Study shows daily pill may work as well as weight loss shots to treat obesity
The needles are small and barely pierce the skin. But that may be enough to turn some Americans off from the idea of using the weight-loss drug semaglutide, sold under the brand names Wegovy and Ozempic.
So, researchers are working on an option.
A recent study, funded by Novo Nordisk, maker of both Wegovy and Ozempic, found an oral tablet of semaglutide, dosed at 50 mg. per day, provided significant weight loss after 68 weeks -- nearly 13 percent more pounds shed than those in the study dosed with a placebo.
“We need oral formulations of these agents,” said Caroline Apovian, MD, an obesity medicine specialist at Brigham and Women’s Hospital, and Co-Director of the Center for Weight Management and Wellness. “Forty two percent of Americans have obesity. Semaglutide saves lives.”
The drug accomplishes this by promoting significant weight loss -- often in the range of 15-20 percent of original body weight. That reduces the risk of heart disease, stroke, diabetes and even some cancers. Side effects of semaglutide mainly occur in the gastrointestinal system and include nausea and constipation.
In the Novo Nordisk study, semaglutide users experienced 74 percent more GI side effects than the placebo group. But most of these effects were mild to moderate, the researchers said.
It’s unclear when a tablet form of semaglutide might hit the market. In addition to safety and efficacy, design challenges remain.
“If you have an oral agent, you have to protect it from being broken down by the stomach and intestine enzymes,” Apovian said. “So it can get through the mucosa and into the bloodstream.”
Semaglutide is based on a natural peptide, but comes with modifications that help the molecule resist stomach degradation. The oral tablets also contain an absorption enhancer.
It’s possible oral tablets might be cheaper than semaglutide injectables because manufacturing processes would differ. But ‘less expensive’ could still mean unaffordable to many Americans. A month’s worth of Wegovy currently runs more than $1,500 a month -- and some insurers won’t cover it.
Apovian suggests the lack of insurance coverage for weight-loss drugs, given all the chronic, expensive health conditions they can help prevent, is penny-wise and pound foolish.
“The highest prevalence of obesity is in our minority patients, our lower socioeconomic class patients who are on Medicaid and Medicare,” Apovian said. “The only way these drugs are going to get to the patients who need them in the United States is for the government to help us make sure that these agents are ubiquitously covered by insurance.”
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