Weighing the Scale on GLP-1s

Glucagon-like peptide-1 (GLP-1) receptor agonists seem to be everywhere today. Whether it be an article highlighting a pharmaceutical company, or a blog discussing celebrity gossip, the words Wegovy, Ozempic, and Mounjaro are becoming a daily occurrence. While the recent trendiness around these drugs might lead people to believe that they are a new discovery, the first GLP-1 was actually approved by the FDA in 2005 to help patients manage their type 2 diabetes. By stimulating insulin secretion from the pancreas and slowing stomach emptying, these drugs lower glucose levels in the blood while also increasing satiety, resulting in more balanced blood sugar levels and eventual weight loss. The powerful weight loss effect of GLP-1s has spurred increased popularity and demand for off-label prescriptions. Although these drugs have the potential to change obesity treatment, their entrance into mainstream media has evidenced how they are being prescribed as a weight loss solution for people who are neither obese, nor diabetic. With the social media craze, supposed celebrity use, and subway ads heightening demand, there have even been supply shortages for those who do need them for on-label treatment.

Hidden behind the eye-catching headlines, however, lies the startling reality that GLPs are riddled with side effects and potential long-term consequences. While the most common side effects are daily nausea, vomiting, and gastrointestinal disturbances, GLP-1s can also cause extreme food aversion. Interestingly, evidence has suggested that this vomiting and food aversion may actually be necessary for the weight loss power of the drugs. Further, some initial animal testing reports link GLP-1s to elevated risk of pancreatitis, pancreatic cancer, and thyroid cancer. Although GLP-1s are poised to be life-altering treatments for many patients, it is vital that greater research is conducted on their side effects and long-term consequences. GLP-1s are not simply a cure to weight loss, but rather drugs with serious potential side effects.

Despite these risks, experts predict the weight loss drug market will reach $100 billion in annual sales in the next few years. It is, therefore, not shocking that pharmaceutical companies are all competing to have the best GLP-1 on the market. Novo Nordisk’s Ozempic is likely to have $12.5 billion in sales this year and Eli Lilly’s value surged from $151 billion to $420 billion with the launch and success of Mounjaro. Now, pharmaceutical companies are increasingly focused on developing oral GLP-1 and weight loss pills, rather than injectables, to capitalize on this market demand even further.

Remarkably, weight loss programs, lifestyle startups, and telehealth companies are cashing in on GLP-1s alongside pharmaceutical companies. WeightWatchers and Noom, for example, both recently bought telehealth companies to facilitate weight loss drug prescriptions for their members. This move is particularly noteworthy given that these companies emphasize a holistic approach to weight loss, previously achieved through dietary and lifestyle modifications. With GLP-1s perceived by many to be "miracle cures" for weight loss, however, it is no surprise that their heads are turning. As trending conversations surrounding gut health and exercise mix with the GLP-1 hype, it will be interesting to see how weight loss companies adapt their theses and business models.

Currently, Medicare is not required to cover any anti-obesity medications, including GLP-1s. However, with the way these drugs are taking the world by storm and the proposed Treat and Reduce Obesity Act, this will likely change soon. In the meantime, research carries on: pharmaceutical companies are working towards creating better, cheaper options of these drugs and researchers are already investigating repurposing of GLP-1s for treating addiction. With far-reaching impact on companies and patients across the healthcare system, the story of GLP-1s will undoubtedly continue to twist and turn. And we will certainly be following along as the story evolves.

Sources

1. GlobalData sees Eli Lilly overtaking Novo Nordisk in obesity (fiercepharma.com)

2. EU raises safety signal about GLP-1 meds from Lilly, Novo (fiercepharma.com)

3. ‘I miss eating’: the truth behind the weight loss drug that makes food repulsive | Food | The Guardian

4. WeightWatchers Moves Into the Ozempic Market With Telehealth Deal - WSJ