Add it to the water?
People who know me today would hardly believe it, but as a child, I had to buy clothes in what was then called the “husky” department. My brother called me “fatso” when he wanted to be mean, and he wasn’t wrong.
Though I slimmed down in adolescence and have remained there for the most part since, there’s still a part of me that wants a magic pill that will let me eat whatever I want and not gain weight.
My ears perked up a few years ago when they developed a new form of fat that humans can’t digest. The suggestion was that people could consume potato chips and other fried foods made with the stuff, and the fat would go right through them. The problem was that everything else did, too, so it never caught on.
What has caught on is overeating. It’s a national (actually, international) problem. Today, nearly 75% of Americans over 20 are overweight; more than four out of 10 qualify as obese.
We know it’s not just from lack of willpower: Our genes, other health conditions, stress, lack of sleep, and the sheer abundance of highly caloric, low-cost foods with little or no nutritive value are a large part of the problem.
We also know the health consequences of being heavy include high blood pressure, heart disease, diabetes, some cancers, depression and more.
Given this, would anyone have predicted that such an intractable problem as universal weight gain and its associated health problems could be (almost) magically reversed by a single class of drugs?
Enter Ozempic and Wegovy (generic name: semaglutide) and Mounjaro and Zepbound (generic name: tirzepatide).
Known as GLP-1 agonists, these drugs were developed to help diabetics control blood sugar. (GLP-1 is a hormone our bodies naturally produce that triggers our pancreas to release insulin, slows digestion and increases feelings of satiety.)
These injectable drugs became household names after having been found to generate significant and relatively easy weight loss in many who take them — at least, for as long as they take them.
The downsides? There are side effects, of course, as with all drugs (in this case, mostly of the gastrointestinal variety). And the drugs must be used weekly (patients get a “pen” so they can self-inject) and currently can cost up to $1,000 per month without insurance.
On the other hand, researchers continue to observe and study some incredible additional health benefits from the drugs.
Along with lowering blood sugar levels in diabetics, they appear to reduce the risk of heart attacks and strokes in patients with cardiovascular disease, and of the need for dialysis or a transplant in those with chronic kidney disease. The drugs also appear to reduce colon cancer risk in diabetics.
While being overweight is associated with all these conditions, the drugs appear in some cases to reduce the risk regardless of how much weight a person loses.
Perhaps in the same way that they reduce the sensation of hunger, they anecdotally have been found to reduce cravings for alcohol, nicotine and other addictive drugs. Randomized studies are underway to confirm these effects.
And the biggie for older adults: Studies have shown that GLP-1 agonists reduce the buildup of amyloid protein in the brain, which is associated with the development of Alzheimer’s disease. Clinical studies to assess Ozempic’s effect on cognitive decline and dementia are ongoing.
And the Alzheimer’s Association recently reported that a different GLP-1 drug “appears to reduce shrinking in the parts of the brain that control memory, learning, language and decision-making by nearly 50% compared to placebo,” reducing cognitive decline in those with mild Alzheimer’s by as much as 18% after one year.
No one is saying these drugs are likely to work equally well in all persons or on all these conditions, nor will they likely work without additional efforts, including improved diet, exercise, therapy and more.
In short, they’re not miracle drugs. But they sure seem to hold a great deal of promise for fighting some of the most serious health conditions we face today worldwide.
I look forward to seeing more results from clinical studies — and to hearing that Medicare will heavily negotiate the price of such drugs, which should be easier to do if we find that three out of four Americans need to take them for the rest of their lives.
A piece of good news: Ozempic’s core patent expires in 2026.
Stay tuned.
