Can a Diabetes Drug Help Obese People Lose Weight?

Curated by Claudia Shannon / Research Scientist / ishonest

Researchers say the drug Ozempic, initially approved to treat type 2 diabetes, can regulate insulin and suppress appetite.

A pharmaceutical drug initially used to treat people with type 2 diabetes is now showing promise in helping obese people without diabetes lose weight.

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Novo Nordisk’s semaglutide compound, under the brand name Ozempic, is designed to act in the body similarly to the hormone glucagon-like peptide 1 (GLP-1).

Traditionally taken once a week via injection, this GLP-1 hormone receptor agonist works in the body by regulating insulin secretion and suppressing appetite.

“This randomized study of weight loss induced with semaglutide in people with obesity but without diabetes has shown the highest weight reductions yet seen for any pharmaceutical intervention,” explained Patrick M. O’Neil, PhD, director of the Weight Management Center and a professor of psychiatry and behavioral sciences at the Medical University of South Carolina.

For many people with type 2 diabetes, their bodies actually struggle to produce enough of this crucial hormone, making it difficult to manage blood sugar levels, control appetite, and most importantly, lose weight.

What the study revealed

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There were 957 participants in the study. None of them had diabetes. All of them had a body mass index (BMI) of 30 or higher.

Some received varying doses of daily injections of semaglutide. Others received a placebo or liraglutide (another GLP-1 receptor agonist). All of the patients received monthly guidance on diet and exercise.

“After one year,” explained the report, “all participants receiving semaglutide had lost significantly more weight than those receiving placebo.”

About 65 percent of participants taking semaglutide lost at least 10 percent of their body weight, compared to only 10 percent from the placebo group and 34 percent in the liraglutide group.

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There are currently many GLP-1 receptor agonist drugs on the market that help people lose weight, but the majority are only approved for use in people with type 2 diabetes.

Ozempic’s biggest competition when it comes to weight loss drugs is Novo Nordisk’s own liraglutide drug marketed by the name Saxenda for weight loss and Victoza for people with type 2 diabetes.

Scheiner cautions against believing the drug can do all the work for you.

“In patients with diabetes, it helps to ‘even the playing field’ because many produce insufficient GLP-1 hormones and are hungrier than usual as a result, so it’s fair to prescribe a drug like this,” Scheiner told ishonest.

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“I happen to love GLP-1 medications for my diabetic patients,” said Colette Nelson, MS, RD, CDE, a diabetes education nurse in New York. “They are very helpful in the weight loss journey. I also think a GLP-1 medication should always be considered for patients before pursuing bariatric surgery because it helps reduce appetite, makes it difficult to overeat, and helps to change long- term behavior.”

Details about Ozempic

Like most medications, there are side effects with Ozempic. The most notable are nausea and mild digestion discomfort issues.

It’s also crucial to start with a low dose and increase gradually as instructed by a healthcare professional.

Compared to many older GLP-1 agonist receptor medications, the delivery system for Ozempic has proven to be one of the most comfortable for Nelson’s patients.

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“They used to leave bruises and welts. Those compounds were thicker and required a larger needle. Ozempic, on the other hand, can be delivered with a very small needle and causes very little discomfort,” Nelson told ishonest.

Before making any grand conclusions, Nelson emphasized that while Ozempic may be looking like the leader in weight loss for GLP-1 drugs, more patient data in people without diabetes is still necessary.

“What I’ve heard from my patients with diabetes? They are very pleased with it,” she said. “They find it more effective with appetite suppression than Trulicity. Everyone responds differently to medications, so we still have to see how the majority responds.”

Some cautionary words

For medical professionals considering prescribing Ozempic to patients without diabetes, there may be more skepticism and caution considering it isn’t a life- saving necessity.

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In Sodicoff’s experience with treating people without diabetes struggling with weight loss, many patients stop taking the medication after a month or two.

“They are not considered life-sustaining the way diabetes and blood pressure medications are,” explained Sodicoff.

He’s also learned to be cautious when there’s a great deal of hype around a new medication.

“I’m never an early adopter of medications. I’ve prescribed newly introduced meds that soon were discovered to be dangerous enough to be withdrawn from the market, like Vioxx and Avandia,” warned Sodicoff.

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“The animal studies indicate a risk for thyroid carcinoma. Hopefully that won’t become a human problem, too. I’ll wait some time until post-marketing data rolls in,” he added.

Before turning to prescribing medications, Sodicoff believes in teaching his obese patients without diabetes to focus on lifestyle changes first.

“High-fat, moderate protein, low-carb diets can perform amazingly well in most patients,” said Sodicoff. “It’s always the first approach to which medications are then occasionally added.”

Read more on: diabetes, obesity


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