There are several weight-loss drugs that have been approved by the FDA for the treatment of obesity. Here are some examples:
1. Orlistat (Alli, Xenical): Orlistat works by inhibiting the absorption of dietary fat in the intestines. It is available over-the-counter as Alli and in higher doses with a prescription as Xenical.
2. Phentermine (Adipex-P, Lomaira): Phentermine is an appetite suppressant that affects the central nervous system. It is approved for short-term use in conjunction with diet and exercise.
3. Lorcaserin (Belviq): Lorcaserin is a selective serotonin receptor agonist that helps promote a feeling of fullness and reduce appetite. However, it was withdrawn from the market in February 2020 due to concerns about its potential link to cancer.
4. Naltrexone-bupropion (Contrave): This combination medication works on the central nervous system to reduce appetite and increase feelings of fullness. It is approved for long-term use in obese or overweight individuals with certain weight-related medical conditions.
5. Liraglutide (Saxenda): Originally approved for the treatment of type 2 diabetes, liraglutide is also approved for chronic weight management. It works by slowing digestion, reducing appetite, and increasing feelings of fullness.
It's important to note that these medications should be used under the guidance of a healthcare professional and in conjunction with lifestyle changes, such as a healthy diet and regular exercise. They may have side effects and are not suitable for everyone, so it's essential to consult with a healthcare provider to determine the most appropriate treatment option based on individual circumstances.
The US Food and Drug Administration on Friday approved drugmaker Novo Nordisk’s application to add cardiovascular benefits to the medicine’s label, making it the first weight-loss drug to also be cleared to reduce the risk of heart attack, stroke or heart-related death in people at higher risk of these conditions.
The label expansion may improve insurance coverage for Wegovy, which costs more than $1,300 per month out of pocket before any discounts. Many insurers, including Medicare, don’t cover drugs for weight loss, leaving patients scrambling to afford them.
“The evidence is that they reduce risk and save lives – and so it is indefensible to deny people access, or make it difficult for people to access, medications that will directly improve their health,” Dr. Harlan Krumholz, a cardiologist and scientist at Yale University and Yale New Haven Hospital, said Friday. He has no conflicts of interest and hasn’t received any payments from Novo Nordisk or Eli Lilly, which makes competing medicines. “The point is that these drugs are not about appearance but about health. By treating obesity, we know we can reduce cardiovascular risk, and that may be only a part of the benefits that accrue.”
The approval is based on a 17,000-patient study that showed that people taking Wegovy, the sister drug to the better-known Ozempic, had a 20% lower risk of a cardiac event than those taking a placebo.
Wegovy is indicated for people with a body mass index of at least 30 – considered to have obesity – or those with a BMI of at least 27 – considered overweight – and at least one “weight-related” health condition like high blood pressure or cholesterol. Ozempic is approved for type 2 diabetes. Both use the active ingredient semaglutide, part of a class of drugs known as GLP-1 receptor agonists.
“Wegovy is now the first weight loss medication to also be approved to help prevent life-threatening cardiovascular events in adults with cardiovascular disease and either obesity or overweight,” Dr. John Sharretts, the FDA’s director of the Division of Diabetes, Lipid Disorders, and Obesity, said in a news release from the agency.
“This patient population has a higher risk of cardiovascular death, heart attack and stroke,” he added. “Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health.”
Novo Nordisk’s trial was done in people with cardiovascular disease, meaning they had a previous heart attack or stroke or symptoms of peripheral artery disease – clogged arteries in the arms or legs. More studies need to be done to show whether there are heart benefits for people who haven’t had a cardiac event.
Wegovy continues to be in shortage, along with other GLP-1 medicines, as drugmakers struggle to keep up with demand. Novo Nordisk said last month that it’s gradually increasing the supply over the course of this year.
“The shortages are really, really bad right now,” Dr. Jody Dushay, an endocrinologist at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School, said Friday. She said she has no affiliations with drugmakers.
She said she hoped the expanded approval would improve insurance coverage, particularly as generic weight-loss drug alternatives can carry heart risks, but noted that “if insurance comes on board with this indication,” she has “no idea how manufacturing will ever catch up.”
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