This headline caught my attention:
“Experimental Weight-Loss Drug Shows Surgery-Like Results”.
This new med, tirzepatide, a once-weekly injectable, will probably be approved by the FDA for use in type 2 diabetics within months, and its use for obesity will likely follow. It sported some impressive results in a large (2,500 subjects) and long (72 weeks) multinational study, yet unpublished, looking at its ability to help obese people shed pounds, a separate indication from its known blood sugar lowering properties.
Being that one of the mechanisms of action of these medicines is to slow down stomach emptying, nausea is an almost intentional side effect. It does help weight loss by making people not want to eat very long or very much, or snack soon after a meal. It can also feel pretty crappy.
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The other concern is safety. GLP-1 agonists have been around almost 20 years, and have a fairly clean track record. For high-risk diabetics, they appear to have a modest effect reducing all-cause deaths. The concerns floated since their inception were based on animal models showing higher rates of pancreatitis and pancreatic cancer, dangers with biological plausibility since part of the activity of these medications involves stimulating the pancreas to make more of the insulin-producing beta islet cells.
