New Weight Loss Medications: What You Need to Know
Being on a diet sometimes feels like an American pastime: If you haven’t experienced the “pleasure” of it, then it’s almost certain that your BFF, baby brother, aunt or someone else in your close circle of family and friends has.
It’s probably no coincidence that government statistics show that more than 30% of Americans are overweight and more than 42% have obesity. A related government survey found that almost half of US adults said they have tried to lose weight in the last 12-month period. The top two methods were exercising and eating less food, followed by consuming more fruits, vegetables, and salads.
People want to lose weight to look a certain way “now,” and they also want to live longer and healthier lives, with a lower risk of developing serious health conditions in the future.
But anyone who has ever dieted can tell you that losing weight is hard and that long-term weight loss requires sustained effort, which can sometimes feel Herculean, even impossible.
A new class of medications — called glucagon-like peptide 1 receptor agonists, or GLP-1s — has taken the country by storm because these drugs seem to make weight loss more effortless. They often quiet the “food noise,” or brain chatter about food, that makes it so hard to stick to those all-important lifestyle changes.
Their brand names have become household words, seemingly overnight. Ozempic and Wegovy have semaglutide as the active ingredient, while Mounjaro and Zepbound contain tirzepatide.
Originally developed for type 2 diabetes, medications such as semaglutide and tirzepatide work by mimicking the hormone glucagon-like peptide 1, which is released in our gut when we eat.
“It’s a peptide that is secreted by our intestine, and it’s normally very short-acting, and it’s degraded by other enzymes in the body really quickly,” obesity specialist Dr. Jorge Moreno told CNN Chief Medical correspondent Dr. Sanjay Gupta on the Chasing Life podcast recently. Moreno, an assistant professor of medicine at Yale School of Medicine, treats patients looking to manage their weight.
He explained that GLP-1 is a nutrient-stimulated hormone that activates when you eat, telling your body you just had food. “(It goes) into the area of the brain that is the hypothalamus … and (it tells) your brain, ‘You’ve had food, stop eating,’” he said.
The medications attach to the same receptors as the GLP-1 hormone but are longer-acting. “And so, they keep this mechanism working consistently,” Moreno said. “They basically decrease your appetite by signaling in the hypothalamus that you’re full.”
Both the hormone and the medications also trigger other actions, such as slowing down the movement of food through the gut and telling the body to release more insulin. Tirzepatide also can attach to the receptors of another related hormone, called GIP for short, which makes it a bit more powerful.
If you are considering starting one of these medications, Moreno recommends keeping these five facts in mind.
These meds are not for everybody
At the moment, the weight loss versions of semaglutide (Wegovy) and tirzepatide (Zepbound) are approved to treat people with obesity, not those looking to shed a few pounds.
“Patients should be aware that these are treatments for a chronic medical condition known as obesity,” Moreno said. “I think it’s important to realize that obesity is a chronic disease that is relapsing (and) that requires long-term treatment.”
He said that Wegovy and Zepbound are — in the parlance of the US Food and Drug Administration — “indicated” for use in people diagnosed with obesity, or those with a body mass index of 30 and above. They’re also indicated for people with a BMI of 27 and above who also have weight-related medical conditions such as type 2 diabetes or high blood pressure. (Semaglutide, sold as Ozempic, and tirzepatide, sold as Mounjaro, are indicated only for people with type 2 diabetes.)
If you haven’t been given one of these diagnoses, you may have trouble getting a prescription, let alone getting your health insurance to cover the hefty price tag.
They work
These drugs are pretty effective in helping many people lose weight. They are filling a gap between earlier weight loss drugs, which Moreno said help people lose on average between 5% and 10% of their body weight, and bariatric surgery, an invasive procedure that he said helps people lose on average around 25% to 30%.
“It’s important to know that these medications are efficacious,” Moreno said. “On average, with semaglutide, the weight loss average can be
