New experimental obesity pill results in 15% weight loss, study finds
[June 27, 2023: Staff Writer, The Brighter Side of News]
Researchers have developed a small-molecule drug that prevents weight gain and adverse liver changes. (CREDIT: Getty Images)
In the battle against obesity, the potential for an effective pill that facilitates weight loss has long been a tantalizing prospect. For more than 40% of Americans grappling with obesity, this notion has ignited hope. Conversely, it has also sparked controversy among advocates of broader weight acceptance who argue against the perpetuation of weight-based stigmatization. But now, it appears the hypothetical could become a reality.
Promising results from two new and separate studies, indicate that high-dose oral forms of the anti-obesity medication found in the drug Wegovy might deliver results comparable to the current popular injectable versions.
These findings could signify a breakthrough for a demographic notoriously challenged by weight loss: individuals living with diabetes. If successful, the maker of the drug, Novo Nordisk, plans to seek approval for these potent tablets from the U.S. Food and Drug Administration (FDA) later this year.
Dr. Daniel Bessesen, the Chief of Endocrinology at Denver Health, although not involved in these new studies, provides valuable insights from a healthcare provider's perspective. "If you ask people a random question, ‘Would you rather take a pill or an injection?’ People overwhelmingly prefer a pill,” he said. However, this preference is contingent on the pill's effectiveness, availability, and affordability being on par with that of the injection. "Those are the most important factors for people," he added.
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To date, there have been other weight-loss pills available, but none have accomplished the significant reductions witnessed with injected drugs such as Wegovy. The potential for an equally effective oral alternative is encouraging, especially for individuals living with obesity. Dr. Katherine Saunders, a clinical professor of medicine at Weill Cornell Health and co-founder of Intellihealth, an enterprise specializing in obesity treatment, believes patients will be "thrilled" with this development.
Novo Nordisk is not a newcomer to the world of oral medications. They already market Rybelsus, an oral version of semaglutide, which treats diabetes and is used in the diabetes drug Ozempic and Wegovy. Rybelsus is available in doses up to 14 milligrams. However, the recent results from two "gold-standard" trials presented at the American Diabetes Association's annual meeting highlight the performance of even higher doses of oral semaglutide, reaching 25 and 50 milligrams.
These larger doses were studied over 16 months in about 1,600 people who were overweight or living with obesity and were concurrently being treated for Type 2 diabetes. The high-dose daily pills significantly outperformed the standard dose of Rybelsus in blood sugar reduction. Starting from a baseline weight of 212 pounds (96.16 kilograms), the subjects experienced weight loss ranging from 15 to 20 pounds (6.80 to 9.07 kilograms), in contrast to approximately 10 pounds (4.54 kilograms) on the lower dose.
More participants reached bodyweight reductions of at least 5% (269 [85%] of 317 vs 76 [26%] of 295; odds ratio [OR] 12·6, 95% CI 8·5 to 18·7; p<0·0001), 10% (220 [69%] vs 35 [12%]; OR 14·7, 9·6 to 22·6), 15% (170 [54%] vs 17 [6%]; OR 17·9, 10·4 to 30·7), and 20% (107 [34%] vs 8 [3%]; OR 18·5, 8·8 to 38·9) at week 68 with oral semaglutide 50 mg versus placebo. (CREDIT: The Lancet)
A similar 16-month study conducted on over 660 adults, either overweight or obese, with at least one related disease—but without diabetes—yielded notable results. A daily 50-milligram dose resulted in an average loss of about 15% of their body weight, or about 35 pounds (15.88 kilograms), in stark contrast to about 6 pounds (2.72 kilograms) with a placebo. The weight loss spurred by these high-dose oral semaglutide pills was "notably consistent" with that achieved by weekly injections of Wegovy, according to the authors of the study.
Despite the exciting prospects of an oral alternative, it is essential to consider the potential side effects. Approximately 80% of the participants who took any dose of oral semaglutide experienced mild to moderate gastrointestinal issues, including nausea, constipation, and diarrhea. In the 50-milligram obesity trial, benign tumors were more prevalent among those who consumed the drug compared to those given a placebo. Also, about 13% of the individuals taking the drug experienced "altered skin sensation," such as tingling or extra sensitivity.
The estimated mean bodyweight change from baseline to week 68 was –15·1% (SE 0·5) with oral semaglutide 50 mg versus –2·4% (0·5) with placebo (estimated treatment difference −12·7 percentage points, 95% CI −14·2 to −11·3; p<0·0001). (CREDIT: The Lancet)
Medical professionals anticipate that these pills will garner significant attention, particularly from those seeking weight loss solutions but with an aversion to needles. Furthermore, the practicality of pills being more portable than injection pens and the absence of a refrigeration requirement adds to their appeal.
However, this oral form of medication might not be universally accepted as a superior option. For the hundreds of thousands of people already using injectable versions such as Ozempic or Wegovy, the oral route might not be as appealing. Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital, shared, "I don’t find significant hesitancy surrounding receiving an injection. A lot of people like the ease of taking a medication once a week." The potential preference for injections might also be influenced by the requirement for the new pills to be taken 30 minutes before eating or drinking in the morning.
Among those unenthused by the prospect of pills is Paul Morer, a 56-year-old employee of a New Jersey hospital system. Morer managed to shed 85 pounds with Wegovy injections and is hopeful of losing 30 more. He expressed his preference for continuing with the weekly injections, even if pills were an option. “I do it on Saturday morning. It’s part of my routine,” he said. “I don’t even feel the needle. It’s a non-issue."
This potential shift to a pill-based weight loss solution has sparked concern among critics who worry about the increased pressure it may put on individuals living with obesity, intensifying the existing social stigma against those who cannot or choose not to lose weight. Tigress Osborn, chair of the National Association to Advance Fat Acceptance, shared her apprehensions: “There is no escape from the narrative that your body is wrong and it should change.”
Regardless of the debate, Novo Nordisk is banking on the allure of a higher-dose pill to treat both diabetes and obesity. Rybelsus, their existing oral medication, has already seen a dramatic surge in sales, reaching about $1.63 billion last year, more than double the figure from 2021.
Several other companies are exploring oral forms of their injectable drugs. Eli Lilly and Co., for instance, is developing an oral version of Mounjaro, a diabetes medication anticipated to be approved for weight-loss soon. They've reported promising mid-stage trial results for orforglipron, an oral pill designed to treat patients who are obese or overweight with and without diabetes. Pfizer has also revealed mid-stage results for dangulgipron, an oral diabetes medication taken twice daily with meals.
Novo Nordisk officials have not yet disclosed the projected cost of their high-dose oral pills, nor how the company plans to ensure sufficient manufacturing capacity to meet demand. Despite its popularity, the injectable dose of Wegovy will reportedly be in short supply until at least September, according to company officials.
The potential for an effective, oral, weight-loss solution presents a transformative shift in the obesity treatment landscape. Still, it is crucial to balance this exciting scientific breakthrough with careful consideration of its societal implications, potential side effects, and the fundamental philosophy of weight acceptance.
For more science and technology stories check out our New Innovations section at The Brighter Side of News.
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