Global voices like Oprah Winfrey, 69, admit she felt “relief, relief, a gift” when she finally became healthy after taking prescription weight loss pills. Then she summarized our story. We also explained how losing weight required more than just willpower, dietary changes, and a ferocious pace in the gym. Here comes the year's biggest health news offering hope for people battling obesity and type 2 diabetes. That was the arrival of the GLP1 receptor agonist known as semaglutide and more popular brand names such as Ozempic and Wigovy. Users shed stubborn fat while also giving them the energy to maintain their weight loss goals through exercise with immediate visible results.
What's the big deal? That weight isn't just about cosmetic acceptance and fending off social ridicule, it's about minimizing the burden of disease and chronic disease. The recognition of the need to treat obesity as another lifestyle disease alongside diabetes, heart, and liver disease has transformed what was once a private concern into a public health issue.
GLP1 receptor agonists will have even more applications
GLP1 receptor agonists are a class of drugs that mimic the effects of a hormone called glucagon-like peptide 1. When blood sugar levels rise, these drugs help produce more insulin to control blood sugar levels. It also suppresses hunger by slowing the movement of food from the stomach to the small intestine. Therefore, eat less and also control fatty liver. Recent clinical trials show that these drugs improve blood pressure and cholesterol levels. Trials are currently underway to see if these drugs can help people quit smoking and drinking after users said they experienced a loss of appetite. This indicates that the drug may also affect many reward pathways in the brain other than food. Therefore, because the drug also acts on inflammation in the brain, researchers are studying the effects of this treatment on Alzheimer's and Parkinson's diseases.
Will it work for Indians too?
Semaglutide, currently available as an oral formulation, offers hope to obese Indians. Weekly injections that produce higher rates of weight loss are not yet available, but may provide long-lasting results.
GLP1 RA is currently the starting point for tyazepatide, a double agonist of GLP1. Tiazepatide has better weight loss properties and diabetes control compared to semaglutide. “Currently, triple agonists like retatortide contain GLP1, GIP, and glucagon (an added third hormone). We achieved 20 per cent weight loss,'' says Dr V Mohan, chairman of Dr Mohan's Diabetes Center in Chennai.
Are these really magic bullets?
“Semaglutide injections have side effects such as nausea, vomiting, abdominal pain, bloating, diarrhea, and gastroparesis. Many people cannot tolerate the dose and give up prematurely.” It has been shown that weight comes back when discontinued and that only long-term use can maintain weight loss,” said Dr. Anup Misra, Chairman, Diabetes, Metabolic Diseases and Endocrine Center of Excellence, Fortis CDOC, New Delhi. I am.
As Dr. Ambrish Mittal, Chairman of Endocrinology and Diabetes at Max Healthcare points out, clinical breakthroughs are not yet translated into public health measures because “you can't keep injecting your whole life.” I don't get it. Muscle loss is also severe. “This accounts for 20-30 per cent of the body weight lost. Indians have less muscle mass anyway, so new drugs will be a challenge for the elderly in the long run,” he added. Additionally, it is not suitable for people with pancreatitis, typical thyroid tumors, and people taking certain medications.
Gray market abuse
Marked changes were observed in the human body after the use of injectable semaglutide, so the Danish company Novo Nordisk, the manufacturer of Ozempic, is constantly rushing to meet the demand. In India, a gray market for weight loss injections is booming due to unscrupulous procurement practices. “As long as the therapy is medically supervised, it is safe. The problem is that this drug is effective in controlling both diabetes and weight, but people are only seeing the latter.” . And they think it's just an over-the-counter drug that they can use freely,” Dr. Mittal reasons.
Dr. Misra witnessed rampant misuse of compounded semaglutide. This abuse involves making small adjustments to the original ingredients that can lead to serious drug quality problems, such as contamination or drugs with too much active ingredient. A combined version of Ozempic and Wegovy may replace pure semaglutide with a salt-based form, but clinical trials have not proven safety and efficacy. “There have been reports of 'adverse effects' from people who have taken the combined form,” says Dr. Misra.
Dr. Mohan argues for data from India to assess whether the new drug would be equally effective in patients in India, where patients “are prone to accumulating abdominal fat due to a high-carbohydrate diet.”
When will the injection be available in India?
It's not like you don't have a choice. “This molecule may have been developed in the West, but once the patent expires, that very company will be able to manufacture it here. Drug discovery is limited, but we are excellent at manufacturing drugs. , we can also manufacture cheaper medicines here and for the US market,” says Dr. Mittal.
Dr. Mohan said an injectable version could be available next year, given the short period between patent expiration and the launch of a lower-priced generic version. The cost of the shot can reach up to Rs 40,000 per month, which is quite a hefty amount. Additionally, while these drugs are most effective at getting you off the weight cliff initially, the three pillars of diet, lifestyle modification, and exercise will still be necessary for the rest of the process, say three experts. the house says. Breakthroughs and building the body are still the result of human efforts.
© Indian Express Private Limited
Date first uploaded: Dec 29, 2023 11:58 IST
