New molecules to help people safely shed extra pounds

Success with weight loss

Drugs that promise to help people lose weight have had a motley past, such as the infamous fen-phen that was withdrawn from the market in 1997 following reports of heart valve injuries. But now the drug company’s pipelines are filling up with new molecules designed to help people safely shed extra pounds, according to a cover story in Chemical and engineering news, an independent news outlet from the American Chemical Society.

About 42% of American adults are considered clinically overweight because they have a body mass index of 30 or higher, according to the U.S. Centers for Disease Control and Prevention. Being on a heavier weight is associated with an increased risk of other health conditions, such as diabetes, heart disease and high blood pressure. Because of these risks, and people’s tendency to cycle between weight loss and recovery throughout their lives, many doctors now consider being fat as a chronic disease called obesity, rather than a behavioral problem, as seen earlier, writes C&EN reporter Mega Satyanarayana. Recent results, however, suggest that 29% of obese people are otherwise metabolically healthy, prompting some to question whether it is stigmatizing to call many people’s normal condition a disease.

The legions of people who want to lose weight for health or aesthetic reasons promise huge financial gains for pharmaceutical companies that can bring safe, effective weight loss drugs to market. But the field’s troubling history has raised the U.S. Food and Drug Administration’s regulatory barrier.

Now, a new drug must not only show that it allows someone to maintain a loss of 5-10% of their starting weight for a year, but it must also have long-term studies showing that it is safe.

Novo-Nordisk’s popular new weight loss drug Wegovy (semaglutide), which mimics a hormone that helps regulate glucose, caused an average weight loss of 15% when combined with lifestyle advice, compared to a 2.5% loss for placebo and advice . In addition, another formulation of Wegovy’s active substance has been used safely to treat diabetes since 2017.

Pharmaceutical companies are exploring other molecules that regulate hormone receptors involved in appetite and energy expenditure. If these drugs are prescribed to treat a chronic condition, many people will have to keep taking the drugs for the rest of their lives to maintain their weight loss, and in the case of Wegovy and similar drugs, deal with long-term side effects of nausea, vomiting and constipation. Meanwhile, some people say it’s too high a price to pay for society’s thin-at-all-cost obsession.

The article, “New Substances for Weight Loss Could Move Weight,” is freely available here.

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