There is no doubt that the new GLP-1 drugs such as Mounjaro and Wegovy have revolutionized obesity care. But a major challenge is that people can often regain weight once treatment is stopped.
"Patients describe it as an enormous hunger that is very difficult to resist. They say the system that controls hunger and satiety is slightly out of balance," says Joanna Uddén, senior physician in obesity at Capio Sankt Görans Hospital and associate professor at Karolinska Institutet.
Necessary change in habits
Healthcare professionals have long known that lifestyle changes such as diet, reduced stress, better sleep and physical activity are crucial to achieving good results from weight-loss medications. But it can still be difficult.
In a new study, published in Nature Medicine, people treated with injections were given either Mounjaro (tirzepatide) or Wegovy (semaglutide) for 72 weeks. Then, 230 of them were given tablets containing orforglipron (a new GLP-1 analogue) and 146 were given a placebo for a year.
The results were clear. Those who received orforglipron maintained a significantly larger portion of their weight loss: between 75 and 79 percent. Those who received placebo maintained an average of between 38 and 49 percent of their weight loss.
The most common side effects were mild gastrointestinal problems, which are typical for this type of medication.
Help along the way
Although the long-term goal may be to stop taking medication, switching to tablets would be a helpful option along the way, according to the researchers behind the study. The tablet form is cheaper and does not require refrigeration like the injections do.
"Patients and unscrupulous practitioners may think that a shorter course of the new drugs is enough. But obesity is a chronic disease, and even if you lose weight quickly, it is easy to regain weight quickly when you stop," says Joanna Uddén.
She adds that in the future it will be important to see how long the effect lasts and what happens when patients stop taking the tablets. Treatment combined with lifestyle changes is the basis for maintaining health benefits over time.
Orforglipron is not approved in Europe but is marketed in the US as Foundayo.
Today, six types of drugs for obesity are approved in the EU:
Xenical and Beacita (orlistat), Mysimba (bupropion-naltrexone), Qsiva (phentermine-topiramate), Saxenda (liraglutide), Wegovy (semaglutide), and Mounjaro (tirzepatide).
Orlistat reduces the absorption of fat from the diet. The others mainly affect appetite regulation and increase the sense of satiety.
Saxenda, Wegovy and Mounjaro are taken as injections. These belong to the class of GLP-1 analogues.
Only orlistat is subsidized for obesity; for other medications, patients must pay the entire cost themselves.
