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The skinny on semaglutide

Almost 70% of American adults suffer from obesity or excess weight, costing the U.S. health care system upward of $173 billion a year.

Medical advancements in the form of prescription drugs or surgery offer hope. As a result, drug names such as Wegovy and Ozempic are on the tips of tongues, driven by social media influencers and advertisers, about weight management treatment. They seem to be revolutionizing the weight-loss industry. In fact, according to analysts at financial firm Cowen Inc., the quickly growing GLP-1 diabetes and weight-loss drug market could reach global sales of all obesity drugs expected to total $30 billion by 2030. But what are they, and why is everyone talking about them now?

The chemical compound in Wegovy and Ozempic is semaglutide, but it isn’t new. Novo Nordisk is the sole manufacturer and patent holder for the compound approved in 2017 (marketed as Ozempic) for treating type 2 diabetes. In 2021, the Food and Drug Administration approved semaglutide for the treatment of obesity. Novo Nordisk then marketed a different product under the commercial name Wegovy.

Given the context for which Novo Nordisk introduced semaglutide products marketed under other names for different diseases despite the same chemical compound — Ozempic for diabetes and Wegovy for obesity — the use of the two interchangeably causes backlash in some cases as supply vs. demand has caused a backlog. There are also concerns as diabetics who rely on medication can’t find it as easily due to the shortage.

Mayo Clinic endocrinologist Dr. Maria D. Hurtado Andrade said Ozempic and Wegovy are semaglutide, marketed under different commercial names. The introduction of semaglutide as a weight-management tool received widespread attention.

Endocrinologist and physician educator Dr. Beverly Tchang said the effectiveness of semaglutide in this context aroused interest.

“Weight management is such a personal thing,” she said.

Lifestyle changes such as a healthy diet and exercise are commonly discussed as the first defense against excess weight. However, Tchang said that in many cases that isn’t enough.

“Ninety percent of people will see some weight loss with these medications, a far higher percentage than we can say for lifestyle changes. I can see why everyone wants to try these medications,” she said.

In the United States, obesity is the No. 1 chronic disease.

“Obesity not only carries a lot of health consequences, but it also has economic consequences,” said Andrade, noting that a deeper understanding of the disease is helpful. “We’re starting to develop better strategies that target the basis of the disease.

“We want to treat this disease. So, we are proactively working to help as many people who struggle with obesity as possible,” she continued. “Many people want to start with trying these medications that are not as effective as bariatric surgery but are pretty good options.”

Available studies show semaglutide’s superiority to liraglutide, the chemical compound in Saxenda, which the FDA approved in 2020 for obesity treatment. Andrade said that, on average, phentermine, a significantly older weight-management drug, generally results in between 7% to 9% body weight loss.

“Semaglutide resulted in up to 16% weight loss. For the first time, we’ve reached that amount of weight lost, showing that this medication may be superior,” she said.

Fortunately, Tchang said, Wegovy and other new weight-loss medications “add a pocket of accessibility to people who haven’t considered weight-management treatment before.”