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HomeInnovationThe conflicted alliance between America and new weight-loss drugs

The conflicted alliance between America and new weight-loss drugs

Approximately half of US adults acknowledge their willingness to try newer injectable weight loss drugs, but this interest decreases significantly once they realize that the weight may return once they stop taking the medication. This trend of people discontinuing their weight loss medications has raised concerns among medical professionals.

The US has one of the highest overweight or obese populations globally, with rates continuing to climb. A study published in the prestigious medical journal The Lancet revealed that in 2021, the prevalence of overweight and obesity exceeded 40% in both sexes combined across all 50 states and Washington, DC, significantly impacting the overall health and mortality rates of Americans.

Semaglutide, initially prescribed as a diabetes medication (Ozempic) before being introduced as a weight loss solution (Wegovy), has gained immense popularity for its ability to induce rapid weight loss. Studies have shown that besides aiding weight reduction, the drug also lowers the risk of cardiovascular events in individuals with diabetes and overweight non-diabetics, as well as chronic kidney disease associated with diabetes.

While semaglutide and other glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are designed for long-term use in managing obesity and diabetes alongside lifestyle modifications like a healthy diet and increased physical activity, recent polling indicates that many Americans are discontinuing them. Surprisingly, the primary reason for discontinuation is quite interesting.

Published in The Lancet: estimated and projected prevalence of overweight and obesity combined, and separately, in male and female adults from 1990 to 2050 in the USA. The dotted vertical line indicates the point from which prevalence estimates start to be forecasts

Ng, Marie et al. 2024

A July 2023 poll by the independent health research organization KFF, formerly The Kaiser Family Foundation, revealed that nearly half of US adults, 45%, expressed interest in a safe and effective weight loss drug. However, this interest dropped significantly to 14% when they learned about potential weight regain after discontinuing the medication, indicating that the primary reason for this decline was not related to other factors such as the need for routine injections (23%) or lack of insurance coverage (16%).

In a follow-up poll on GLP-1 RA drugs in May 2024, KFF reported an increase in public awareness of these drugs from 19% in the previous year to 32%. Approximately one in eight American adults, 12%, reported taking a GLP-1 RA, with most indicating its use for managing a chronic condition like diabetes or heart disease (62%) or for weight loss purposes.

Over half of all adults (54%) mentioned facing challenges in affording the cost of GLP-1 RAs, with 22% describing it as “very difficult.” Even among insured adults, 53% found it challenging to afford these drugs, yet 12% of Americans continued to take GLP-1 RAs despite the cost, including those diagnosed with diabetes, heart disease, or obesity in the past five years.

A study conducted by the Evernorth Research Institute in Missouri on the discontinuation of GLP-1 RAs among patients with obesity and/or type 2 diabetes was published in JAMA Network Open, coinciding with KFF’s 2024 poll data. The study revealed high discontinuation rates at three, six, and 12 months, with patients with obesity experiencing a more pronounced trend compared to those with diabetes or both conditions. Factors like race, gender, and insurance enrollment influenced the likelihood of discontinuation.

It's forecast that obesity will affect over 80% of American men and women by 2050
It’s forecast that obesity will affect over 80% of American men and women by 2050

“The alarmingly high rates of GLP-1 RA discontinuation should prompt concern among clinicians, policymakers, and public health experts,” stated Dr. Sadiya Khan, an associate professor of cardiology and preventive medicine at Northwestern University Feinberg School of Medicine. Dr. Khan authored an opinion piece in JAMA in response to the Evernorth study and KFF’s poll data from 2023 and 2024.

According to Dr. Khan, the high cost of these therapies is a significant barrier to their continued use, along with misconceptions about their role in managing chronic diseases. Despite the benefits of GLP-1 RAs for cardiovascular health, the findings highlight the need for further discussion on the challenges associated with maintaining long-term adherence to these drugs.

“High-potency GLP-1 RAs have revolutionized treatment for individuals facing overweight, obesity, or diabetes,” Dr. Khan mentioned. “Aside from weight-related benefits, drugs like semaglutide have demonstrated a substantial reduction in cardiovascular disease events, irrespective of weight loss achieved.”

As the US obesity dilemma persists, the The Lancet study predicts that an alarming percentage of adult males and females will be overweight or obese by 2050. Finding safe and effective strategies to tackle overweight and obesity is crucial to prevent this concerning projection.

Source: Northwestern University

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