New obesity drugs come with embarrassing side effects

Irene Isotalo has always managed to lose weight, but always put it back on. The now 66-year-old first dieted when she was 14 at Weight Watchers. She then tried diet after diet and bought so many books on weight loss that she thought she had more books than the public library.

Desperate, she finally visited a weight management clinic at the University of Michigan. She had her sleep apnea and knee pain but couldn’t control her appetite.

“I just have the urge to eat,” said Isoltaro, a former interior design coordinator. “It’s like the panic you get when you want food.”

“My mental embarrassment was deep,” she said.

But now those cravings have vanished since she started taking Wegobee, one of a new class of anti-obesity drugs prescribed by the clinic’s doctors. She lost 50 pounds of her weight and ditched her black clothes she wore to hide her body. Her obesity-related medical problems disappeared, along with many of her prejudices that alienated her from her family and friends.

But she, like other patients at the clinic, may be judged by others to be getting injections to treat obesity rather than find the willpower to lose and keep it off. I still struggle with that fear.

But the drug “changed my life,” she said.

With Wegovy and drugs like this, it’s a “very exciting time in this space,” says Susan Janoff, co-director of the Obesity Lab at the National Institute of Diabetes, Gastroenterology and Kidney Diseases. Dr. Ski said.

about 100 million American or 42 percent According to the US Centers for Disease Control and Prevention, 80% of the adult population is obese. For the first time, obese patients who have been in medical jeopardy for their entire lives can escape the merciless trap of futility dieting and see weight loss along with a reduction in obesity-related health problems. .

But the dirt still remains.

“There’s a moral element to this,” Dr. Yanofsky says. “People really believe that obese people should use willpower, and that taking medicine is an easy solution.”

Unlike other chronic diseases, obesity is fully public, Dr. Jankowski said. “No one looks at you and knows you have high blood pressure cholesterol,” she said.

Obesity is “one of the most stigmatized diseases in the world.”

Wegoby and a similar but less effective drug, Saxenda, are the only drugs in this class so far approved for the treatment of obesity. Other drugs such as Ozempic and Munjaro are also diabetes drugs, but they are also drugs that promote weight loss.

Novo Nordisk, the maker of Wegovy, reports that doctors in the United States have written about: 110,000 prescriptions for medicine. Due to huge demand, the company recently put Wegovy ads on hold.

“We can’t make enough,” Novo Nordisk spokesman Ambre James Brown said. Due to very limited supply, the company only markets the drug in its headquarters in the United States, Norway and Denmark. The hefty list price of $13,492 per month makes it out of reach for most people without insurance. But more and more insurance companies are doing so.

The drug comes at a time when researchers are documenting the risks of obesity and the futility of prescribing diet and exercise alone as treatment. Decades of research consistently show that few people can lose and maintain excess weight through lifestyle changes alone.

Obese people are at risk for a variety of serious medical conditions, including diabetes, high blood pressure, high cholesterol, sleep apnea, and non-alcoholic fatty liver disease, the leading reason for liver transplantation in the United States.

Losing weight can make some of these complications go away.

But the belief, fueled by diet gurus, influencers and the industry that sells supplements and diet plans, persists that people can lose weight if they really try.

So people who take drugs like Wegovy often find themselves in uncomfortable situations, influenced by the popular view that obesity is a lifestyle choice.

At the University of Michigan Clinic, there are people like Isotaro. Her reluctance to admit to taking Wigobee comes from her belief that those who take Wigobee are often thought to be cheating.

But another patient, Katara Ewing of Detroit, is quick to respond when you ask anyone to take the drug. She tried dieting, but thanks to Wegovy she was able to lose her 90 pounds.

After an all-nighter at the Ford factory, she showed up to the weight management clinic in a bright green sweater, full of energy and energy. Now that she has lost weight, she has more energy, her mood is brighter and her high blood pressure is gone.

But many longtime friends died, and she realized that weight loss had unintended social consequences.

“I have only real friends left, and very few of them,” Ewing said.

Obesity medicine experts say it’s no surprise. The same is true after losing weight through bariatric surgery.

Obesity is such a critical condition that it changes relationships. A normal weight person may feel superior to their obese friend, which helps define the relationship until the friend loses weight. Other friends who are obese themselves may use their condition as a bonding element in their relationships. Now it’s gone.

Another issue is the drug’s reputation. vanity potionamplified by comedian punchline at the oscar award Even in other attention-grabbing occasions.

But when Samuel Simpson came to the weight management clinic, he thought losing weight was a matter of life and death.

Simpson feared facing the fate of her mother, brother and sister, all of whom were obese and diabetic. All developed renal failure and eventually died, each dying at the age of 59.

He first met Dr. Amy Rothberg at the clinic almost two years ago, when he was 58. He was obese and diabetic. He was taking high doses of insulin to keep his blood sugar down, but his kidneys were beginning to fail.

“I was very scared,” he said. “Will I end up on dialysis like everyone else? I will go down in history.”

He started with a diet, then Dr. Rothberg added the drug Maunjaro from Eli Lilly. The drug appears to be even more potent than Wigoby in promoting weight loss, but is currently only approved for diabetics.

He has now lost 44 pounds, 20% of his original weight, and his diabetes is in remission. Losing weight “changed my life,” he says.

To anyone who asks how he lost weight, he would answer:

“I am not a roadside preacher, but if someone asks me how I did this, I will tell them,” he said.

Art Regner had another problem. The talkative color commentator for the Detroit Red Wings hockey team said he wasn’t ready to resort to medication. But when he visited Dr. Rothberg’s office, he was mortified. He had regained 22 of the 76 pounds he had lost from dieting.

Dr. Rothberg, who is also the medical director of Rewind, a diabetes counseling company, suggested Wigoby or Munjaro. But Regner felt he needed enough willpower to do it himself. He knows he has high blood sugar and is aware of the effects of diabetes.

Dr. Rothberg gently explained that it wasn’t his fault that the weight kept coming back.

“I think biology is plotting against you,” she said. “I don’t think it’s a matter of willpower.”

Mr. Regner was unfazed. “I believe in myself,” he said. “I wake up in the morning and look in the mirror and say, ‘Do or don’t do it.'”