GLP-1 Agonist Drugs Show Promise for Treating More Conditions

GLP-1 agonist drugs like Ozempic, Wegovy, Mounjaro, and Zepbound, initially used for weight loss and diabetes, are showing promise for treating various conditions beyond their original scope. Novo Nordisk’s Ozempic and Wegovy, along with Eli Lilly’s Mounjaro and Zepbound, are leading this trend.

Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound — brand names for drugs semaglutide and tirzepatide — are far and away the most famous members of a booming class of medications known as GLP-1 agonists. These medications mimic a gut hormone called GLP-1. They were initially approved to treat diabetes and, more recently, obesity, and with more and more people using the drugs, signs of other potential benefits are starting to emerge.

For one, Novo Nordisk gathered enough data to prove this and scored approval from the Food and Drug Administration last March to add cardiovascular benefits to Wegovy’s label (experts expect Zepbound will be shown to have similar heart benefits). And earlier this month Eli Lilly issued a press release notifying the world that it was eying a label expansion for Zepbound after a late-stage trial found that the drug “meaningfully improved sleep apnea symptoms,” which means the drug “has the potential to be the first pharmaceutical treatment for the underlying disease,” according to Lilly’s senior vice president for product development Jeff Emmick.

To expand on this, Eli Lilly’s weight loss drug Zepbound has shown effectiveness in reducing obstructive sleep apnea in adults with obesity, potentially becoming the first pharmaceutical treatment for this condition. The drug led to significant reductions in sleep apnea events in two studies, with participants experiencing an average weight loss of around 20%.

These findings, though not yet peer-reviewed, indicate the drug’s potential to address a major health issue beyond weight loss. Experts believe these results could influence insurance coverage for the drug, and Lilly plans to present additional details at the American Diabetes Association conference in June and submit them to the FDA later this year.

Additionally, companies like Novo Nordisk, Eli Lilly, Boehringer, and Zealand Pharma are exploring GLP-1 drugs as a potential treatment for fatty liver disease. As a recent Forbes article points out:

Studies also indicate the GLP-1 class could potentially help with a range of brain disorders, where they potentially help boost mood, cognitive function and alleviate symptoms for conditions including Parkinson’s, Alzheimer’s, depression, bipolar disorder and anxiety, areas that have long been notorious sticking points for pharmaceutical development.

Substance use disorders and addiction is another promising avenue following reports of diminished cravings among people taking GLP-1 drugs, though scientists are still working to figure out why — the drug could feasibly act on parts of the brain and nervous system as these also produce the GLP-1 hormone or have relevant hormone receptors for it — and confirm whether the medications can indeed curb addiction.

Of course, post-approval reports are crucial, as they may reveal unforeseen negative effects. Still, the weight loss market has no indication of slowing down. On the contrary, analysts estimate that the weight loss drug market could be worth at least as much as $100 billion by 2030, with Novo Nordisk and Eli Lilly currently dominating it. These companies’ extensive data and label expansions set a high bar for competitors.

Your responses and feedback are welcome!

Source: “Drugs Like Ozempic And Mounjaro Could Treat Other Conditions — Here’s What Scientists Are Looking At,” Forbes, 04/18/24
Source: “Eli Lilly’s weight loss drug Zepbound found to reduce sleep apnea, company says,” NBC News, 04/17/24
Image by Isabella Fischer on Unsplash

Understanding the “Ozempic Baby” Phenomenon

In the realm of weight loss medications, few have captured attention quite like Ozempic. Promising not just significant weight loss but also sustainable results, Ozempic and other GLP-1 drugs have garnered a reputation for effectiveness. However, beyond their intended purpose, a curious trend has emerged — the rise of what some term “Ozempic babies.”

This phenomenon, where women report getting pregnant while on Ozempic, has sparked intrigue and concern alike. The internet is rife with women sharing their stories, and every platform — from Reddit to TikTok to mainstream news channels and heavyweights like The Washington Post — is buzzing.

So, while the drug hasn’t been approved for fertility enhancement, the correlation between weight loss and fertility, coupled with Ozempic’s impact on birth control, sheds light on this unexpected occurrence. Let’s take a look at the two main reasons this is happening and why fertility experts advise against getting pregnant while taking Ozempic.

Weight loss can lead to increased fertility

Last week, The Bump published an article by Associate Editor Wyndi Kappes that pointed out two possible reasons that taking Ozempic can lead to an unexpected pregnancy. Kappes interviewed Karen Wheeler, M.D., FACOG, a reproductive endocrinologist at Reproductive Medicine Associates, who highlighted the link between weight loss and enhanced fertility. Dr. Wheeler said:

We know that weight loss can increase the rate of ovulation in women with irregular periods… Women who lose weight with Ozempic who were not previously ovulating may start to ovulate and if not using effective contraception, may get pregnant while on Ozempic.

Also, lower BMI resulting from weight loss can improve pregnancy rates, especially in assisted reproductive technology, according to Dr. Wheeler.

Ozempic’s impact on birth control

The second reason that women may be getting pregnant on Ozempic has to do with the drug’s effect on birth control. Dr. Wheeler pointed out that while no direct studies correlate Ozempic with decreased birth control effectiveness, the drug’s influence on gastric processes could affect pill absorption. This is especially true if Ozempic is causing such side effects as nausea and vomiting.

Lauren Bishop, M.D., ob-gyn, an assistant professor of obstetrics and gynecology at Columbia University Fertility Center, also pointed out that weight loss medications, in general, may decrease the efficacy of oral contraceptive pills. She said:

These medications can slow how the stomach is processing its contents, thus altering how birth control pills are absorbed and processed.

Why getting pregnant on Ozempic isn’t recommended

Despite the potential fertility benefits, caution is warranted. Drs. Wheeler and Bishop emphasize the lack of studies on Ozempic’s safety during pregnancy. Animal studies hint at adverse fetal outcomes, indicating a potential risk for human pregnancies. Dr. Wheeler explained:

Pregnant rats who were given Ozempic had increased rates of fetal death, structural abnormalities and growth alterations… It can take up to 6 weeks for Ozempic or similar medications to be gone from the body, so someone who is planning to conceive should stop Ozempic at least 2 months prior to conception.

In light of these findings, women on Ozempic are advised to take extra precautions regarding birth control. Barrier methods or long-acting reversible contraception are recommended until more is understood about the drug’s interaction with contraceptives and its effects on pregnancy.

Dr. Wheeler also underscored the importance of seeking professional guidance when navigating fertility and weight loss. “If you are overweight or obese and trying to conceive, please speak with your ob-gyn or fertility specialist about the pros and cons of different weight loss therapies,” she said.

The bottom line

While Ozempic (and similar GLP-1 drugs) may offer weight loss benefits, its role in conception remains uncertain and potentially risky. Until more studies emerge, taking Ozempic and pregnancy shouldn’t coincide. Women are encouraged to explore alternative weight-loss therapies and consult with healthcare providers to make informed decisions.

Your responses and feedback are welcome!

Source: “Ozempic Babies: Experts Weigh in on the Drug’s Effect on Fertility,” The Bump, 4/10/24
Image by Hollie Santos on Unsplash

The Role of Exercise in Sustaining Weight Loss Beyond Medication

For nearly a year, the discourse surrounding GLP-1 weight loss drugs such as Wegovy, Zepbound and Saxenda has been ongoing, with a central focus on what happens when patients stop using the meds. There’s been a prevailing concern: Can weight loss be maintained once these medications are discontinued? A recent Danish study, spearheaded by Professor Signe Sørensen Torekov and her team from the Department of Biomedical Sciences at the University of Copenhagen and Hvidovre Hospital, sheds crucial light on this matter.

GLP-1 weight loss drugs such as Wegovy have undoubtedly been instrumental in assisting users in shedding excess weight, especially in an era where obesity rates continue to rise. However, the apprehension lies in the aftermath of cessation — the fear of weight regain looms large. But Torekov’s study challenges this assumption. He says,

It is actually possible to stop taking the medication without large weight regain, if you follow a structured exercise regime. Our study offers new hope, as we have shown that the majority of those who take weight loss medication and exercise regularly are able to maintain the beneficial effects a year after treatment termination.

The study, led by Postdoc Simon Birk Kjær Jensen, scrutinized the effects following treatment for obesity, providing valuable insights into the long-term outcomes of these medications. Jensen says,

Even though medical treatment for obesity is effective, people who stop taking the drugs have difficulties maintaining the beneficial effects. Within a year, they will typically have gained more than two thirds of the lost weight. However, our study shows that people who exercise during treatment do not have the same propensity to put on weight post treatment.

Two hours of exercise a week is enough

The study’s methodology included four groups: a placebo group, a group receiving Saxenda (liraglutide 3 mg), an exercise-only group, and a group receiving Saxenda while also exercising regularly. The results underscored the significance of exercise, revealing that just two hours of exercise a week, coupled with medication or even on its own, significantly contributed to maintaining the benefits of treatment.

Jensen explains,

All it takes is two hours of exercise a week that gets the heart rate up and makes you pant. And it may differ from one person to the next. For people with severe obesity and low initial fitness level, a brisk walk may be sufficient, whereas people with higher fitness level may have to practise running or cycling, e.g. interval spinning.

Torekov emphasizes, “We now have an effective drug for obesity, but it’s imperative to combine medical treatment with regular physical exercise.” The study indicates that exercise not only aids in weight maintenance but also enhances overall quality of life, as evidenced by improved energy levels and mental well-being among participants in the exercise groups.

The implications of this study are profound, suggesting a paradigm shift in the approach to obesity treatment. Torekov and Jensen even advocate for the integration of exercise recommendations into prescriptions for weight loss drugs.

Your responses and feedback are welcome!

Source: “With regular exercise, medical weight loss treatment does not have to be permanent,” EurekAlert.com, 2/20/24
Source: “Healthy weight loss maintenance with exercise…,” ScienceDirect.com, 2/19/24
Image by Yulissa Tagle on Unsplash