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Crossing the two -digit barrier of weight loss – the loss of at least 10% of body weight – generates health benefits from cardiovascular protection to the reduction of risk of chronic diseases, and has gained impetus with the arrival of new obesity medications, especially weight loss pens. Soon, the doubt came, “What if we go up the goal?”
Formulas used in weight loss pens are complex and difficult to replicate – (Credit: Freepik)
A study that will be presented today at the American Diabetes Association Scientific Congress (ADA) in Chicago (USA), brings promising answers. By tripling the dosage of Semaglutida, one of the most common active ingredients of these devices, it is possible to obtain similar results to bariatric surgeries, loss of more than 20% of weight, without changes in the side effects of the amount already prescribed.
The research conducted by Novo Nordisk, a Wegovy manufacturer, featured 1,407 adults, classified as obese (BMI equal to or greater than 30) and without diabetes. All had a history of at least one unsuccessful episode of weight loss through diet and were instructed to improve habits (food and physical activity) over 72 weeks of intervention.
In the end, the increased dose (7.2mg) provided an average weight loss of 21%, and for one third of volunteers, the rate reached at least 25%. Among those who received 2.4mg of Semaglutida and the Placebo group (only habits), the average index was, respectively, 17% and 2%. “By exceeding 20% weight loss, we are talking about results that approach bariatric surgery, we are talking about a new level in the drug treatment of obesity,” says Julia Cabral, an endocrinologist and medical manager of Novo Nordisk.
Main author of the study and medical director of Wharton Medical Clinic, Canada, Sean Wharton evaluates that the results consolidate the advances made with the use of semaglutado. “We already know that it brings benefits to the health of people with cardiovascular, liver disease, knee osteoarthritis, pre-diabetes and type 2 diabetes. These findings expand the possibilities of treatment for obesity people, both weight loss and improvement of overall health.”
Tolerance
In the assessment of Bruno Geloneze, professor at the Faculty of Medical Sciences at Unicamp and lead researcher at the Obesity Research Center and Comorbidities (OCRC) of the São Paulo institution, in addition to the loss of more than 20%, draws attention to the study to the triplicated dose tolerability. “Although everyone likes how much you lost weight, what I liked the most was to know how much it has tolerated. I’m inferring that the side effects go to a certain limit and then the body goes more or less adapting to that.”
The most common adverse events were gastrointestinal, such as nausea and abdominal discomfort, the vast majority of light to moderate intensity, decreasing over the weeks. They abandoned the study due to these complications 3.3% of those receiving the increased dose and 2%, the 2.4mg dose, a rate considered low. Safety and tolerability attested to the study also reinforce the understanding that the substance can be used in the long run, says Geloneze.
Even with the increasingly positive results, the use of these medications cannot be viewed as an isolated or immediate solution against obesity, punctuates endocrinologist Wanessa Stival. The medical of the Hewa clinic follows patients who use semaglutide for a given time, continuously and intermittently, according to clinical specificities and other questions analyzed together, including financial. “This more realistic and individualized understanding of treatment is critical to avoiding frustrations and aligning expectations,” he explains.
Beyond aesthetics
According to endocrinologist Michele Borba, from the Delaborba Clinic, in an obesity treatment, doctors do not only evaluate if the patient reached an ideal weight. Among the “most realistic” goals adopted are the so -called controlled obesity, when weight loss is 15% or more and the person can keep under control blood pressure, blood sugar and other conditions, even without completely losing weight. “In the study with the new dosage of Wegovy, 70.4% fit this definition,” he adds.
The expert reinforces that coping with obesity is not just an aesthetic dilemma, as overweight increases the risk of diseases such as type 2 diabetes, high blood pressure, liver fat and joint problems. It is estimated, for example, that two thirds of excess weight-related deaths are due to cardiovascular causes. “This data comes at an important moment, when obesity already affects more than one in five adults in Brazil. They bring new hope for those who face difficulties with overweight and seek an effective and safe option,” he says.
Endocrinologist Julia Cabral recalls that clinical practice guidelines advocate the treatment of long -term obesity and emphasize not only weight loss, but the benefits of patient health treatment as a whole. “We need to think about the treatment of obesity as something that goes beyond the balance, and that achieves an improvement in the global health of patients, increasing the years lived with quality of life.”
The triplicated dosage of Semaglutado still needs to be approved by the regulatory agencies to be used in Brazil. There is no forecast. Novo Nordisk provides to request the update of the new application in the European Union in the second half of this year, with subsequent regulatory submissions in the other markets where WeGovy is already approved.
