From diabetes to obesity: an unexpected connection
The development of drugs based on incretin hormone analogues, which help regulate blood glucose levels, began with the aim of improving the health of people with diabetes. However, researchers noticed an additional effect: significant weight loss in treated patients. This finding opened the doors to new research, which led to the approval of liraglutide in 2015 (marketed as Saxenda) as the first drug in this group specifically indicated to treat obesity.
However, Saxenda's time on the market will be short, as it ends in 2025. This is partly due to the emergence of more modern, effective alternatives that have captured the attention of both doctors and patients.
The arrival of semaglutide: a game-changer
The drug that made the difference was semaglutide, which was initially marketed as Ozempic to treat type 2 diabetes. Its effectiveness in weight loss led to the development of Wegovy, a specific product for the treatment of overweight and obesity. Although both drugs have the same active ingredient, they have different indications and doses appropriate for each need.
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Ozempic is prescribed for diabetes and is funded by the National Health System in Spain (SNS) for specific cases.
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Wegovy, on the other hand, is indicated for people with a body mass index (BMI) of 30 or over, or from 27 if the patient has an excess weight-related health problem. Currently, there is no public funding in Spain for this indication, so patients have to bear its full cost.
Both drugs are administered in weekly injections, with doses ranging from 0.25 mg to 2.4 mg in the case of Wegovy.
New candidates: tirzepatide
A new candidate came onto the market in July 2024: tirzepatide, marketed as Mounjaro. This drug goes one step further; as it combines action on the GLP-1 hormone receptors (as with semaglutide) with activation of GIP hormone receptors, which directly influence fat metabolism.
Mounjaro was approved to treat either diabetes or obesity; although, like Wegovy, it does not have public funding in Spain. It is marketed in a number of doses, from 2.5 mg to 10 mg, and is also administered as a weekly injection.
Beyond medication: a holistic approach
While these advances are exciting and offer new opportunities, it is essential to remember that obesity is a complex condition that requires a comprehensive approach. Drugs are only one part of the treatment, which should also include:
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Lifestyle changes: such as a balanced diet and regular physical activity.
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Psychological support: to work on emotional aspects related to food and weight.
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Medical supervision: to personalise and tailor treatment according to individual needs.
Having a multidisciplinary team is key to achieving sustainable long-term results.
The future of obesity treatment
Emerging drugs, such as semaglutide and tirzepatide, not only improve weight loss, but also have additional benefits in metabolic control and cardiovascular health. However, their high cost and lack of public funding pose challenges to their accessibility. As we move forward, it will be crucial to balance scientific innovation with health policies that ensure more people can benefit from these treatments.
