(NewsNation) — Medications, including some created to treat diabetes, have become increasingly popular for their ability to help people shed pounds.
Two of those drugs are now competing for FDA approval for weight loss.
As the drugs’ weight loss uses become more common, doctors and the FDA are weighing in on their risks and benefits.
Is there a weight loss drug that is currently FDA-approved?
Six major weight loss drugs are currently approved by the FDA. Those are Contrave, Sexenda, Xenical or Alli, Qysmia, Wegovy, and Imcivree.
One drug, Imcivree, is only approved for people with certain inherited conditions, and two, like Ozempic, also used to treat diabetes.
Some of the drugs come with serious side effects. For instance, Contrave can cause suicidal thoughts, Xenical/Alli can cause digestive issues and Qsymia has the potential to be abused because it acts like a stimulant.
What are the two drugs competing to get approval at the moment?
Ozempic is a drug used to treat Type 2 diabetes, but doctors have been prescribing it for weight loss, which is considered an off-label use of the med, since the FDA has only approved it for diabetes treatment. It is given as a once-a-week injection. In addition to lowering blood sugar and regulating insulin, it suppresses the appetite.
Mounjaro is a medication from Eli Lilly. Like Ozempic, it treats diabetes and is a weekly injection. Also like Ozempic, it suppresses the appetite but it also changes how the body burns fat. Both Ozempic and Mounjaro are designed to be long-term drugs, with the potential for weight to return if you stop taking them.
How do they work?
Simply put, Ozempic, Wegovy and Terzepatide (Mounjaro) help suppress your appetite and impact how your body processes the food you eat.
“As you eat a meal, eventually, you feel full, and eventually you feel less hungry and eventually you stop eating,” said Dr. Holly Lofton, director of the Medical Weight Management Program at NYU Langone Health. “That’s what the drugs do. They send you messages that you’re no longer hungry. You’re more full and you should stop eating. … They also hormonally help us metabolize foods in a way that helps our fat cells shrink indirectly.”
When considering whether to prescribe a weight loss medication, Lofton talks with patients about their individual goals and health. That’s because people have different genetic makeups, exercise differently, and want to see different results.
Weight-loss medication might not be a good fit for someone with a binge eating disorder, for example, since it wouldn’t target the root cause of the behavior.
“Medical information related to weight should really be taken from a medical professional, and not an internet person who’s not a professional, because everyone has a different experience with the medication,” she said.
How would you be able to get them if they were approved by the FDA?
These drugs differ from over-the-counter fat burners, which are typically designed to “rev up” a person’s energy, Lofton said.
If approved for weight loss, both Ozempic and Weygovy would require a prescription. Current prices for the medications are also similar, with list prices of around $1,000 per month without insurance. The FDA can also set guidelines on who is eligible for the drug, only approving it, for example, for patients over a certain BMI.
Patients in the private insurance market may be able to get the medicine at a lower cost, but that coverage is murkier with insurance like Medicaid or TRICARE, public health physician Dr. Chris Pernell said.
“It’s concerning for those who may be of a lower socioeconomic status and on Medicaid or maybe concerning for those who are of a certain age and on Medicare (or) those who may be in the military and their families that are on TRICARE,” she said.
Why are they so popular and what impact has it had on supply?
Conversations about weight loss often focus on lifestyle modifications like eating healthier or exercising more, but don’t take into account whether a person has access to affordable healthy foods, or if genetics could be impacting how a person stores fat, Pernell said.
“(It) just gives us another tool and very powerful tools in our toolkit to give to persons who have overweight and obesity, so that they can reduce the likelihood of disability and death,” she said.
Used properly, some experts say it could even help mitigate the United States’ obesity epidemic, which impacts about one in three adults, according to the National Institute of Health.
As its popularity grows, however, supply is dwindling.
Ozempic is currently on the FDA’s list of medications in short supply. The sudden popularity of the drug for weight loss, driven in part by social media, has made it difficult for some diabetes patients to access the drug.
Mounjaro is not currently considered to have a shortage, but Eli Lilly has warned that it, along with another diabetes medication made by the company, is likely to face supply issues in the U.S.
Is there any risk to either drug?
All medications come with risks, and Ozempic and Mounjaro are no exception.
Serious side effects of Ozempic and Mounjaro can include kidney problems, vision changes, pancreas or gallbladder disease and low blood sugar. In some cases, Ozempic has suppressed appetite so much that patients have suffered from malnutrition.
There is also a possibility that Mounjaro could increase the risk of thyroid cancer, though that is based only on animal studies at this time.
The most common side effects Lofton sees are nausea, diarrhea, constipation and vomiting, she said.
It’s also important to note that even on prescribed weight-loss medicine, diet and physical activity are important and weight gain is possible once you stop taking the medicine.
“The medication is changing the physiology while you’re taking it, it is not changing it forever,” Lofton said. “It’s not curing obesity. Weight can be maintained with lifestyle, but the degree that the medication is changing the hormones that affect fat cell regulation and appetite, that goes away when you stop the medication, and that can lead to weight regain.”
