While not everyone with type 2 diabetes is overweight or obese, obesity is tied to diabetes in a number of ways. Excess body fat is understood to contribute to insulin resistance, in which your body’s cells don’t use insulin efficiently — a hallmark of type 2 diabetes. And as we noted in a recent news item, up to half of new cases of type 2 are linked to obesity, particularly in women.
So any treatments for diabetes that also help support weight loss may be worthy of special consideration for many people. There has been good news on this front recently, with a study finding that a biologic drug, bimagrumab, both reduces body fat and improves glucose levels in people with type 2 diabetes. And it has been known for years that metformin, the first-line drug for type 2 diabetes, helps support mild weight loss in many people who take it.
Now, a study has found that another drug for type 2, Ozempic (semaglutide), may lead to substantial weight loss in obese people even if they don’t have diabetes — potentially offering a new way to help treat obesity.
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Once-weekly injection leads to major weight loss
The new study, published in the New England Journal of Medicine, was a clinical trial involving 1,961 participants, all of them adults. None of the participants had diabetes, and all of them were obese, with a body-mass index (a measure of weight that takes height into account) of 30 or higher. Participants were randomly assigned to take a once-weekly injection of either Ozempic or a placebo (inactive substance). All of the participants also took part in a lifestyle intervention program aimed at losing weight.
After 68 weeks of treatment, members of the Ozempic group lost an average of 14.9% of their body weight — a large, clinically important weight reduction. Members of the placebo group, on the other hand, lost an average of only 2.4% of their body weight. As you would expect with thee numbers, a larger proportion of people in the Ozempic group lost at least 5% of their body weight — 86%, compared with just 32% in the placebo group. And a larger proportion also lost at least 10% of their body weight — 69% for Ozempic, but only 12% for placebo. These numbers matter because studies have shown that losing just 5% to 10% of your body weight can lead to significant health benefits if you’re overweight or obese.
Members of the Ozempic group also experienced greater improvement in risk factors for cardiovascular disease, as well as self-reported physical functioning in daily life. The most common side effects of Ozempic were nausea and diarrhea, which tended to be mild to moderate and temporary. But more people in the Ozempic group stopped their treatment because of gastrointestinal issues — 4.5%, compared with 0.8% in the placebo group.
A new option for obesity treatment?
This study shows that Ozempic is a strong contender as a stand-alone treatment for obesity, and may soon get regulatory approval for that purpose. This is important because right now, there aren’t many approved drug treatments for obesity. Of course, people with type 2 diabetes can already be prescribed Ozempic for blood glucose control under current guidelines — and this study shows that for those who are obese, doctors should potentially give Ozempic special consideration as a treatment.
It’s worth noting that certain groups were underrepresented as participants in this study, including men, Black people, and other nonwhite people. And as noted in a Healio article on the study, over 40% of participants had prediabetes, or impaired glucose tolerance that doesn’t meet the threshold for diabetes. For this reason, it’s unclear how effective Ozempic might be in obese people with normal glucose tolerance.
The researchers also noted that since bariatric surgery (also known as metabolic or weight-loss surgery) has been shown to be an effective treatment for both obesity and type 2 diabetes, future studies should compare surgery with drug treatments like Ozempic for both conditions. “In sum, we have a long way to go to control the obesity epidemic,” they concluded.