Ozempic is just the beginning of a new era of obesity treatment. A study published this week predicts the emergence of similar experimental drugs that will likely be even more effective in helping people lose weight.
Researchers from McGill University conducted the study, which was a review of clinical trial data regarding GLP-1 drugs like semaglutide (the active ingredient in Ozempic and Wegovy). Researchers have reaffirmed the safety and effectiveness of current medications. But they also highlighted the potential superiority of new compounds currently in development, such as retatrutide, which has so far helped people lose more than 20% of their initial body weight in trials.
Semaglutide is a synthetic, longer-lasting version of the hormone GLP-1, a hormone that regulates, among other things, hunger and insulin production. Developed by Novo Nordisk, semaglutide was first approved for type 2 diabetes in 2017 as Ozempic, and then for obesity in 2021 as Wegovy. It is far from the first GLP-1 drug to be made available to the public, but semaglutide has been a game-changer in the treatment of obesity. It has been shown to help people lose between 10 and 15 percent of their weight in studies, far above the typical success seen with diet and exercise alone and even surpassing typical results from older medications GLP-1.
However, semaglutide is not the only new kid on the block. Eli Lilly’s tirzepatide mimics both GLP-1 and another hunger-related hormone called GIP, a powerful combination that allowed it to dethrone semaglutide. In clinical trials, people taking tirzepatide lost up to 20% of their baseline weight. There are also dozens of other obesity treatments in the works, some of which have been tested in humans and are poised to eclipse even tirzepatide.
McGill researchers analyzed data from 26 randomized clinical trials involving GLP-1 monotherapy drugs, dual agonists like tirzepatide, and even triple agonist drugs like retatrutide, which combines synthetic versions of three hormones linked to hunger: GLP-1, GIP, and glucagon. These trials included people who were obese but did not have type 2 diabetes.
As expected, they found that the drugs approved today were generally safe and effective, with tirzepatide currently performing the best (participants lost up to 17% of their body weight after 72 weeks of treatment). But they also highlighted that retatrutide performed even better over a shorter period of time, with participants losing up to 22% of their body weight after just 48 weeks of treatment.
“We found that, among the 12 GLP-1 (drugs) identified by our research, the greatest average reduction in body weight was reported in randomized controlled trials of retatrutide, tirzepatide, and semaglutide,” the researchers wrote. researchers in their article published Tuesday in the Annals of Internal Medicine.
Retatrutide is being developed by Eli Lilly and is currently being tested in Phase 3 trials, which will reach conclusion by 2026. And it won’t be the only newcomer arriving in the near future that could outperform existing drugs of today.
Last year, for example, early trial results of the drug amycretin (developed by Novo Nordisk) suggested that it could cause greater weight loss than semaglutide and tirzepatide. Other pharmaceutical companies are working on their own competitors to Ozempic, such as Boehringer Ingelheim and Zealand Pharma’s dual agonist survodutide. Expectations became so high that Novo Nordisk shares fell when it announced that its drug candidate CagriSema (a mixture of semaglutide with the experimental drug cagrilintide) had only helped people lose 22% of weight. during a recent test, instead of the expected 25%.
These medications are of course not free from their drawbacks. They usually cause gastrointestinal symptoms such as diarrhea and vomiting, and are linked to rare but serious complications like gastroparesis (stomach paralysis). Another major concern is their price, with semaglutide and tirzepatide often costing around $1,000 per month without insurance coverage (which is often not provided by private and public insurers). This cost and growing demand have fueled a gray and black market for these drugs, with people turning to cheaper, but less safe, compounded and counterfeit versions.
Some experts hope that the advent of more GLP-1-related drugs will help alleviate some of these problems, particularly in terms of cost and insurance coverage. We’ll see if this actually happens. But it is almost certain that many drugs will become available to replace semaglutide and tirzepatide, which are currently the best treatments for obesity.
