Obesity drug may reduce the risk of type 2 diabetes
Boris Johnson slams Jamie Oliver's criticism of obesity policy
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Known as semaglutide, the drug is used to help treat patients with obesity. Obesity is a build-up of excessive fat and weight and, although exercise and a balanced diet are considered the best ways to treat it, often they are not enough.
Sometimes medication may be required to help assist or boost those with obesity in their quest to lose weight, semaglutide is one of those drugs.
In a study published in the journal Diabetologia, researchers injected the drug into patients with obesity in two trial steps known as STEP1 and STEP4. Patients in STEP1 were given 2.4mg or a placebo per week for 68 weeks while those in STEP4 were given the same dosage over 20 weeks and then some were switched to a placebo for the next 48 weeks.
From this the researchers used Cardiometabolic Disease Staging (CDMS) to predict the patient’s risk of developing type 2 diabetes over the succeeding 10 years. CDMS is calculated using a formula taking into account a patient’s age, sex, race, and BMI.
After the results were calculated, the researchers found those in STEP1 were 61 percent less likely to develop type 2 diabetes in comparison to a 13 percent reduction for those on the placebo taken as part of the study.
The risk scores in question were mirrored in weight loss with the semaglutide group losing 17 percent and those on the placebo experiencing just a three percent drop in weight.
Meanwhile, in STEP4 participants, the largest decrease in obesity scores were seen in those who had used semaglutide for the first 20 weeks. As a result, the authors concluded that this indicated that semaglutide had a profound impact on diabetes risk.
Dr Garvey, one of the authors behind the study, said: “Semaglutide reduces the future risk of diabetes by over 60% in patients with obesity – this figure is similar whether a patient has prediabetes or normal blood sugar levels.”
Dr Garvey added: “Sustained treatment is required to maintain the benefit. Given the rising rates of obesity and diabetes, semaglutide could be used effectively to reduce the burden of these chronic diseases.”
Why the trial is significant.
The results showing the effectiveness of semaglutide is significant at a time when obesity rates are rising, particularly in the UK where the condition affects one quarter of British adults and increases the risk of a range of potentially fatal illnesses.
Furthermore, semaglutide has also recently been approved in the United States while NICE (National Institute for Health and Care Excellence) has also released draft guidelines for England and Wales stating it should be prescribed to adults with obesity.
In guidance published on the 8th of February they said: “NICE has today (Tuesday 8 February 2022) issued draft guidance recommending semaglutide to adults with at least one weight-related condition and a body mass index (BMI) of at least 35 kg/m2, and exceptionally, to people with a BMI of 30.0 kg/m2 to 34.9 kg/m2.”
The health body added: “Semaglutide can only be prescribed as part of a specialist weight management service with multidisciplinary input and for a maximum of two years. Clinical trial evidence shows that people lose more weight with semaglutide alongside supervised weight loss coaching than with the support alone.”
On the impact of semaglutide on obesity, Dr Garvey said: “It appears to be the most effective medication to date for treating obesity and is beginning to close the gap with the amount of weight loss following bariatric surgery.
“Its approval was based on clinical trial results showing that it reduces weight by over 15 percent on average, when used together with a healthy lifestyle programme. This amount of weight loss is sufficient to treat or prevent a broad array of obesity complications that impair health and quality of life and is a game changer in obesity medicine.”
Meanwhile, NICE’s Helen Knight commented: “We know that management of overweight and obesity is one of the biggest challenges our health service is facing. It is a lifelong condition that needs medical intervention, has psychological and physical effects, and can affect quality of life.”
What are the main treatments for obesity?
Obesity is not a condition which someone can medicate their way out of, it requires work and dedication by the patient to help reduce their weight.
The two main pillars of losing weight and eating a healthy diet are regular exercise and a balanced diet. The NHS recommends at least 150 minutes (two-and-a-half hours) of moderate to intense exercise per week as a minimum.
Meanwhile, on the guidelines for a healthy diet, the NHS added: “There’s no single rule that applies to everyone, but to lose weight at a safe and sustainable rate of 0.5 to 1kg a week, most people are advised to reduce their energy intake by 600 calories a day.
“For most men, this will mean consuming no more than 1,900 calories a day, and for most women, no more than 1,400 calories a day. The best way to achieve this is to swap unhealthy and high-energy food choices – such as fast food, processed food and sugary drinks (including alcohol) – for healthier choices.”
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