AT A GLANCE
- President Biden and Senator Sanders write in USA Today that ‘…Novo Nordisk, Eli Lilly must stop ripping off Americans with high drug prices.’
- Foodsmart founder and CEO Dr. Jason Langheier is profiled by Forbes, with his company as ‘…the largest foodcare provider in the United States.’
- Lauren J. Young at Scientific American wants to understand how ‘Ozempic Quiets Food Noise in the Brain.’
- Not everyone loses weight on Ozempic, from Emily Mullin at WIRED.
- JAMA Ophthalmology on whether there is an association between semaglutide and risk of the serious eye condition nonarteritic anterior ischemic optic neuropathy, or NAION.
- JAMA Network Open publishes on clinical evidence supporting the potential benefits of GLP-1RAs for prevention of 13 obesity-associated cancers.
NEWS
- President Biden and Senator Sanders write in USA Today that ‘…Novo Nordisk, Eli Lilly must stop ripping off Americans with high drug prices.’
- They continue that ‘…prices of Ozempic and Wegovy can be up to six times higher than prices in Canada, Germany, Denmark and other major countries…’ and comment ‘…That’s unacceptable.’
- The authors further cite that ‘…Novo Nordisk made over $12 billion in profits, in part by charging Americans over $1,000 a month for a prescription drug that can be profitably manufactured for less than $5.’
- Simply put, ‘…Novo Nordisk must substantially reduce the price of Ozempic and Wegovy.’
- Foodsmart founder and chief executive officer Dr. Jason Langheier is profiled by Forbes, with his company as ‘…the largest foodcare provider in the United States.’
- Foodsmart is described on its website as ‘…the first telehealth experience that combines registered dietitian services, tailored meal planning tools, and the most broadly integrated food delivery marketplace in one location to make eating well easy on your mind and wallet.’
- Foodsmart serves 2.2 million people and “tens of millions” for whom Foodsmart is free.
- Sadly, Dr. Langheier states more than 44 million Americans (1in 8 people) live with daily food insecurity.
- In addition, Foodsmart is ‘…joining forces with TPG’s Rise Fund to lead an investment of over $200 million…’ to scale operations and expand reach.
- In fact, people lose weight, and save an average of 34% on their grocery bill.
- Impressive!
OPINION
- Lauren J. Young at Scientific American wants to understand how ‘Ozempic Quiets Food Noise in the Brain.’
- Biochemist Svetlana Mojsov of the Rockefeller University says the ‘…next frontier is to understand the biology behind the Ozempic effects on the brain.’
- Meranda Hall, a 32-year-old administrator at a law firm in New York City, lost 78 pounds on Wegovy; she also ‘…used to be an enthusiastic social drinker, an eight-margs-at-Taco-Tuesday type of girl. Now she’s a sober Sally.’
- GLP-1 receptor agonists report not only a decreased desire for food but reduced cravings for alcohol, nicotine, drugs, online shopping, nail picking—the list goes on.
- Lorenzo Leggio, an addiction researcher at the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse is studying the effects of GLP-1 medications on this reward pathway for potential addiction treatments.
- All good stuff, but eating, drink, and additional vices are a part of our social lives – how will we fill the void?
- Not everyone loses weight on Ozempic, from Emily Mullin at WIRED.
- At three months on the injectable GLP-1 drug, Danielle Rosas has lost just 5% of her total body weight, or 15 pounds.
- Indeed, she was ‘…disappointed. She had hoped to lose more – in trials, patients had lost three times as much.’
- Worse, she had the side effects – nausea and feeling generally unwell.
- She decided to go off the drug.
- The 15% to 20% weight loss from Ozempic-type meds ‘…are averages, and in the real world, drugs don’t always perform as well as they do in carefully controlled trials.’
- Dr. Hans Schmidt, director of the Center for Weight Loss & Metabolic Health and chief of bariatric surgery at Hackensack University Medical Center in New Jersey notes ‘…around 15 percent of his patients don’t respond well to GLP-1s.’
- There is a variation in response, as for any clinical treatment, be it a medication, a behavioral program, or even for surgery.
- In addition, ‘…Without lifestyle changes, these medications are likely to be less effective for weight loss.’
- The same is true for my past patients having undergone bariatric surgery – most did remarkably well, whilst a smaller proportion did not meet their desired goals.
DATA
- HIV-associated lipohypertrophy, which is characterised by an abnormal accumulation of abdominal visceral adipose tissue, may be effectively treated with semaglutide.
- The Lancet Diabetes & Endocrinology publishes a randomized trial of 108 subjects with HIV, reporting a 30% reduction in abdominal visceral adipose tissue.
- JAMA Surgery published on 78 patients in Norway, whereby researchers subjected patients to gastric bypass or very low energy diet; in a weight loss matched manner.
- Despite similar fat mass loss, clinically meaningful reductions in major atherogenic blood lipids were demonstrated after gastric bypass in comparison with the restrictive diet.
- The authors conclude that RYGB may reduce CV risk independent of weight loss.
- The study duration was just nine weeks, and while the results are impressive, we should more likely focus on the combined and independent effects of the two most effective treatments for clinical obesity, i.e. bariatric surgery and GLP-1 meds.
- We should go further than simply clinical impact, and undertake cost-effectiveness studies.
- JAMA Ophthalmology on whether there is an association between semaglutide and risk of the serious eye condition nonarteritic anterior ischemic optic neuropathy, or NAION.
- From just over 16,000 patients in a data registry, 710 had type 2 diabetes with just 194 on semaglutide; and 979 were overweight or obese, with 361 prescribed semaglutide.
- There was a four times higher risk of NAION for the semaglutide cohort with type 2 diabetes over 36 months; similarly, there was a seven times higher risk of NAION for the semaglutide cohort with overweight or obesity over 36 months.
- NAION, sometimes referred to as eye stroke, is the second most common form of optic neuropathy and a significant cause of blindness among adults.
- These findings are indeed surprising and may have confounding factors – NAION is more common in patients with diabetes.
- Awareness and onward vigilance is necessary for sure.
- JAMA Network Open publishes on clinical evidence supporting the potential benefits of GLP-1RAs for prevention of 13 obesity-associated cancers, or OACs?
- From 1.6 million patients with type 2 diabetes, those treated with a GLP-1 drug versus insulin had a significant risk reduction in 10 of 13 OACs, over a fifteen-year follow-up period.
- More specifically the cancers are esophageal, colorectal, endometrial, gallbladder, kidney, liver, ovarian, and pancreatic cancer as well as meningioma and multiple myeloma.
- The reduction in risk ranged from 65% for gallbladder cancer and 59% for pancreatic cancer, to 24% for kidney cancer and 26% for endometrial or uterine cancers.
- However, there was a lesser impact on patients who were taking the diabetes drug metformin, which is much more widespread and cheaper too.
- Overall, we know this type of data well in the case of bariatric surgery and an upwards of 35% reduction in many of these cancers out to ten-plus years; so whilst these data are not surprising, they are certainly on onward importance.
ADDITIONAL TOPICS
- Reuters notes India plans incentives for diabetes, obesity drug makers in 2026, government official says.
- The New York Times on How to Help Americans Eat Less Junk Food.
- US News discusses Semaglutide vs. Weight Loss Surgery: Which Is Better?
- JAMA Network Open publishes Multivitamin Use and Mortality Risk in 3 Prospective US Cohorts.
- Nature Medicine publishes A new framework for the diagnosis, staging and management of obesity in adults.
- Dr. Arya Sharma and colleagues at ICHOM launch a Set of Patient-Centered Outcome Measures for Adults living with Obesity.
