On June 04, 2021, the U.S. Food and Drug Administration (FDA) announced the newest addition to the shortlisted anti-obesity drugs that earned its approval: semaglutide. Touted as the “game-changer” by media outlets for its promising clinical results, semaglutide is believed to be “an important advancement in pharmacotherapy” that addresses the long-enduring obesity crisis in the U.S.
Although this anti-obesity drug is considered a milestone in medical science, it is necessary to know the treatment before prescribing them to the public. This advice is in light of controversies about anti-obesity treatments wherein health risks outweigh the overall benefits.
This article discusses the latest developments in pharmacology covering the area of weight loss and anti-obesity drugs.
What’s In The Article?
Semaglutide: The Newest Drug Against Obesity
Other FDA-Approved Drugs For Weight Management
Withdrawal Of Lorcaserin (Belviq and Belviq XR) From The Market
Final Thoughts
Semaglutide: The Newest Drug Against Obesity
Semaglutide belongs to the glucagon-like peptide-I receptor agonists class, otherwise referred to as GLP-1 RAs. GLP-1 is a hormone naturally released in the gastrointestinal tract during nutrient intake. Its effects include increased insulin release from the pancreas, delayed stomach emptying, and appetite suppression.
As a result, the patient achieves a feeling of satiety or fullness, which lasts much longer than the naturally-produced GLP-1 hormone levels. Initial studies revealed that participants lost an average of 15 kg during a 15-month trial.
The U.S. Food and Drug Administration has given its approval for the use of semaglutide under the brand name Wegovy for chronic weight management in adults with obesity having at least one weight-related comorbidity, such as high blood pressure, type 2 diabetes, or high cholesterol.
According to the regulatory board, semaglutide should be combined with a calorie diet and increased physical activity. Since 2014, this under-the-skin injection has been the first approved anti-obesity drug for chronic weight management in adults.
Who is Qualified to Take Semaglutide?
Patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related illness are qualified to take 2.4 mg of semaglutide once a week. In addition, adults with a BMI of 30 kg/m2 without existing comorbidities can also acquire semaglutide injections.
How does Semaglutide Work?
Semaglutide, under the brand name Wegovy, works by imitating a hormone called glucagon-like peptide-1 (GLP), which targets the areas of the brain that controls appetite and food intake. By increasing insulin release in the pancreas, delaying stomach emptying, and suppressing appetite, Wegovy helps in long-term weight management. Yet, to reduce gastrointestinal side effects, it is advised to gradually increase the dosage to 2.4 mg once weekly for 16 to 20 weeks.
Safety of Semaglutide Use
The FDA warned of possible adverse reactions in using Wegovy in conjunction with other products containing semaglutide, GLP-1 receptor agonists, and drugs intended for weight loss (prescription drugs, over-the-counter treatments, and herbal products). Furthermore, Wegovy has yet to be studied in patients with a history of pancreatitis.
Among the most common side effects recorded in users of Wegovy include nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, eructation, hypoglycemia in patients with type 2 diabetes, flatulence, gastroenteritis, and gastroesophageal reflux disease.
A warning is similarly issued against the potential risk of thyroid C-cell tumors in patients taking Wegovy. The drug should not also be used in patients with a family history of medullary thyroid carcinoma and those with a rare condition called Multiple Endocrine Neoplasia syndrome type 2.
Regardless, the FDA considers these side effects tolerable and proceeds to endorse semaglutide injection as one of the only six approved medications for long-term obesity treatment.
Other FDA-Approved Drugs For Weight Management
Liraglutide - A subcutaneous injection belonging to the same class as semaglutide that targets the brain receptors to suppress appetite and food intake; it can be prescribed to adults and children aged 12 and above.
Orlistat - An oral medication that reduces the amount of fat the body absorbs from food intake; it can be prescribed to adults and children aged 12 and above.
Phentermine-topiramate - A mixture of oral drugs that helps curb appetite and gives a sensation of stomach fullness; it can only be prescribed to children 12 years and above.
Naltrexone-bupropion - A mixture of oral drugs that helps manage appetite and gives a sensation of satiety.
Setmelanotide - An injectable drug that can reduce appetite and increase the feeling of fullness and the body’s resting metabolism; It is the first weight management treatment approved by the FDA for people with rare genetic disorders. It can be used in patients six years and older.
Withdrawal Of Lorcaserin (Belviq and Belviq XR) From The Market
On February 13, 2020, the FDA requested the withdrawal of lorcaserin from the market, most commonly known by brand names Belviq and Belviq XR. Approved by the FDA in 2012, lorcaserin is a prescription medicine that used to be administered to adults who were obese or had weight-related medical conditions. It works by increasing the feeling of satiety, thereby helping suppress one’s appetite.
The FDA earlier required the drug manufacturer to conduct a randomized, double-blind, placebo-controlled clinical trial to study the occurrence of cardiovascular problems among patients taking lorcaserin. Unfortunately, the regulatory board discovered that more patients using lorcaserin were diagnosed with cancer over the five-year trial. The cancer types reported include pancreatic, colorectal, and lung cancers.
The safety call included instructions for healthcare professionals to stop prescribing and dispensing lorcaserin to obese or overweight patients.
Final Thoughts
It is prudent to remain updated regarding the FDA’s new rulings to avoid endangering the lives of obese and overweight patients, who typically manifest at least one underlying comorbidity. As a healthcare professional, it is essential to identify which drugs will prove effective for patients in the long run and will not similarly aggravate their existing conditions.
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