Young people with obesity may soon have a powerful new tool to help them lose weight.
Results from a clinical study published Wednesday in the New England Journal of Medicine found that teens who received a weekly injection of an appetite-reducing drug lost an average of 14.7 percent of their starting body weight, while those who received a placebo and diet and exercise counseling gained 2.7% of their starting weight. The trial involved 201 young people between the ages of 12 and 17 in three medical centers across the country, in Europe and Mexico.
By the end of the study, more than 40 percent of participants who took the drug, along with lifestyle counseling, were able to reduce their BMI by 20 percent or more, study co-author Aaron said. Kelly, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota.
The drug semaglutide, sold under the brand name Wegovy, has been used to treat type 2 diabetes. Diabetes doctors have noticed a side effect of the drug, which works by telling the pancreas to secrete more insulin to control blood sugar. Some patients have lost weight. When doctors reported weight loss to drug maker Novo Nordisk, the company designed studies to investigate the impact of semaglutide as a tool to tackle obesity. A previous study in adults showed that the drug actually helped with weight loss. The Food and Drug Administration approved it in 2021 for adults with obesity.
“I’m absolutely excited,” said Kelly. “We have entered the stage where we are seeing the kind of weight loss where teenagers come to us in tears. This is the first time they have been able to control their weight in their life ”.
According to the Centers for Disease Control and Prevention, more than 1 in 5 young people in the United States are considered obese based on BMI. Children with obesity face higher rates of weight-related illness later in life, experts say.
“We have a huge problem with overweight and obesity in this country,” said Dr. Monica Bianco, assistant professor of pediatrics at Northwestern University Feinberg School of Medicine and attending physician at Lurie Children’s Hospital in Chicago. “When obese children become young adults, they start developing conditions like hypertension, diabetes and high cholesterol,” she said. “We are seeing people as young as 30 having heart attacks.”
By the time Emmalea Zummo entered the studio, her weight had risen to 250 pounds. The 17-year-old from Jeannette, western Pennsylvania, had struggled for years with weight gain related to a hormonal condition called polycystic ovary syndrome, or PCOS.
“I’ve tried diets,” Zummo said. “I tried to exercise. I play more sports than any other guy I know and nothing would work. My body would just get used to the extra exercise, get used to the new diet, and the weight would come back. “
Zummo felt hopeless. “I was diagnosed with depression because of my weight,” he said.
When the opportunity to participate in the study presented itself, Zummo jumped at it. “Even on the first date when they explained to me what the drug was, it was already like I felt lighter mentally,” she said.
He lost over 70 lbs. Now, his weight has dropped to 170-180, “which I’m really happy about,” Zummo said. “I felt better in my own skin, which is something I’ve never felt before.”
Participants’ average weight was 237 pounds and 193 made it to week 68; 131 received the drug plus lifestyle surgery and 62 received lifestyle surgery alone.
Overall, 73% of those who received the drug experienced weight loss of 5% or more compared with 18% of those who received the lifestyle intervention alone.
In addition to weight loss, the drug reduced some cardiovascular risk factors, including waist circumference and bad cholesterol. Teens also reported a noticeable improvement in their quality of life.
“This is the first time I know that an anti-obesity drug in adolescents has been shown to improve their quality of life,” said Kelly.
There were some side effects, including nausea, which seemed to subside as teens became accustomed to the drug.
There is another drug approved for use in adolescents with obesity. Based on the results of the new study, semaglutide is the “most effective anti-obesity drug for adolescents,” Kelly said.
Many people still think of obesity “as a lifestyle problem that is under our control,” said Dr. Eduardo Grunvald, medical director of the weight management program at the University of California, San Diego. “But we know that the impact of the right lifestyle interventions is modest at best.”
Will the weight come back?
While weight loss surgery in teens tends to be accepted by the public, “weight loss medications in children are a new concept for most people,” Grunvald said. “As we get more data on safety and efficacy, these drugs will become more common.”
The efficacy found in the new study “is exciting to the general public and to those of us who practice bariatric medicine,” said Dr. Zhaoping Li, professor of medicine, Lynda and Stewart Resnick Endowed Chair in Human Nutrition, and director of the Center for Human Nutrition at the David Geffen School of Medicine at the University of California, Los Angeles.
One thing the study doesn’t shed light on is whether the drug will continue to be effective over the long term, Li said.
Long-term follow-up data on people who took diabetes medications shows people gained weight, Li said. “Of course the biggest problem is that if people stop taking this drug after a year or two, will the weight come back? The answer is probably yes,” she said.
Apparently, even when people undergo weight loss surgery, “three years later, there is significant weight gain,” Li said.
When a weight loss drug like this is prescribed to patients, it shouldn’t be the end of things, Li said. “We should use this as an opportunity to identify the fundamental problems that led to weight gain in patients’ individual lives and help them make fundamental changes not only to lose weight and maintain weight loss, but also to help them lead a healthier lifestyle, “he said.
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