
“We are not looking for the ideal weight”
And it affects what They are not weight loss drugs.: “We don’t like that term, we don’t like it at all because they are drugs to help us maintain a healthy lifestyle, to maintain your best healthy weight. We are not looking for the ideal weight,” she clarifies.
“They are drugs that have a great return on health, it is not something frivolous or aesthetic. The first thing to do is to become aware that obesity is a disease with many complications, more than 200, and the objective is not to lose weight but to gain years of life and quality of life in those years, avoiding complications,” states the expert.
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