VIDEO: ‘Tremendous progress’ of anti-obesity medications in last decade

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So, just about a little under a decade ago, the medications that we had available to us as providers to help our patients lose weight were associated with about 5% to at most 10% total body weight loss with a single medication. So, these medications were Contrave (naltrexone/bupropion, Currax Pharmaceuticals), Saxenda (liraglutide, Novo Nordisk), Qsymia (phentermine/topiramate, Vivus). In 2022, Wegovy (semaglutide, Novo Nordisk) was approved, and that was absolutely groundbreaking. Wegovy is associated with 15% total body weight loss. And now Zepbound is associated with at least 22% total body weight loss. So, this medication was FDA approved in November of 2023 for overweight and obesity. This is really exciting because Zepbound is the most effective medication that we currently have that’s FDA approved. So, Zepbound has really ushered in a new era of unprecedented efficacy. And we have many more powerful anti-obesity medications in the pipeline. So, tremendous progress in literally under a decade.

So, for providers like me, we have so many more tools in our armamentarium and we still use all of the tools in our armamentarium. So, it’s not like we’ve replaced the old medications with the new ones. We use everything. But just to have these more options and more really effective options is incredible. Another exciting development that’s happened in the recent past is the SELECT trial, which is a cardiovascular outcomes trial by Novo Nordisk looking at the anti-obesity medication Wegovy, demonstrated 20% cardiovascular risk reduction among people with obesity and with established cardiovascular disease and without diabetes. So, we already know that this medication semaglutide is associated with cardiovascular risk reduction for people with diabetes. So, the difference here is that this population does not have diabetes, and we see a very clinically significant cardiovascular risk reduction with this medication. So that is really exciting. It’s now absolutely undeniable that treating obesity can save lives, and it’ll be harder for employers or payers to deny access to care for their employees and patients who have obesity and cardiovascular disease.

This SELECT data actually led to Wegovy receiving an additional indication for cardiovascular risk reduction for individuals with obesity and established cardiovascular disease. So, this is the first time we’ve had an additional indication for an anti-obesity medication, which is a really big deal because obesity, unfortunately, is not yet widely recognized as a disease in its own right. So, these additional indications, and there will be others coming shortly, will lead to greater access. So, huge news for us. And, in fact, we now have data showing that Zepbound, so Eli Lilly’s medications Zepbound, the latest anti-obesity medication, there’s data showing that using Zepbound among individuals with obesity and with sleep apnea improves a patient’s sleep apnea in ways that we have never seen before. I mean, the standard of care right now is CPAP machine, which unfortunately doesn’t lead to weight loss. Sometimes it could even lead to a little bit of weight gain. So, for patients with sleep apnea, the standard of care doesn’t affect weight at all. The best way to treat sleep apnea is to help people lose weight. And now we have proof in randomized controlled trials that Zepbound actually helps people not only lose a significant amount of weight, but improves their sleep apnea. So, more comorbidity improvements and more indications to come.