Albie Colantonio for ForbesIn the summer of 2023, Dr. Amir Zamani, a 42-year-old Johns Hopkins trained physician who is a partner on Bain Capital’s life sciences team in Boston, was obsessed with obesity drugs. Ozempic, the blockbuster injectable for type 2 diabetes from Novo Nordisk, was taking America by storm, on pace to generate some $14 billion in revenue that year for the Danish pharmaceutical giant…….Continue reading……
By Amy Feldman Source: Forbes . Critics:Some compounded versions have been found to contain salts of semaglutide including the sodium and the acetate in an attempt to avoid the patent of the base semaglutide product. These are not evaluated for safety and effectiveness by and thus are considered not shown to be safe or effective by the US Food and Drug Administration (FDA).
A 2014 meta-analysis found that semaglutide may be effective in lowering liver enzymes (transaminitis) and improving certain radiologically observed features of metabolic dysfunction–associated steatotic liver disease. French national health care insurance system database had previously suggested 1–3 years use of glucagon like peptide-1 receptor agonists like exenatide, liraglutide and dulaglutide may be linked with increased occurrence of thyroid cancer. Semaglutide belongs to the same family of medicine.
A meta-analysis involving data from 37 randomized controlled trials and 19 real world studies (46,719 patients) showed that semaglutide use over 18 months was not associated with increased risks of any cancer, supported by a high grade of evidence. In July 2023, the Icelandic Medicines Agency reported two cases of suicidal thoughts and one case of self-injury of users of the injection, prompting a safety assessment of Ozempic, Wegovy, Saxenda, and similar drugs.
In January 2024, a preliminary review conducted by the FDA confirmed no evidence had been found to suggest that the medicine causes suicidal thoughts or actions. Semaglutide has shown potential to reduce interest in alcohol consumption among users. Scientists speculate that semaglutide may influence brain regions involved in addiction and appetite regulation, although the exact mechanisms remain under study.
Animal research has indicated that drugs similar to semaglutide can reduce alcohol intake. Semaglutide and similar drugs, such as dulaglutide and liraglutide, have been used to treat binge eating disorder (BED), as they can successfully minimize obsessive thoughts about food and binging urges.
Dietary supplements, foodstuffs, or programs for weight loss are heavily promoted through advertisements in print, on television, and on the internet. The US Food and Drug Administration recommends caution with use of these products, since many of the claims of safety and effectiveness are unsubstantiated, and many of the studies purporting to demonstrate their effectiveness are funded by the manufactures and suffer a high degree of bias.
Individuals with anorexia nervosa or bulimia nervosa, and some athletes, try to control body weight with diet pills, laxatives, or diuretic medications, although the latter two generally have no impact on body fat and only cause short-lived weight-loss through dehydration. Both diuretics and laxatives can cause electrolyte abnormalities which may cause cognitive, heart, and muscle problems, and can be fatal.
Canadian clinical practice 2006 guidelines state that there is insufficient evidence to recommend in favor of or against using herbal medicine, dietary supplements or homeopathy against obesity. Some botanical supplements include high dosages of compounds found in plants with stimulant effects including yohimbine and higenamine.
Caffeine, coffee and green tea can suppress appetite (the hormone ghrelin) and decrease caloric intake (food consumption). It can also cause beneficial changes in fat metabolism or lipolytic actions. According to a review, habitual intake of 3 to 4 cups of coffee appears to be safe and to be associated with the most robust beneficial effects.
Thermogenic actions and, in the case of the caffeinated drink mate (yerba maté), prolonged gastric emptying time may also play a role. Some anti-obesity medications can have severe, even, lethal side effects, fen-phen being a famous example. Fen-phen was reported through the FDA to cause abnormal echocardiograms, heart valve problems, and rare valvular diseases.
One of, if not the first, to sound alarms was Sir Arthur MacNalty, Chief Medical Officer (United Kingdom). As early as the 1930s, he warned against the use of 2,4-Dinitrophenol as an anti-obesity medication and the injudicious and/or medically unsupervised use of thyroid hormone to achieve weight reduction. The side effects are often associated with the medication’s mechanism of action.
In general, stimulants carry a risk of high blood pressure, faster heart rate, palpitations, closed-angle glaucoma, drug addiction, restlessness, agitation, and insomnia. Another medication, orlistat, blocks absorption of dietary fats, and as a result may cause oily spotting bowel movements (steatorrhea), oily stools, stomach pain, and flatulence.
A similar medication designed for patients with Type 2 diabetes is Acarbose; which partially blocks absorption of carbohydrates in the small intestine, and produces similar side effects including stomach pain and flatulence…
National Institute for Health and Clinical Excellence. Clinical guideline 43: Obesity: The prevention, identification, assessment and management of overweight and obesity in adults and children. London, 2006.
“WIN – Publication – Prescription Medications for the Treatment of Obesity”. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Food and Drug Administration. Archived from the original on 18 January 2017. Retrieved 16 December 2019.
FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014″. FDA. 21 June 2021. Retrieved 19 July 2022.
Drug interventions for the treatment of obesity in children and adolescents”. The Cochrane Database of Systematic Reviews.
Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians”. Annals of Internal Medicine
Guidance for Industry Developing Products for Weight Management”. Food and Drug Administration.
Evekeo Prescribing Information” (PDF).
Effects of GLP-1 on appetite and weight”. Reviews in Endocrine & Metabolic Disorders.
The return of rainbow diet pills”. American Journal of Public Health.
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