Young obese people may soon have a powerful new tool to help them lose weight.
Results of a clinical trial published Wednesday in the New England Journal of Medicine found that teenagers who received a weekly injection of an appetite-reducing drug lost an average of 14.7% of their starting body weight, while those who received a placebo and advice on diet and exercise gained 2.7% of their initial weight. The trial included 201 young people aged 12 to 17 at three medical centers across the country, in Europe and Mexico.
By the end of the study, more than 40% of participants who received the drug, along with lifestyle counseling, were able to lower their BMI by 20% or more, the co-author said. study, Aaron Kelly, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota.
The drug semaglutide, sold under the brand name Wegovy, has been used to treat type 2 diabetes. Diabetes doctors have noticed a side effect of the drug, which works by telling the pancreas to secrete more insulin to control the blood sugar. Some patients lost weight. When doctors reported the weight loss to drugmaker Novo Nordisk, the company designed trials to study the impact of semaglutide as a tool in the fight against obesity. An earlier study in adults showed that the drug actually helped with weight loss. The Food and Drug Administration approved it in 2021 for obese adults.
“I’m absolutely excited,” Kelly said. “We have entered the phase where we see the kind of weight loss where teenagers come to us in tears. This is the first time they have controlled their weight in their lives.
According to the Centers for Disease Control and Prevention, more than one in five young people between the ages of 12 and 19 in the United States are considered obese based on their BMI. Obese children face higher rates of weight-related illnesses later in life, experts say.
“We have a huge overweight and obesity problem in this country,” said Dr. Monica Bianco, assistant professor of pediatrics at Northwestern University Feinberg School of Medicine and attending physician at Lurie Children’s Hospital in Chicago. “As obese children become young adults, they begin to develop conditions such as hypertension, diabetes, and high cholesterol,” she said. “We see people as young as 30 having heart attacks.”
By the time Emmalea Zummo entered the study, her weight had soared to 250 pounds. The 17-year-old from Jeannette, western Pennsylvania, had struggled for years with weight gain linked to a hormonal condition called polycystic ovary syndrome, or PCOS.
“I tried diets,” Zummo said. “I tried to play sports. I play more sports than any other kid I know, and nothing would work. My body would just get used to the extra exercise, get used to the new diet, and the weight would come back.
Zummo felt hopeless. “I was diagnosed with depression because of my weight,” she said.
When the opportunity arose to participate in the study, Zummo jumped at the chance. “Even on the first date, when they were explaining what the medicine was, it was already like I felt lighter mentally,” she said.
She lost over 70 pounds. Now his weight is down to 170-180, “which I’m really happy with,” Zummo said. “I felt better about myself than I had ever felt before.”
Participants’ average weight was 237 pounds and 193 reached week 68; 131 received the medication plus the lifestyle intervention, and 62 received the lifestyle intervention only.
Overall, 73% of those who received the drug lost 5% or more weight, compared to 18% of those who received only the lifestyle intervention.
In addition to weight loss, the drug reduced certain cardiovascular risk factors, including waist circumference and bad cholesterol. Teenagers also reported a noticeable improvement in their quality of life.
“This is the first time to my knowledge that an anti-obesity drug in adolescents has been shown to improve their quality of life,” Kelly said.
There were a few side effects, including nausea, which seemed to lessen as the teenagers got used to the drug.
There is another drug approved for use in obese adolescents. Based on the results of the new study, semaglutide is the “most effective anti-obesity drug for adolescents,” Kelly said.
Many people still think of obesity “as a lifestyle issue that’s within our control,” said Dr. Eduardo Grunvald, medical director of the weight management program at the University of California, San Diego. “But we do know that the impact of lifestyle interventions is modest at best.”
Will the weight come back?
While teen weight-loss surgery tends to gain public acceptance, “medication to treat weight in children is a new concept for most people,” Grunvald said. “As we get more data on safety and effectiveness, these drugs are going to become more common.”
The efficacy found in the new study “is exciting for the general public and for those of us who practice bariatric medicine,” said Dr. Zhaoping Li, Professor of Medicine, Lynda and Stewart Resnick Endowed Chair in Human Nutrition, and director of the Center for Human Nutrition at the David Geffen School of Medicine at the University of California, Los Angeles.
One thing the study doesn’t shed light on is whether the drug will continue to be effective long-term, Li said.
Long-term follow-up data on people who took diabetes medication shows that people gained weight, Li said. one or two years, would the weight come back? The answer is probably yes,” she said.
It turns out that even when people have weight loss surgery, “three years later, there is significant weight gain,” Li said.
When a weight-loss drug like this is prescribed to patients, it shouldn’t be the end of things, Li said. “We should use this as an opportunity to identify the root issues that led to weight gain. into the individual lives of patients and help them make fundamental changes not only to lose weight and maintain weight loss, but also to help them lead a healthier lifestyle,” she said .
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