New research shows that injections sold under the brand names Wegovy, Ozempic, and Rybelsus could slash the risk of heart attacks or stroke in obese people without diabetes. But how much do we actually know about these so-called 'weight loss drugs'?
After the UK launch of Danish multinational healthcare company Novo Nordisk, weight loss treatments known as GLP-1 medicines were made accessible to Brits through specialist NHS weight management services - sparking both interest and apprehension.
Now researchers from University College London (UCL) have found evidence to suggest that 'miracle' weekly injection semaglutide - which is also used to treat diabetes - could have 'other actions which lower cardiovascular risk beyond reducing unhealthy body fat'.
The team, led by Professor John Deanfield, conducted a five-year study to determine whether Wegovy, Ozempic and Rybelsus, could also reduce the risk of heart attacks, strokes or heart failure in obese individuals, regardless of any weight loss.
Stating that the findings, which supported this hypothesis, could 'have important clinical implications', Professor Deanfield concluded: "These alternative mechanisms may include positive impacts on blood sugar, blood pressure or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these."
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Weight loss drugs have proven to be a divisive topic. For some, they represent a revolutionary step forward in the field of healthcare and obesity management. Others however have expressed concerns about potential risks.
As experts consider new possibilities, the Mirror takes a look at all we know about this 'game-changing' treatment - from how they work, to warnings over reported side effects...
How do weight loss drugs actually work?
When prescribed under the brand name Wegovy, semaglutide can help suppress appetite by increasing insulin sensitivity, while a lower dose known as Ozempic is understood to be effective when managing blood glucose levels in those with type 2 diabetes. These injections are said to help people lose around 15 per cent of their body weight, making it a tempting option for those who've previously struggled to shed the pounds, but there are some things you should be aware of.
Weight loss injections work by mimicking the effects of a hormone known as glucagon-like peptide-1 (GLP-1), which is usually released after a person finishes their meal. It also slows down digestion, allowing users to feel fuller for longer.
Speaking with the Mirror, Dr Deborah Lee, from Dr Fox Online Pharmacy, explained that this medicine activates GLP-1 receptors in the pancreas and the brain, lowering elevated blood glucose levels, but only when blood glucose levels by stimulating insulin production. This treatment also helps to reduce the amount of glucose released in the liver, slowing down the rates of gastric emptying and reducing appetite.
She continued: "Overall, Semaglutide causes weight loss because lowering appetite and reducing food cravings, leads to a large reduction in calorie intake. Users particularly tend to lose their interest in high-fat foods. Studies show that semaglutide results in an average reduction of calorie intake by 35 per cent at each meal. It does not affect the production of glucagon when blood glucose levels are low. In animal studies, semaglutide also has cardiovascular benefits as it has a positive effect on plasma lipids (cholesterol), lowers blood pressure and reduces systemic inflammation."
How do you get hold of weight loss drugs?
These self-administered injections are currently only being considered for those with a Body Mass Index (BMI) of at least 35 or more, individuals with weight-related health conditions, and those who've unsuccessfully tried to lose weight through conventional methods. People with a BMI within the 30 to 34.9 range may also be considered if they've been referred to a specialist weight management clinic.
A nurse or doctor will show you how to use Wegovy, which should be injected on a weekly basis and can be taken for up to two years. The NHS also doesn't recommend taking Wegovy while pregnant or breastfeeding, or if you have certain health conditions.
According to the NHS website: "You can only take liraglutide or semaglutide if they're prescribed for you by a specialist weight management service. A doctor might recommend that you take one of these medicines if diet and exercise changes have not worked on their own. You'll need to eat a balanced, reduced-calorie diet and exercise regularly while taking liraglutide or semaglutide.
"Before prescribing liraglutide or semaglutide, your doctor will talk you through the benefits and limitations, including any side effects you might get."
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The demand for this product has unfortunately caused issues for those who need it to manage their diabetes. As explained by Dr Lee: "What has happened is that many people who are not diabetic, have obtained private prescriptions for Ozempic, using it off-license for weight loss, such that the drug is now in short supply for those with diabetes who need it to manage their illness. Wegovy is the only form of semaglutide licensed for use for weight loss. In the UK, at present, it can only be prescribed on the NHS by a specialist weight loss clinic.
"Being prescription-only should mean the supply and administration of Wegovy is properly regulated. This means a person using Wegovy will be properly assessed as medically eligible to use the product, will be followed up with the necessary checks being made, and will be given advice and support with their weight loss journey. However, unfortunately, this is not always the case as patients have been able to purchase weight loss drugs such as Wegovy without these proper checks being made."
How effective are they?
Addressing the effectiveness of this sort of medication, Dr Lee shared: "In a 2022 review and meta-analysis of randomised placebo-controlled trials of the use of semaglutide in obese or overweight patients without type 2 diabetes, which included eight studies and 4,567 patients, semaglutide resulted in a highly statistically significant average 10 per cent weight loss (10.5 Kg).
"In the semaglutide group, BMI was reduced by an average of 3.71 kg/m 2, waist circumference was reduced by an average of 8.25cm, and a greater proportion of patients on semaglutide lost 5 per cent, 10 per cent, 15 per cent, or 20 per cent of their total body weight.
"The semaglutide group also had positive outcomes in terms of reduced blood pressure, C-reactive protein (a measure of inflammation) and favourable changes to their cholesterol profile."
According to Dr Lee, Wegovy users have been found to shed approximately five per cent of their body weight after the first month, eight per cent after two months and 15 per cent of their body weight after one year, while cardioprotective benefits were also evident.
Not all experts are convinced by the effectiveness of such injections, however, with commercial nutritionist Mark Gilbert having previously cautioned that so-called 'skinny jabs' may not work in the long term. Gilbert, who works for the 1:1 Diet by Cambridge Weight Plan, has warned that these jabs shouldn't be considered an adequate substitute for getting all the nutrients you need to keep your body working as it should.
According to Gilbert: "Slimming jabs are usually used by people who are already deficient in one or more nutrients, causing them to eat very few calories and thus making it difficult to attain adequate nutritional status. By contrast, The 1:1 Diet is specifically formulated to provide all the nutrients you need." Responding to presenter Anna Richardson's Channel 4 doc The Truth About the Skinny Jab, which aired back in September, Gilbert argued that jabs were mostly 'no better than a yo-yo diet'.
He explained: "Two-thirds of weight loss is regained within a year of stopping these drugs. Additionally, almost 40 per cent of weight loss on Wegovy, for example, is lean tissue rather than fat loss. As such, weight loss jabs cause a substantially lower percentage of fat loss than on our diet."
Are there any risks?
Usually, it takes approximately five to 10 minutes for food to exit your stomach, however, weight loss injections can stretch this out to an hour or more. This more glacial pace of digestion can help address hunger pangs. Still, it can have some unwelcome side effects, according to Wasim Hanif, professor of diabetology and endocrinology at University Hospital Birmingham.
In an interview with the Mail Online, Professor Hanif revealed: "Studies show around one in 100 people on the drugs develop gastroparesis (or stomach paralysis), where stomach muscle contractions become too weak to digest food and pass it on to the intestines; this can cause nausea and vomiting. Around half those who develop gastroparesis also become constipated."
This advice comes as a woman who took Ozempic learned from doctors that she will now 'never have a solid bowel movement again for the rest of her life' after being hospitalised with a life-threatening bowel injury back in January 2023. This hospitalisation came mere months after she began taking Ozempic for weight loss treatment in October 2022.
According to her complaint, which was obtained by the Mail Online, Billie Farley 'started vomiting and having intense abdominal pain' around three months after beginning Ozempic treatment. After a CT revealed the full extent of her injuries, the 47-year-old claims she was told by doctors that 'Ozempic had been the probable cause of her bowel injuries and to stop taking it immediately'.
Doctors also informed her that she would never have a solid bowel movement again, and would likely be in pain for the rest of her life. Farley has now alleged the label ''failed to adequately warn [her] and her medical provider of the true risks of taking Ozempic' and claims 'her life is forever changed because of her usage of Ozempic'.
In a statement given to MailOnline, Novo Nordisk said: "Novo Nordisk believes that the allegations in the lawsuit are without merit, and we intend to vigorously defend against these claims. Patient safety is our top priority at Novo Nordisk, and we work closely with the US Food and Drug Administration to continuously monitor the safety profile of our medicines.
"GLP-1 medicines have been used to treat type 2 diabetes (T2D) for more than 18 years, and for the treatment of obesity for eight years. This includes Novo Nordisk GLP-1 products such as semaglutide and liraglutide that have been on the market for more than 13 years. Semaglutide has been extensively examined in robust clinical development programs, and large real world evidence studies and has cumulatively over 9.5 million patient years of exposure.
"The known risks and benefits of semaglutide and liraglutide medicines are described in their FDA-approved product labeling. Novo Nordisk stands behind the safety and efficacy of all of our GLP-1 medicines when they are used as indicated and when they are taken under the care of a licensed healthcare professional."
According to Dr Lee, Wegovy can result in side effects. 44 per cent of users reported nausea, 30 per cent diarrhoea, 24 per cent vomiting, 24 per cent constipation, 20 per cent stomach pain and seven per cent bloating. Low blood sugar levels can also result in side effects such as headaches, anxiety, rapid heartbeat, sweating, tiredness, irritability, drowsiness, and confusion.
A Novo Nordisk spokesperson told the Mirror: "At Novo Nordisk we have a long-term commitment to improving the lives of people living with obesity and changing how the world sees, prevents and treats obesity which increases the risk factors for severe health conditions such as cardiovascular disease, diabetes and cancer.
"There is no one-size-fits-all solution to obesity, and medications are only one part of the solution. We are committed to providing as many treatment options as possible for people living with obesity. We know that current pharmacotherapy treatment options are limited, and we believe it is important that HCPs are able to prescribe different treatment options to support people with obesity in their weight loss efforts. Wegovy® (semaglutide injection) is a prescription-only medicine and therefore requires a healthcare professional to prescribe the medicine under strict supervision."
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