In the 1950s and 60s, amphetamine-based diet pills were very popular, but besides being addictive, serious side effects emerged and lost their popularity. In 1997, the same type of drugs were banned because of the damage they caused to the heart valve.
But is it necessary to use these drugs to combat obesity? Is there any way around this? Jens Juul Holst and Joel Habener, the scientists who pioneered Wegovy, which is known as the “miracle weight loss drug” in our country, gave their opinions on the subject.
Anti-obesity drugs are seen as “a bottomless pit into which people put money and time”.
The new version of weight loss drugs, which were produced in the past and whose formula is more or less known, looks very different. These drugs work by mimicking a hormone called glucagon-like peptide 1 (GLP-1), which regulates blood sugar levels and keeps people full for longer by slowing the rate at which food leaves the stomach. Drugs that mimic GLP-1 also seem to be a very powerful tool for weight loss.
Some people in the US report losing at least 15% of their body weight after 68 weeks using semaglutide for weight loss, which is approved for type 2 diabetes. The name of the drug is Ozempic, which is about to be approved in the UK.
But GLP-1 dates back more than 40 years, before obesity became the current health crisis.
Two scientists, who played an important role in the development of drugs by working on the hormone GLP-1, provide some information about the future of these drugs. One of them is Professor Jens Juul Holst in the Department of Biomedical Sciences at the University of Copenhagen; the other is Professor Joel Habener at the Mass General Research Institute in Massachusetts. In 2021, Habener, Holst, and Daniel Drucker were awarded the Warren Alpert Foundation Award for their work in discovering and developing treatments based on the hormone GLP-1.
The story of the hormone GLP-1 actually goes somewhere other than diabetes and obesity. Holst discovered this with his duodenal ulcer disease.
This disease means looking at the hormones that people secrete while eating.
GLP-1 not only stimulates insulin secretion; Holst, who discovered that it also inhibits glucagon secretion, mentions the presence of too much glucagon in people with diabetes and this causes high blood sugar.
The scientist, who has always been on friendly terms with Ozempic and Wegovy manufacturer Novo Nordisk, adds that he was intrigued by talking about things that could stimulate insulin secretion. However, when Novo Nordisk saw that it did not stimulate insulin secretion in people with diabetes, they withdrew support, saying that the drug would not work.
The real turning point was a study by Michael Nauck in 1993.
As a result of this study, people with type-2 diabetes were vaccinated with GLP-1 and their blood sugar was found to return to completely normal levels within four hours. This is something that shows the drugs are working on people with Type-2 diabetes. It stimulated the secretion of glucagon while stimulating insulin secretion. Later, these drugs were found to inhibit food intake.
Joel Habener says they think it could be a potential treatment for diabetes, type 2 diabetes.
But he adds that you have to be very careful to keep the dose low when trying these drugs. Because many patients felt sick while eating. Within 30 minutes of eating a meal, blood insulins were measured to check how effective it was.
Most of the subjects stated that they could not finish their meals. Today, there are 10 to 15 percent of people in the world with a body mass index of 30 or higher. In the USA, this number is around 40%. This shows that obesity is a serious metabolic problem.
In fact, it was already known in humans that the effect of GLP-1 dose on food intake would be determined and it would work. The problem was the side effects.
The main challenge throughout the development of these GLP-1 drugs was finding a balance between the two. One of the really important observations was that Novo Nordisk created a fixed combination of long-acting insulin and GLP-1 called Xultophy. This drug has been given to people with severe diabetes and it has been shown to work very well for them. But it turned out that it took 14 weeks to gradually administer the dose to reach a stable dose with the drug.
The more carefully these drugs are used, the less side effects are seen.
One of the problems is that these drugs are not always used by the people who need them most.
Ozempic has become quite popular among celebrities. These drugs could be a public health revolution, says Derek Thompson of The Atlantic, but it’s important to underline that by early 2023 they represent “a more elegant cultural make-up than a medical intervention.”
The most satisfying thing about drugs at the moment is that they are very effective in controlling type-2 diabetes.
Obesity is still seen as a cosmetic problem around the world, and people are thought to be obese because they eat too much or don’t exercise enough, or because they don’t have the willpower.
However, there is something we need to know that obesity; It is not an eating disorder, but a metabolic disease with genetic and environmental inputs. According to Holst, people will use GLP-1s for a while after they realize they have stopped eating, and they will stop, just like with any drug. But there is a lot to know about the use of these drugs with caution.
Underlining that this is not a money issue, scientists say that the reason is only the ongoing instability. Just like any other drug, one of these weight loss drugs, Wegovy, will not be for the rest of their lives. Professors who saw this picture repeated that the same is true for other drugs.
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