Peptide-1 drugs (Zepbound and other peptide-1 drugs of the Glucagon type (GLP-1) have had incredible success in clinical loss trials and have since become extremely popular in the United States But do drugs work in the real world as well?
Previous clinical trials have shown that:
- Semaglutide (Ozempic and Wegovy) could lead to a 14.9% body weight reduction Over 68 weeks.
- Shooting (Mounjaro and Zepbound) could lead to a 20.9% body weight reduction Over 72 weeks.
However, a new study published on June 10 Obesity found that Patients taking these drugs outside a study framework have not seen the same types of results.
“In the real world, we have observed Weight reduction or weight loss was lower that what we (we) saw in the randomized control trials, ”said the study author Hamlet Gasoyan, PHD, MPHDeputy professor of medicine and researcher at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.
“The way we can explain it according to our data: half of the patients Abandoned treatment During the first year, and eight out of 10 On the lower doses drugs studied, ”said Gasoyan Health.
The results are not necessarily surprising, experts said, and are not a concern among users of GLP-1. Even lower amounts of weight loss can cause significant cardiovascular and metabolic advantages.
For this study, Gasoyan and his team examined the data of nearly 7,900 users of GLP-1 in Ohio and Florida who were overweight or obeseBut did not have Type 2 diabetes. About three -quarters of the participants were women, whites and had private insurance. There were 6,109 people taking semaglutide and 1,772 taking shooting.
After a year, the average weight reduction Among the participants, there was:
- 7.7% for semaglutide
- 12.4% for shooting
On the other hand, People in clinical trials lost 14.9% and 20.9% of their body weight on semaglutide or shooting, respectively.
Richard Siegel, MDEndocrinologist and co -director of diabetes and lipid center at the Medical Center tuffs, told Health that The results comply with the previous results In the field of weight management, where the effects of drugs are much more important in trials than in the real world.
There are several reasons why this is the case:
- Study participants are often healthier or vulnerable groups with existing conditions are not recruited for studies.
- The trials are carried out in ideal medical environments.
This means that in the real world, patients can feel more serious side effects or difficulty accessing their drugs. Consequently, they can choose to Take a lower dose of a drug or stop taking it completely, Miss the advantages of the drug.
Stop drugs early
In the last Obesity The study, around 22% of semaglutide patients and around 16% of shooting patients have ceased to take their medication throughout the first year of the trial. Shortly after the one year brand, 31% of additional semaglutide users and 34% of shooting users have also left their medication.
It means Less than half of the participants continued to take their drug GLP-1 throughout the study period.
People who have stopped taking shooting or semaglutide in the first three months have lost only 3.6% of their body weight, while those who resigned after three to 12 months lost 6.8% of their body weight.
But why did so many people end their treatment early? Gasoyan said he was working on research at the moment, which revealed that cost, insurance -related factors and side effects are probably the best culprits.
In addition, “supply shortages during the study period may have contributed to an increase in stop rates, which is higher three times higher than in clinical trials”, ” Osama Hamdy, MD, PHDMedical director of the Obesity Clinic and Diabetes Clinic Program for patients hospitalized at the Harvard Medical School, told Health.
Dose differences
Although higher doses of semaglutide and shooting are linked to greater weight loss in the tests, “Many people cannot reach this dose because of intolerance” and side effects, Siegel explained.
In Gasoyan’s study, on 80% of study participants were on a “Low interview dose”, “ which is defined as less than 1.7 milligrams (MG) of semaglutide or less than 10 mg of shooting. In clinical trials, participants took 2.4 mg of semaglutide and 15 mg of shooting.
However, study Participants who took higher doses (like those in clinical trials) have seen Comparable weight loss results: 13.7% with semaglutide and 18% with shooting, just slightly below the results of clinical trials.
Higher doses were also linked to Other health benefits, The study revealed.
“We had a subset of patients prediacy In our study cohort, “said Gasoyan.” Those who have never interrupted treatment had the highest chance of bringing glucose levels back to normal levels. “”
Although you don’t lose as much weight on the semaglutide or shooting compared to patients in clinical trials, Even small amounts of weight loss can always be significant.
“We focus too much on the quantity more than we can lose”, ” Amy Rothberg, MDDirector of the University of Michigan’s weight management program, said Health. “People can solve a large part of their health problems, as we know about the diabetes prevention program, with as little as 5% (reduction in body weight).”
But if you are looking for the best possible results, there are things you can do to Increase your chances to see greater weight loss and metabolic advantages.
“The key is to get on the dose, As long as the side effects are not too limiting and the weight loss is not too fast, ” Babak Orandi, MD, PHDSpecialist in obesity medicine on the Nyu Langone Health Management Management Program, told Health.
In fact, in the new Obesity Study, researchers revealed that patients were a lot more likely to lose at least 10% of their body weight If they took a higher medication dose and did not end their medication early.
Healthy nutrition And exercise Are also crucial if you want to optimize the effects of GLP-1 drugs and reduce the risk of side effects, experts have agreed.
“People should eat slowly, eat less than they do normally and avoid fatty or fatty foods when they start these drugs or increase the dosage,” said Orandi.
In the end, GLP-1 drugs work better when patients have a Multidisciplinary team working to help them, Gasoyan, Siegel and Rothberg have underlined.
Administrators can help ensure appropriate access to drugs through insurance pre-authorizations, while nutritionists and other lifestyle experts help you make the necessary food and behavioral changes.
People who stop GLP-1 drugs are again risky to gain weight, so these are these Lifestyle changes that are really essential for lasting results. “Without having changed their behavior, they are set up to regain the weight,” said Rothberg.