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A New “Miracle” Weight Loss Drug?

The FDA recently announced the approval of a new weight loss drug, Wegovy®.  This once a week injection is in the family of drugs called “GLP-! Agonists”.  Glucagon-like-peptide 1 is hormone released from the gut after a meal and has an impact on glucose levels in the bloodstream.   An additional effect of GLP-1 is a lowering of appetite by impacting areas of the brain are responsible for regulating appetite.  Wegovy® is in the class of drugs that act like GLP-1.  The initial use of the GLP-1 drugs was for diabetes control but it was also noted that weight loss occurred in those people taking a GLP-1 agonist.

How much weight loss can be expected?  In the studies performed on Wegovy (generic name is Semiglutide) the weight loss that occurred was in and around 10% of body weight over a 68 week period.  People with diabetes seemed to lose loss weight than non-diabetics.

Like most prescription medications, there are boat loads of potential side effects of Wegovy: nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).  

The cost of this new drug has not exactly been disclosed, but if similar to the other GLP-1 agonists on the market, the price will be over $1000 a month.  It is not clear whether insurance companies will cover the cost.

Posner’s thoughts:  I have practiced medicine for over 40 years and this ain’t my first rodeo of having a new “miracle” weight loss drug/treatment being approved by the FDA and having patients ask me whether we will be using this treatment in our program.  Around 2014, there were several new, “miracle” weight loss drugs approved by the FDA:  Belviq (now off the market and the subject of many lawsuits), Qsymia (a mixture of two old drugs, phentermine and Topamax) and Contrave (a mixture of two old drugs, bupropion and naltrexone).  Did any of these highly touted when released “miracle” weight loss treatments impact the obesity epidemic?  Not a chance.

Placing this into further perspective, the trials of Wegovy lasted over a year (68 weeks) so the 10% or so weight loss would translate into a 20 pound weight loss in a 200 pound person in over a year.  Heck, our program produces this amount in 12 weeks with a prescription med that costs about $40 bucks a month and a 12 week robust program with post-program support that costs no more than one month of treatment with Wegovy with zero support behind this.

The point: Weight loss pills and/or injections without any comprehensive support program accompanying them have zero chance of producing long term weight control.  I wish there was a “miracle” weight loss treatment that made it very easy for overweight/obese people to lose weight and keep that weight off without all of the work that is required.  Alas, no such treatment exists.

So, do we plan on bringing on board a $1200 a month injectable into our program?  Not at this time.  And, I will take anyone’s bet out there that in 2-3 years, we will not hear much about Wegovy as I believe it will suffer the same fate as any previously touted “miracle weight loss treatment”.  Behavioral modification is THE necessary component for successful long-term weight control.

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