To help shed pounds, extremely heavy individuals may turn to prescription medications, such as Saxenda (liraglutide). A study published in August 2018 in The Lancet has found that a new medication in the same drug class as liraglutide may provide additional help in the battle against obesity. “This phase 2 trial of semaglutide for weight loss among [people] without diabetes showed that semaglutide was superior to placebo at all the doses studied, and the weight loss was generally dose dependent: the higher the dose, the greater the loss,” says lead author Patrick M. O’Neil, PhD, the director of the Weight Management Center at the Medical University of South Carolina in Charleston. After one year, the mean weight loss for those taking a placebo was 2.3 percent, while those taking 0.05 milligrams (mg) of semaglutide (the lowest dose) had a mean loss of 6 percent and those taking 0.4 mg (the highest dose) had a 13.8 percent weight drop. RELATED: How One Woman Put Diabetes in Remission by Changing Her Diet
How Researchers Studied the Weight Loss Effects of Semaglutide vs. Liraglutide
Dr. O’Neil adds that the trial found that semaglutide also produced better results compared to liraglutide at the end of 52 weeks. “The 7.8 percent [mean] weight loss in the liraglutide group in this study was comparable with other similar length studies of liraglutide 3.0 mg for weight management, but was significantly less than the 11 to 14 percent reductions seen with semaglutide doses of 0.2 mg or more per day in the groups escalated every four weeks,” O’Neil and his colleagues wrote in the paper. For this trial, O’Neil and his fellow researchers followed 957 obese individuals without diabetes over one year. Participants had a mean age of 47 and a mean body mass index (BMI) of 39. BMI is a measure of body fat based on weight and height. A measure of 30 and above is considered obese. Investigators randomly assigned participants to receive either semaglutide, liraglutide, or placebo. All participants received counseling on maintaining a healthy diet and exercising regularly. RELATED: 9 Types of Medication That Help Control Type 2 Diabetes
Liraglutide and Semaglutide Already Approved for Diabetes Treatment
Although this investigation was conducted with obese people who did not have diabetes, O’Neil points out that the Food and Drug Administration (FDA) has already approved both liraglutide (in 2010 under the brand name Victoza) and semaglutide (in 2017) for the treatment of type 2 diabetes in adults. While the FDA also green-lighted liraglutide as an aid for obesity management (under the brand name Saxenda) in 2014, the agency has yet to approve semaglutide for weight loss. “Diabetes medications differ widely in their weight effects, so patients should discuss this with their doctor,” says O’Neil, furthermore adding that the dosages studied in the current investigation are different from those dosages that are approved for use in people with diabetes.
How GLP-1 Receptor Agonists, Like Semaglutide and Liraglutide, Work
Both semaglutide and liraglutide are in a class of injectable drugs known as GLP-1 receptor agonists. These also include Trulicity (dulaglutide), Bydureon or Byetta (exenatide), and Adlyxin (lixisenatide). All these drugs have been shown to reduce blood sugar levels, body weight, blood pressure, and lipids (fats in the blood). GLP-1 is a type of incretin hormone, which is secreted from the small intestine, according to an April 2010 article in the Journal of Diabetes Investigation. These hormones target beta cells in the pancreas and stimulate insulin release into the body, which helps keep blood sugar levels from going too high. GLP-1 receptor agonists work by mimicking the functions of incretin hormones. “GLP-1 receptor agonists are very effective treatments for type 2 diabetes; they can be used in combination with other medications that have different mechanisms of action, and this is an effective strategy in addressing the various body systems and organs that contribute to the high blood glucose levels we see in type 2 diabetes,” says Minisha Sood, MD, an endocrinologist with Lenox Hill Hospital in New York City. In general, GLP-1 agonists are well tolerated, but they may cause nausea, vomiting, diarrhea, constipation, headache, injection-site reaction, allergic reaction, and in rare cases, pancreatitis (inflammation of the pancreas). In this study, authors said that semaglutide causes only minor gastrointestinal issues. RELATED: How to Help Treat Type 2 Diabetes From the Inside Out
Why the Study Was Limited, and What We Still Don’t Know About Semaglutide
“This study is another important step in recognizing that changing a person’s internal hormonal environment can lead to successful weight loss along with diet and exercise,” adds Dr. Sood, who was not involved in the investigation. “Weight loss — even a modest 5 percent of body weight — has significant health benefits.” Sood notes that it would be of value to gather more information focusing on weight loss in people with diabetes who take semaglutide. She further points out that the research may be limited by the fact that it was funded by Novo Nordisk (the manufacturer of semaglutide), and therefore, the company oversaw all data collection, analysis, and reporting. Scientists also did not strictly regulate diet or exercise in the groups. “This was a phase 2 trial and not sufficient to conclusively demonstrate [the] efficacy of semaglutide for weight loss across a broad sample of [people] with obesity and overweight,” says O’Neil. “Phase 3 studies are accordingly underway.”
