Editor’s note: Season 9 of the Chasing Life With Dr. podcast explores… Sanjay Gupta The intersection between body weight and health. We’ll delve into a wide range of topics, including how to talk to kids about weight and myths surrounding menopause and weight gain. You can Listen to the season here.
Main points of the story
These new medications often quiet “food noise,” or brain chatter about food
Wegovy and Zepbound are approved to treat people with obesity
Ozempic and Mounjaro are intended for people with type 2 diabetes
(CNN) – Dieting sometimes feels like an American pastime: If you haven’t enjoyed the “fun” of it, your best friend, little brother, aunt, or someone else in your close circle of family and friends has almost certainly tried it.
It is perhaps no coincidence that government statistics show that more than 30% of Americans are overweight and more than 42% are obese. Related government survey It found that nearly half of U.S. adults said they had tried to lose weight within the past 12 months. The two main methods were exercising and eating less, followed by consuming more fruits, vegetables and salads.
People want to lose weight to look a certain way “now,” and they also want to live longer, healthier lives, with a lower risk of developing serious health conditions in the future.
But anyone who has ever dieted can tell you that losing weight is hard and that long-term weight loss requires sustained effort, which can sometimes seem daunting, even impossible.
A new class of drugs — called glucagon-like peptide-1 receptor agonists, or GLP-1s — has swept the country because these drugs seem to make weight loss easier. They often quiet down “food noise,” or brain chatter about food, making it very difficult to stick to these important lifestyle changes.
Their brand names became household words, seemingly overnight. Ozempic and Wegovy both contain semaglutide as the active ingredient, while Mounjaro and Zepbound contain tirzepatide.
The Chasing Life With Dr. podcast explains: Sanjay Gupta details the ins and outs of these new drugs to give listeners a crash course on what’s all about them. You can listen below.
Watch this interactive content on CNN.com
Drugs such as semaglutide and tirzepatide were originally developed to treat type 2 diabetes, and work by mimicking the hormone glucagon-like peptide 1, which is released into our intestines when we eat.
Dr. Jorge Moreno, assistant professor at Yale University School of Medicine
“It’s a peptide that’s secreted by the intestines, and it’s usually very short-acting, and it’s broken down by other enzymes in the body very quickly,” obesity specialist Dr. Jorge Moreno told CNN’s chief medical correspondent, Dr. Sanjay Gupta. Lately Life Podcast. Moreno, an assistant professor of medicine at Yale University School of Medicine, treats patients looking to control their weight.
GLP-1 is a nutrient-stimulated hormone that activates when you eat, telling your body that you’ve just eaten, he explained. “(It goes) to the area of the brain that is the hypothalamus… and (tells) your brain, ‘You’ve eaten, stop eating,'” he added.
The drugs bind to the same GLP-1 hormone receptors but are longer-acting. “So they keep this mechanism constantly working,” Moreno said. “It basically reduces your appetite by signaling to the hypothalamus that you are full.”
Both the hormone and medications also trigger other actions, such as slowing the movement of food through the intestines and telling the body to secrete more insulin. Tirzepatide can also bind to the receptor of another related hormone, called GIP for short, making it a little stronger.
If you’re thinking about starting one of these medications, Moreno recommends keeping these five facts in mind.
These medications are not for everyone
Currently, the weight-loss versions of semaglutide (Wegovy) and tirzepatide (Zepbound) are approved to treat people with obesity, not those looking to shed a few pounds.
“Patients should be aware that these are treatments for a chronic medical condition known as obesity,” Moreno said. “I think it’s important to realize that obesity is a chronic disease that relapses (and) requires long-term treatment.”
Wegovy and Zepbound are — in FDA parlance — “recommended” for use in people diagnosed with obesity, or those with a body mass index of 30 and above, he said. It’s also intended for people with a BMI of 27 and above who also have weight-related medical conditions such as type 2 diabetes or high blood pressure. (Semaglutide, sold as Ozempic, and tirzepatide, sold as Mounjaro, are prescribed only for people with type 2 diabetes.)
If you’re not given one of these diagnoses, you may have trouble getting a prescription, let alone getting your health insurance to cover the hefty prices.
These medications are very effective in helping many people lose weight. They bridge a gap between previous weight-loss drugs, which Moreno said helps people lose 5% to 10% of their body weight on average, and bariatric surgery, a surgical procedure that he said helps people lose 25% to 30%. in the middle. %.
“It’s important to know that these medications are effective,” Moreno said. “On average, with semaglutide, the average weight loss can be close to 15%. Tirzepatide reaches the levels of weight loss in bariatric surgery, with weight loss reaching approximately 21%.”
This class of drugs — GLP-1 receptor agonists — has been used since 2005 to treat diabetes, so it has a relatively long safety record.
““It’s also important to understand that these are safe medications,” Moreno said. “Yes, like any other medication, these medications have side effects. The most common among the patients I see are nausea, constipation, and acid reflux, which we call GERD.
“Now, the rare side effects — and by rare I mean less than 1% of cases — include things like pancreatitis, which is… inflammation of the pancreas — very rare,” he said. But as these drugs grow in popularity, he added, “a rare event becomes somewhat more prominent, because there are more people using these drugs.”
Like any chronic disease, treatment requires a partnership with your doctor.
“Just like diabetes, just like high blood pressure, obesity management requires close monitoring. This is not a one-on-one conversation with your doctor,” Moreno said.
It is recommended to follow up every month or every two months. “You have to stand up for yourself,” he said. “You should definitely be followed closely, because this is a long-term strategy to help you.”
“One drug won’t fix everything,” Moreno said, noting that these medications are just one component of a comprehensive obesity treatment plan.
“Lifestyle is still important,” he added. “This is a good time to start exercising. This is a good time to start changing some eating patterns that will be beneficial for weight loss. … I think this is really something that patients should get out of the way.”“
We hope these five things help you understand how these new medications work and what to consider when taking them. Listen to the full episode here To learn more. And join us next week on Chasing Life Podcast When we explore the business side of these drugs.