This weight loss drug is safe and effective
So many people are looking for a game changing new trick to lose a few pounds.
It’s pretty staggering if you ever step back to take a look at all of the energy and media attention spent on superfoods, metabolism boosters, and weight loss hacks.
And it’s not just our time and attention that we’re spending. The supplement and weight loss industries are worth tens of billions of dollars a year, and I haven’t even mentioned all the kale that gets purchased only to spoil in refrigerators across the country.
But what if I were to tell you that there’s an existing weight loss tool that can help you lose 15% of your bodyweight? That means losing about 30 pounds if you’re 180 right now.
It would be pretty exciting!
Guess what - that weight loss tool is here! It’s safe. It’s effective. And it’s been tested in a placebo-controlled, randomized trial.
This weight loss hack is actually a medication
Semaglutide is a medication originally developed for diabetes.
It’s a type of medication called a glucagon like peptide receptor-1 agonist (or GLP-1 agonist) that is one of the new diabetes medications that are changing the paradigm of how we prevent cardiovascular complications in diabetics.
The recently published STEP 1 trial looked to evaluate the benefit of a once weekly injection of semaglutide in a group of about 1306 patients (and another 655 given a placebo injection) with the goal of weight loss, not control of diabetes.
The patients were predominantly women, predominantly white, with BMIs over 30 (technically meeting criteria for obesity). They weren’t super sick - about a third with high blood pressure or high cholesterol, less than 15% with any other significant medical problems. They weren’t diabetics.
The intervention here was simple - once a week injection of semaglutide compared to a once a week injection of placebo. It’s not even a pill that’s taken everyday.
The results of this trial are kind of incredible. Average weight loss of 14.9% of body weight over 68 weeks. The graph speaks for itself:
And this worked for most people. About 86% of people lost at least 5% of their body weight, and 70% of people lost more than 10%:
The drug is quite safe with the majority of side effects being in the gastrointestinal realm, the most dangerous one being gallstones. But - and this is important - semaglutide protects against cardiovascular events even if it causes more nausea, diarrhea, and constipation than a placebo does.
The big question here: why didn’t this get more attention?
I’m not suggesting that this study was ignored - all the major publications wrote about it, like the New York Times and CNN. But it doesn’t feel like semaglutide broke through into the zeitgeist in the way that I would expect based on these findings.
Have you heard about this drug?
If you’re overweight, has your doctor mentioned it?
How many doctors know about this study?
Now, being published in the New England Journal of Medicine hardly means that findings are silenced. This isn’t cancel culture.
But I find it sort of odd that this isn’t bigger news. These results are really impressive - 15% of body weight at the end of a year is life changing weight loss. And the fact that we have such promising evidence about the safety and cardiovascular effects of this medication means that I don’t think we’re looking at another fen-phen situation down the road, where a weight loss drug actually caused significant morbidity.
I suspect the reason this isn’t making more news is because a medication for weight loss doesn’t conform to our stereotypes about how to lose weight.
A drug for weight loss doesn’t fit our expectations that weight loss requires either sacrifice or a secret
Think about the narratives you hear when it comes to weight loss.
You read stories about people who totally changed their lives, started exercising, cut out pizza, stopped drinking beer, and the weight comes off.
You also hear stories about people who found just the right supplement and used it to lose their excess weight.
The semaglutide successes should be celebrated in the same way!
If semaglutide were a nutritional supplement, it would be on your Facebook news feed, you’d see adds for it on Instagram, and you’d be seeing segments about it on Dr. Oz.
But since it’s a drug, news doesn’t spread the same way. There’s a stigma around going to your doctor to get a weight loss prescription that doesn’t exist from buying something in the nutrition aisle at CVS. Since you need a prescription, and it’s injectable, it feels like there’s something different about semaglutide than the crap you can find at GNC.
The bottom line here is that this is amazing news! This medication may be life changing for the carefully selected patient.
There’s no reason to stigmatize using semaglutide to lose weight - just like there’s no reason to stigmatize bariatric surgery, which is also pretty remarkable in its weight loss benefit.
I’m certainly going to be talking about semaglutide more, because this is news worth spreading.
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