May 21, 2024 – Weight loss drugs Wegovy or Ozempic were in a position to produce significant weight reduction no matter whether participants had previously undergone weight-loss surgery, a first-of-its-kind study shows.
In addition, insurance coverage was essentially the most common problem for people wanting to begin taking the favored drugs, called GLP-1 receptor agonists. Side effects and drug shortages were among the reasons people stopped taking the drugs.
Overall, people lost a median of 6% of their Total body weight in nearly a 12 months of taking semaglutide, a category of medication that features Wegovy and Ozempic. When researchers compared individuals who had weight-loss surgery with those that had not, the general weight reduction was nearly an identical: 5.8% for many who had surgery versus 6.0% for many who had not.
Participants on this study lost a smaller percentage of their total body weight than participants in clinical trials of the drugs, who tended to lose as much as 15% of their body weight, said lead researcher Pourya Medhati, MD, a postdoctoral fellow at Brigham and Women's Hospital in Boston.
These findings suggest that actual weight reduction outcomes may differ from those in rigorously controlled research studies. Medhati presented the findings at Digestive Disease Week (DDW) 2024 in Washington, DC.
Total weight reduction was not significantly different between men and girls within the surgery group. However, within the non-surgery group, women lost 6.4% while men lost only 4.8% – a major difference.
Medhati and Ali Tavakkoli, MD, chief of the Division of General and Gastrointestinal Surgery at Brigham and Women's Hospital, used electronic health records to check 2,491 adults who were prescribed semaglutide at Brigham and Women's Hospital between 2018 and 2023. The average age was 51 years, 74% were white, and 78% were women. Overall, 13% had undergone weight-loss surgery.
Costs, negative effects and other concerns
The researchers examined problems related to starting and maintaining semaglutide treatment in a subgroup of 500 patients. For example, a complete of 75 people never began taking the drug. The majority (72%) of this group said this was resulting from insurance coverage or the price of the drug. Another 19% gave no reason and 9% said it was resulting from negative effects.
People with higher BMI and diabetes are less more likely to start taking semaglutide, Medhati said.
Another 100 of the five hundred patients began treatment with semaglutide after which stopped it. Again, insurance coverage and value were the explanations given, this time by 13%. About 36% stopped treatment due to negative effects; 21% cited a scarcity of semaglutide; and 30% stopped treatment for an unspecified reason.
“Our study underscores the importance of addressing the issue of insurance to ensure broader access,” Medhati said.
The 325 individuals who continued taking semaglutide lost a median of 8.5% of their total body weight after 50 weeks.
Access stays unequal
“These drugs are incredibly effective in treating obesity and weight-related diseases in both people with and without a history of bariatric surgery,” said session co-moderator Matthew Kroh, MD, vice chair of innovation and technology within the Cleveland Clinic's Department of General Surgery.
More equitable access to semaglutide and other GLP-1 antibiotics is required, he said. “Because the cost is so high and they are not currently covered by most health plans, people with better financial means have access to these drugs,” while others may not.
Kroh said the findings may only apply to the patients, most of whom were female, white and middle-aged. But he praised the researchers for conducting the study outside of a clinical trial. “Real-world data will help us make these decisions in the future,” he said.