Latest news with #LouisAronne
Mint
3 days ago
- Health
- Mint
Weight-loss drugs have a surprising foe: Fat activists
In the world of fat activism, the 'O-words"—overweight and obesity—are expressly verboten. That's because advocates and 'fat studies" scholars want to destigmatize and accommodate fatness—their preferred term—and push back against the view that overweight or obese people are somehow abnormal or diseased. Now a third problematic O-word has emerged: Ozempic. From the perspective of these activists and scholars, the hype around GLP-1 agonists, for which Ozempic has become the catchall term, only dials up the pressure to lose weight. It's one thing for an obese person to refuse to undergo bariatric surgery, which involves hospitalization, complications and a significant recovery. But to resist a weekly home injection? That can really test peoples' sympathy. 'Ozempic is 100% making things worse for us," said Tigress Osborn, executive director of the National Association to Advance Fat Acceptance (NAAFA), an advocacy group founded in 1969. 'It's created an even louder public narrative that you could just solve all your problems by taking this magical drug, and if you don't take it, well then, you deserve what you get." 'Ozempic is 100% making things worse for us,' said Tigress Osborn, executive director of the National Association to Advance Fat Acceptance, pictured in July. These concerns contrast sharply with the latest thinking in obesity medicine, which views reframing obesity as a disease—which the American Medical Association did in 2013—as a crucial step toward destigmatization. For doctors, GLP-1s such as Ozempic, Wegovy, Zepbound and Mounjaro are breakthrough tools for addressing obesity, which increases the risk of developing other serious conditions, including type-2 diabetes and heart disease. 'We are not prosecuting people for having obesity," said Louis Aronne, one of the founders of obesity medicine as a subspecialty and the director of the Comprehensive Weight Control Center at Weill Cornell Medicine in New York City. 'We look at treating obesity as central to helping with all their other health problems." Patients who lose weight with GLP-1s regularly see their health markers for prediabetes and hypertension improve. They often suffer less from sleep apnea, which allows them to feel better rested and elevates their mood. This can eliminate the need for antidepressants, which can themselves cause weight gain. Over the past 60 years, obesity rates have tripled in the U.S. due in part to more sedentary lifestyles and changes in diet, including more calorie-dense ultraprocessed foods. 'Obesity experts have been trying to overcome these challenges for decades and give people better lives, and we finally feel like we're really getting somewhere," Aronne said. The advent and ubiquity of GLP-1 drugs may mark a turning point for the treatment of obesity, but they have also widened a chasm between activists and academics and much of the rest of the world, including medical specialists. One side believes it can help people overcome obesity; the other wants to shift the focus from changing their bodies to helping them live in them. 'People think that if everyone can just take this expensive, dangerous drug, we can get rid of fat people," said Marilyn Wann, 58, a longtime fat activist in the Bay Area, who like many activists is suspicious of GLP-1s' possible long-term side effects. 'These drugs are going through the same excitement-and-disappointment cycle we've seen with every method of intentional weight loss. It just creates more work for fat activists." Certain facts are indisputable. Four in 10 adults in the U.S. have a body-mass index or BMI over 30. The financial costs are significant. The Centers for Medicare and Medicaid Services recently estimated that obesity is associated with approximately $385 billion in health spending in 2024. According to a recent paper in JAMA, employees with obesity have seven times the medical claims costs and 11 times the indemnity claims costs of those with a healthy weight. They file twice as many worker compensation claims. These costs correspond with obesity's significant health consequences, which include osteoarthritis, hyperlipidemia and other chronic diseases. Obesity-related complications include incontinence, asthma, psoriasis, reflux and kidney disease. According to a 2023 paper in the journal Nature, roughly 8% of all medical expenditures in the U.S. are associated with the treatment of obesity. Weight loss expenditures are similarly outsized. According to Grand View Research, the weight loss industry was $142.58 billion in 2022 and is projected to reach $298.66 billion by 2030. UBS estimates the GLP-1 market alone will grow to $126 billion in sales by 2029. Other aspects of obesity are less well understood. While there's a consensus that genetics, environment, insulin and other hormones play a role, no one quite knows how, or why some people become obese in the first place while others don't. Fat activists and scholars argue that a causal relationship between obesity and its associated maladies has yet to be definitively established, and that obesity itself is not a disease. In their view, it is inaccurate and unhelpful to stigmatize overweight people as inherently ill. Fat people, they point out, can be just as healthy as thin people, and diseases like hypertension can afflict anyone, regardless of weight. Obesity doctors see rejecting the disease framework as counterproductive. 'I don't think we should be using the argument that we don't know the etiology of obesity to say that it's not a disease," said Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital in Boston. 'We have incredibly good data showing that excess fat tissue causes inflammation, heart disease and diabetes." She bristles at efforts to claim that obesity doesn't raise the risk for complications: 'that is simply not the case." Apovian acknowledged that some heavy people, including Sumo wrestlers and other athletes, are 'very healthy," but noted that 'the majority of people with high BMIs are not." In her practice, she said, patients cry happy tears and weep with relief when she explains that they have a disease, that a malfunction in their system is sending false signals around hunger and satiety. Deborah McPhail, a medical sociologist at the University of Manitoba, understands that sense of relief. 'We as individuals internalize this notion that we have failed ourselves, our family, our society, our public healthcare system because we have 'allowed' ourselves to become a certain weight and therefore a burden," she said. 'To be told, 'This is beyond you, you don't have control over it' is really important for people to hear." Activists believe that some of the health problems afflicting the overweight are products of a biased healthcare system that treats their bodies as problems in themselves. 'The unfortunate reality is that a lot of the time, fat people don't get the care they need, which can result in healthcare disparities," said Ani Janzen, operations and project leader at the Association for Size Diversity in Health, one of several organizations that address fat bias in medicine. 'It's an awful Catch-22 because those disparities are then used to enforce the idea that larger people are in worse health than people are in smaller bodies." Pamela Mejia, a researcher who conducted a study on fat bias in the media for NAAFA, is familiar with this prejudice. 'I have a doctor who is convinced that everything that happens to me, from a sprained ankle to a migraine, would be helped if I lost weight," she said. 'Once I fell and bruised myself hiking and the doctors said, 'It would be better if you lose weight.' I just fell off a mountain! Does he think the mountain attacked me because I'm fat?" Nearly every fat activist has similar nightmare stories. Tigress Osborn recalls being pressured to have weight-loss surgery before undergoing a medically necessary hysterectomy. Then there are the smaller but repeated indignities confronted during routine medical visits. The absence of larger chairs in the waiting room. Hospital robes that won't fully cover their naked bodies. Equipment ranging from blood-pressure cuffs to MRI machines that cannot accommodate them. Orthopedic surgeons who refuse to do knee or hip replacements because they believe it will be too complicated or that body weight will compromise recovery. Doctors who immediately assume the reason for any visit is to lose weight and if that's not why they're there, well, it should be. No wonder overweight and obese people avoid or delay healthcare services, a fact backed by multiple studies. Either they are embarrassed by their weight or want to avoid being lectured about it. They put off cancer screenings and other tests, which some believe contribute to higher mortality rates among overweight people. Obesity doctors concede that the medical profession has a long way to go in how it approaches excess weight. Not only are more specialists needed, but doctors across the field need to be better trained. Apovian described an obese man in his 60s who couldn't move his legs, and a doctor had written on his chart, 'Patient didn't want to move his legs." By the time doctors realized the patient had an abscess blocking his spinal cord, he was paralyzed. In 2022, when leading U.S. organizations dedicated to obesity medicine gathered to discuss treatment and prevention, their consensus statement acknowledged that 'Bias and stigmatization directed at people with obesity contributes to poor health and impairs treatment." Fat studies, an interdisciplinary field that arose in the 1990s, focuses on what it calls 'weight-based oppression" and those who benefit from it. It criticizes the weight-loss industry for repeatedly selling quick fixes that help perpetuate weight cycling in a drive for profit. Fen-Phen, a 1990s diet drug that was recalled after it was shown to cause life-threatening heart problems, serves as a cautionary tale. Like ethnic studies and queer studies, fat studies was inspired by activism and organized around identity, incorporating aspects of social sciences, the arts and the humanities. In the language of fat studies, to 'fatten" an issue means to examine it through the lens of the fat justice movement. Scholars are now 'fattening" GLP-1s. One fear is an increased pressure to lose weight and a demonization of those who don't, despite the fact that GLP-1s are ineffective in 10-15% of patients. Even when successful, the drugs tend to yield a weight loss of 5% to 20%, which won't transform someone who weighs 350 pounds into a thin person. Much of the work of fat studies scholars focuses on stigma, building on 20th-century sociologist Erving Goffman's pioneering theory that stigmas around 'guilty" traits like obesity result in stronger biases than ones that are 'not your fault," such as schizophrenia. A general awareness of unconscious biases has grown in recent years, but body size remains an outlier. Research has shown that weight discrimination is nearly as common as race discrimination, and stronger against women than men. 'The most pressing issue to me is how amazingly negative and gratuitous the negative stereotypes are against fat people and all the daily ways in which this bias is made clear," Esther Rothblum, a professor emerita of psychology at San Diego State University and former editor of Fat Studies, an academic journal, told me. 'People say things about fat people that they would never say about black or elderly or gay people. It's very hard to be a member of any oppressed group in society but when it comes to fatness, people don't even see a problem with their prejudice." Of course, fat activists, like all identity campaigners, don't speak for everyone they aim to represent. Many overweight people find the movement's preferred word, 'fat," shaming. Plenty still want to escape what they see as an emotional and medical burden. Tommy Tomlinson, author of the 2019 memoir 'The Elephant in the Room: One Fat Man's Quest to Get Smaller in a Growing America," has lost 58 pounds since he began taking GLP-1s last year. For him, the change has been more than physical. 'The constant food noise in my head, always thinking about the next meal, looking up the menu for the place you're going to that night—all that has disappeared," he told me. 'It's an incredibly transformative thing in my life." Tomlinson described a conversation he once had with Lee Kaplan, an obesity doctor and pioneer in the field. Kaplan asked Tomlinson if after being on the drugs for a while, he believed there was a chemical component to losing weight. Tomlinson said he did. Could this also mean, Kaplan asked, that something chemical in his body made Tomlinson gain all that weight in the first place? 'I hadn't thought about it in those clear and direct terms before," Tomlinson recalled. 'It was shattering in a way but also comforting. To be told, 'It's not your fault.'" The fracas over whether a slimmed down Lizzo or Kelly Clarkson has betrayed the body positivity movement may garner more attention, but activists readily acknowledge that these drugs offer real relief to some people. The more important point, they maintain, is that regardless of the successes GLP-1s bring to any one individual, the larger problem of how fatness is handled socially, medically and economically persists. 'My goal isn't to stop people from wanting to lose weight," Osborn of NAAFA told me. Instead, it's 'to reach more people with the knowledge that you don't have to beat yourself up over being in this body, that we can work toward creating a world where people can live freely in the bodies they are in." That kind of message, she says, 'offers that same sense of relief—but delivers it to everyone."
Hindustan Times
3 days ago
- Health
- Hindustan Times
Weight-Loss Drugs Have a Surprising Foe: Fat Activists
In the world of fat activism, the 'O-words'—overweight and obesity—are expressly verboten. That's because advocates and 'fat studies' scholars want to destigmatize and accommodate fatness—their preferred term—and push back against the view that overweight or obese people are somehow abnormal or diseased. Now a third problematic O-word has emerged: Ozempic. From the perspective of these activists and scholars, the hype around GLP-1 agonists, for which Ozempic has become the catchall term, only dials up the pressure to lose weight. It's one thing for an obese person to refuse to undergo bariatric surgery, which involves hospitalization, complications and a significant recovery. But to resist a weekly home injection? That can really test peoples' sympathy. 'Ozempic is 100% making things worse for us,' said Tigress Osborn, executive director of the National Association to Advance Fat Acceptance (NAAFA), an advocacy group founded in 1969. 'It's created an even louder public narrative that you could just solve all your problems by taking this magical drug, and if you don't take it, well then, you deserve what you get.' 'Ozempic is 100% making things worse for us,' said Tigress Osborn, executive director of the National Association to Advance Fat Acceptance, pictured in July. These concerns contrast sharply with the latest thinking in obesity medicine, which views reframing obesity as a disease—which the American Medical Association did in 2013—as a crucial step toward destigmatization. For doctors, GLP-1s such as Ozempic, Wegovy, Zepbound and Mounjaro are breakthrough tools for addressing obesity, which increases the risk of developing other serious conditions, including type-2 diabetes and heart disease. 'We are not prosecuting people for having obesity,' said Louis Aronne, one of the founders of obesity medicine as a subspecialty and the director of the Comprehensive Weight Control Center at Weill Cornell Medicine in New York City. 'We look at treating obesity as central to helping with all their other health problems.' Patients who lose weight with GLP-1s regularly see their health markers for prediabetes and hypertension improve. They often suffer less from sleep apnea, which allows them to feel better rested and elevates their mood. This can eliminate the need for antidepressants, which can themselves cause weight gain. Over the past 60 years, obesity rates have tripled in the U.S. due in part to more sedentary lifestyles and changes in diet, including more calorie-dense ultraprocessed foods. 'Obesity experts have been trying to overcome these challenges for decades and give people better lives, and we finally feel like we're really getting somewhere,' Aronne said. The advent and ubiquity of GLP-1 drugs may mark a turning point for the treatment of obesity, but they have also widened a chasm between activists and academics and much of the rest of the world, including medical specialists. One side believes it can help people overcome obesity; the other wants to shift the focus from changing their bodies to helping them live in them. 'People think that if everyone can just take this expensive, dangerous drug, we can get rid of fat people,' said Marilyn Wann, 58, a longtime fat activist in the Bay Area, who like many activists is suspicious of GLP-1s' possible long-term side effects. 'These drugs are going through the same excitement-and-disappointment cycle we've seen with every method of intentional weight loss. It just creates more work for fat activists.' Obesity's toll Certain facts are indisputable. Four in 10 adults in the U.S. have a body-mass index or BMI over 30. The financial costs are significant. The Centers for Medicare and Medicaid Services recently estimated that obesity is associated with approximately $385 billion in health spending in 2024. According to a recent paper in JAMA, employees with obesity have seven times the medical claims costs and 11 times the indemnity claims costs of those with a healthy weight. They file twice as many worker compensation claims. These costs correspond with obesity's significant health consequences, which include osteoarthritis, hyperlipidemia and other chronic diseases. Obesity-related complications include incontinence, asthma, psoriasis, reflux and kidney disease. According to a 2023 paper in the journal Nature, roughly 8% of all medical expenditures in the U.S. are associated with the treatment of obesity. Weight loss expenditures are similarly outsized. According to Grand View Research, the weight loss industry was $142.58 billion in 2022 and is projected to reach $298.66 billion by 2030. UBS estimates the GLP-1 market alone will grow to $126 billion in sales by 2029. Other aspects of obesity are less well understood. While there's a consensus that genetics, environment, insulin and other hormones play a role, no one quite knows how, or why some people become obese in the first place while others don't. Dr. Caroline Apovian, with patient Natasha Monahan at the Center for Weight Management and Wellness at Brigham and Women's Hospital, said she often sees patients weep with relief when she explains that obesity is a disease. Fat activists and scholars argue that a causal relationship between obesity and its associated maladies has yet to be definitively established, and that obesity itself is not a disease. In their view, it is inaccurate and unhelpful to stigmatize overweight people as inherently ill. Fat people, they point out, can be just as healthy as thin people, and diseases like hypertension can afflict anyone, regardless of weight. Obesity doctors see rejecting the disease framework as counterproductive. 'I don't think we should be using the argument that we don't know the etiology of obesity to say that it's not a disease,' said Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women's Hospital in Boston. 'We have incredibly good data showing that excess fat tissue causes inflammation, heart disease and diabetes.' She bristles at efforts to claim that obesity doesn't raise the risk for complications: 'that is simply not the case.' Apovian acknowledged that some heavy people, including Sumo wrestlers and other athletes, are 'very healthy,' but noted that 'the majority of people with high BMIs are not.' In her practice, she said, patients cry happy tears and weep with relief when she explains that they have a disease, that a malfunction in their system is sending false signals around hunger and satiety. Deborah McPhail, a medical sociologist at the University of Manitoba, understands that sense of relief. 'We as individuals internalize this notion that we have failed ourselves, our family, our society, our public healthcare system because we have 'allowed' ourselves to become a certain weight and therefore a burden,' she said. 'To be told, 'This is beyond you, you don't have control over it' is really important for people to hear.' Activists believe that some of the health problems afflicting the overweight are products of a biased healthcare system that treats their bodies as problems in themselves. 'The unfortunate reality is that a lot of the time, fat people don't get the care they need, which can result in healthcare disparities,' said Ani Janzen, operations and project leader at the Association for Size Diversity in Health, one of several organizations that address fat bias in medicine. 'It's an awful Catch-22 because those disparities are then used to enforce the idea that larger people are in worse health than people are in smaller bodies.' Four in 10 adults in the U.S. have a body-mass index or BMI over 30. The Centers for Medicare and Medicaid Services recently estimated that obesity is associated with approximately $385 billion in health spending in 2024. Pamela Mejia, a researcher who conducted a study on fat bias in the media for NAAFA, is familiar with this prejudice. 'I have a doctor who is convinced that everything that happens to me, from a sprained ankle to a migraine, would be helped if I lost weight,' she said. 'Once I fell and bruised myself hiking and the doctors said, 'It would be better if you lose weight.' I just fell off a mountain! Does he think the mountain attacked me because I'm fat?' Nearly every fat activist has similar nightmare stories. Tigress Osborn recalls being pressured to have weight-loss surgery before undergoing a medically necessary hysterectomy. Then there are the smaller but repeated indignities confronted during routine medical visits. The absence of larger chairs in the waiting room. Hospital robes that won't fully cover their naked bodies. Equipment ranging from blood-pressure cuffs to MRI machines that cannot accommodate them. Orthopedic surgeons who refuse to do knee or hip replacements because they believe it will be too complicated or that body weight will compromise recovery. Doctors who immediately assume the reason for any visit is to lose weight and if that's not why they're there, well, it should be. No wonder overweight and obese people avoid or delay healthcare services, a fact backed by multiple studies. Either they are embarrassed by their weight or want to avoid being lectured about it. They put off cancer screenings and other tests, which some believe contribute to higher mortality rates among overweight people. Obesity doctors concede that the medical profession has a long way to go in how it approaches excess weight. Not only are more specialists needed, but doctors across the field need to be better trained. Apovian described an obese man in his 60s who couldn't move his legs, and a doctor had written on his chart, 'Patient didn't want to move his legs.' By the time doctors realized the patient had an abscess blocking his spinal cord, he was paralyzed. In 2022, when leading U.S. organizations dedicated to obesity medicine gathered to discuss treatment and prevention, their consensus statement acknowledged that 'Bias and stigmatization directed at people with obesity contributes to poor health and impairs treatment.' Losses and gains Fat studies, an interdisciplinary field that arose in the 1990s, focuses on what it calls 'weight-based oppression' and those who benefit from it. It criticizes the weight-loss industry for repeatedly selling quick fixes that help perpetuate weight cycling in a drive for profit. Fen-Phen, a 1990s diet drug that was recalled after it was shown to cause life-threatening heart problems, serves as a cautionary tale. Like ethnic studies and queer studies, fat studies was inspired by activism and organized around identity, incorporating aspects of social sciences, the arts and the humanities. In the language of fat studies, to 'fatten' an issue means to examine it through the lens of the fat justice movement. Scholars are now 'fattening' GLP-1s. One fear is an increased pressure to lose weight and a demonization of those who don't, despite the fact that GLP-1s are ineffective in 10-15% of patients. Even when successful, the drugs tend to yield a weight loss of 5% to 20%, which won't transform someone who weighs 350 pounds into a thin person. Much of the work of fat studies scholars focuses on stigma, building on 20th-century sociologist Erving Goffman's pioneering theory that stigmas around 'guilty' traits like obesity result in stronger biases than ones that are 'not your fault,' such as schizophrenia. A general awareness of unconscious biases has grown in recent years, but body size remains an outlier. Research has shown that weight discrimination is nearly as common as race discrimination, and stronger against women than men. 'The most pressing issue to me is how amazingly negative and gratuitous the negative stereotypes are against fat people and all the daily ways in which this bias is made clear,' Esther Rothblum, a professor emerita of psychology at San Diego State University and former editor of Fat Studies, an academic journal, told me. 'People say things about fat people that they would never say about black or elderly or gay people. It's very hard to be a member of any oppressed group in society but when it comes to fatness, people don't even see a problem with their prejudice.' Of course, fat activists, like all identity campaigners, don't speak for everyone they aim to represent. Many overweight people find the movement's preferred word, 'fat,' shaming. Plenty still want to escape what they see as an emotional and medical burden. For Tommy Tomlinson, pictured in 2018, taking GLP-1s has proven 'transformative' in how he views food and weight. Tommy Tomlinson, author of the 2019 memoir 'The Elephant in the Room: One Fat Man's Quest to Get Smaller in a Growing America,' has lost 58 pounds since he began taking GLP-1s last year. For him, the change has been more than physical. 'The constant food noise in my head, always thinking about the next meal, looking up the menu for the place you're going to that night—all that has disappeared,' he told me. 'It's an incredibly transformative thing in my life.' Tomlinson described a conversation he once had with Lee Kaplan, an obesity doctor and pioneer in the field. Kaplan asked Tomlinson if after being on the drugs for a while, he believed there was a chemical component to losing weight. Tomlinson said he did. Could this also mean, Kaplan asked, that something chemical in his body made Tomlinson gain all that weight in the first place? 'I hadn't thought about it in those clear and direct terms before,' Tomlinson recalled. 'It was shattering in a way but also comforting. To be told, 'It's not your fault.'' The fracas over whether a slimmed down Lizzo or Kelly Clarkson has betrayed the body positivity movement may garner more attention, but activists readily acknowledge that these drugs offer real relief to some people. The more important point, they maintain, is that regardless of the successes GLP-1s bring to any one individual, the larger problem of how fatness is handled socially, medically and economically persists. 'My goal isn't to stop people from wanting to lose weight,' Osborn of NAAFA told me. Instead, it's 'to reach more people with the knowledge that you don't have to beat yourself up over being in this body, that we can work toward creating a world where people can live freely in the bodies they are in.' That kind of message, she says, 'offers that same sense of relief—but delivers it to everyone.' Weight-Loss Drugs Have a Surprising Foe: Fat Activists Weight-Loss Drugs Have a Surprising Foe: Fat Activists Weight-Loss Drugs Have a Surprising Foe: Fat Activists
Medscape
24-06-2025
- Health
- Medscape
Combination Treatment Reduces Weight While Keeping Muscle
CHICAGO — Combined use of semaglutide with an investigational monoclonal antibody called bimagrumab produced significant fat mass loss while preserving lean mass, results from the phase 2b BELIEVE study found. Loss of muscle mass is an emerging concern with increasing use of GLP-1 agonists for weight loss as lean body mass is estimated to account for up to 15%-40% of total weight loss from GLP-1 drugs. One potential solution is bimagrumab, which blocks the activin pathways that inhibit growth in skeletal muscle and increases lipid storage in adipose tissue, leading to both increased muscle mass and decreased fat mass. 'We're presenting an entirely new mechanism for managing obesity. We've heard a lot about GLP-1s and their combinations. This is going to be a unique one with bimagrumab, a drug that has completely different mechanism of action,' study investigator Steven B. Heymsfield, MD, professor and director of the Body Composition-Metabolism Laboratory at the Pennington Biomedical Research Center of the Louisiana State University System, Baton Rouge, told Medscape Medical News . Results from the study comparing bimagrumab and semaglutide alone and in combination for treating obesity were presented on June 23, 2025, here at the American Diabetes Association 85th Scientific Sessions. Bimagrumab's effects are complementary to those of GLP-1 drugs and other appetite suppressants, explained co-investigator Louis J. Aronne, MD, professor of metabolic research and director of the Comprehensive Weight Control Center at Weill-Cornell Medical College, New York, at a press briefing. As such, he added, the drug's potential uses include being an adjunct to GLP-1 agonists for obesity induction therapy as an alternative to incretins for people who can't tolerate them or who don't respond adequately, and as a potential preferred maintenance therap. Fat Mass vs Muscle Mass The BELIEVE study was a randomized, double-blind, placebo-controlled, multicenter study in 507 adults with obesity or overweight. Participants were randomized into a total of nine groups: placebo; bimagrumab alone at doses of 10 mg/kg and 30 mg/kg; semaglutide 1.0 mg or 2.4 mg plus placebo; and one of four groups of combined bimagrumab and semaglutide — bimagrumab 10 mg/kg plus semaglutide 1 mg; bimagrumab 30 mg/kg plus semaglutide 1 mg; bimagrumab 10 mg/kg plus semaglutide 2.4 mg; or bimagrumab 30 mg/kg plus semaglutide 2.4 mg. Bimagrumab was given intravenously at weeks 4, 16, 28, and 40; subcutaneous semaglutide was given weekly. The primary treatment period was 48 weeks, followed by an open-label extension to 72 weeks with both the placebo and bimagrumab 10 mg/kg groups switching to bimagrumab 30 mg/kg. Body composition was assessed with DEXA. At week 72, body weight was reduced by 22.1% from baseline in the combined bimagrumab 30 mg/kg plus semaglutide 2.4 mg group (highest of both doses), compared with reductions of 15.7% with semaglutide 2.4 mg alone and 10.8% with bimagrumab 30 mg/kg alone. Loss of fat mass was 45.7% with the high-dose combination vs 27.8% with semaglutide 2.4 mg and 28.5% with bimagrumab 30 mg/kg alone. Lean mass loss was 2.9% with the high-dose combination, compared with a loss of 7.4% with semaglutide 2.4 mg and a gain of 2.5% with bimagrumab 30 mg/kg alone. The percentage of weight loss that was due to fat mass at week 48 was 92.9% for the high-dose combination, 71.5% for semaglutide alone, and 100% for bimagrumab alone. The proportions of participants achieving weight loss of 20% or more were 69.8% with the combination versus 25.0% with semaglutide, and 10.9% with bimagrumab. And, the proportions achieving 30% or greater fat mass reduction were 94.0%, 36.4%, and 50.0%, respectively, Heymsfield reported. Visceral adipose tissue decreased more with bimagrumab alone or in combination compared with semaglutide alone, with parallel changes from baseline in waist circumference. High-sensitivity C-reactive protein, a key inflammatory biomarker, decreased by 83% in the high-dose combination group by week 48, Aronne said. Adiponectin also increased more with bimagrumab alone or in combination compared with semaglutide alone. Both total and LDL cholesterol rose in the bimagrumab groups and then returned to baseline in the combination groups containing semaglutide 2.4 mg by week 72. Baseline LDL was 114.3 mg/dL, rising by about 15%-30% in the bimagrumab groups by 12-24 weeks. The combination groups returned to baseline by 72 weeks, whereas the bimagrumab-only group dropped, but not back to baseline. When asked about that, Aronne said 'We believe that the route of administration might be a reason for that observation. I think we need more research to figure this out.' Increased LDL Cholesterol: Is It a Concern? Asked to comment, Simeon Taylor, MD, PhD, professor of medicine and director of the Institutional Research Training Program in Diabetes & Obesity at the University of Maryland School of Medicine, Baltimore, told Medscape Medical News that the efficacy data were 'amazing,' and that the combination 'delivered unprecedented efficacy as judged by biomarkers, specifically the combination of loss of fat mass plus the increase in lean mass. These changes were accompanied by clinically meaningful improvements in blood pressure and glycemic indices. It will be critical to understand the impact on 'hard' clinical endpoints such as cardiovascular outcomes.' However, Taylor added that the trial raised some safety concerns, particularly an increase in LDL cholesterol that the investigators said was transient, but they didn't present data about what measures might have been used by the individual clinicians in the study to mitigate that rise. 'It will be important for the investigators to clarify how statin doses were managed. If the adverse effects of bimagrumab were transient, that could be a favorable scenario. If the LDL cholesterol returned toward baseline because statin doses were increased, that would have different implications,' he said. Obesity expert Amy E. Rothberg, MD, clinical professor of internal medicine and of nutritional sciences at the University of Michigan, Ann Arbor, agreed, and also cited other missing information, such as muscle quality. 'There were no biopsies done. They were doing DEXA. That tells us about distribution and volume, but it doesn't tell us anything about quality.' Rothberg also noted that the only objective functional measure was hand grip, while the rest were self-administered survey instruments. 'There are a lot of unknowns, but impressive data just the same.' Hard to Predict Safety Concerns Common adverse events with bimagrumab-containing groups included muscle spasms (ranging from 46.4% with 10 mg to 63.6% with the high-dose combination), diarrhea, and acne, while semaglutide was associated with the typical nausea, diarrhea, constipation, and fatigue. Similar events occurred in the four combination groups, in which 9% of those treated discontinued due to adverse events over 72 weeks. There were no deaths. The bimagrumab-containing groups showed early and transient increases in alanine aminotransferase and lipase, while semaglutide-containing groups had sustained increases in lipase. 'The biology of activin receptors is extremely complex. It is hard to predict all of the possible safety concerns. Phase 3 studies and pharmacovigilance will provide better understanding,' Taylor told Medscape Medical News . 'Some potential safety issues only become apparent when large numbers of people have taken the drug for long periods of time, he said, adding that 'obesity drugs are understandably required to have a very 'clean' safety profile.' The BELIEVE phase 2 study was essentially proof-of-concept, said Heymsfield. Semaglutide is a product of Lilly competitor Novo Nordisk. This unusual situation came about because the study was initiated in 2023 by Versanis Bio, which Lilly later acquired. Lilly is now conducting phase 2 trials of bimagrumab with its own GLP-1-based drug tirzepatide, this time co-formulated with bimagrumab in a subcutaneous injection. Heymsfield has a contract with Lilly for clinical trials (institutional support). He has received honoraria for serving on medical advisory boards of Tanita Corporation, Novo Nordisk, Lilly, Regeneron, Abbott, and Medifast. He is on the Data Safety Monitoring Committee for Novo Nordisk. Aronne receives consulting fees from/and serving on advisory boards for Altimmune, Atria, Eli Lilly, Jamieson Wellness, Janssen Pharmaceuticals, Jazz Pharmaceuticals, Juvena Therapeutics, Kallyope, Novartis, Novo Nordisk, Pfizer, Prosciento, Senda Biosciences, Versanis, Veru Pharmaceuticals, and Zealand Pharmaceuticals; receives research funding from AstraZeneca, United Kingdom, Eli Lilly, Janssen Pharmaceuticals, Belgium, and Novo Nordisk, Denmark; having equity interests in ERX Pharmaceuticals, Intellihealth, Jamieson Wellness, Kallyope, Myos Corp, and Veru Pharmaceuticals; and serves on a board of directors for ERX Pharmaceuticals, Intellihealth, and Jamieson Wellness. Taylor has reported receiving payments from the National Institute of Diabetes and Digestive and Kidney Diseases for an inventor's share of a patent covering metreleptin as a treatment for generalized lipodystrophy. He was employed by Eli Lilly in 2000-2002 and Bristol Myers Squibb in 2002-2013.
Toronto Sun
23-06-2025
- Health
- Toronto Sun
Lilly drug saves muscle when added to Wegovy weight-loss shot
The findings offer a potential solution to one of the key problems that's emerged with popular obesity shots Published Jun 23, 2025 • 1 minute read A Wegovy injection pen arranged in Waterbury, Vermont, US, on Monday, April 28, 2025. Photo by Shelby Knowles / Bloomberg Reviews and recommendations are unbiased and products are independently selected. Postmedia may earn an affiliate commission from purchases made through links on this page. Patients who took an experimental drug from Eli Lilly & Co. together with Novo Nordisk A/S's Wegovy maintained muscle while losing weight, offering a potential solution to one of the key problems that's emerged with popular obesity shots. This advertisement has not loaded yet, but your article continues below. THIS CONTENT IS RESERVED FOR SUBSCRIBERS ONLY Subscribe now to read the latest news in your city and across Canada. Unlimited online access to articles from across Canada with one account. Get exclusive access to the Toronto Sun ePaper, an electronic replica of the print edition that you can share, download and comment on. Enjoy insights and behind-the-scenes analysis from our award-winning journalists. Support local journalists and the next generation of journalists. Daily puzzles including the New York Times Crossword. SUBSCRIBE TO UNLOCK MORE ARTICLES Subscribe now to read the latest news in your city and across Canada. Unlimited online access to articles from across Canada with one account. Get exclusive access to the Toronto Sun ePaper, an electronic replica of the print edition that you can share, download and comment on. Enjoy insights and behind-the-scenes analysis from our award-winning journalists. Support local journalists and the next generation of journalists. Daily puzzles including the New York Times Crossword. REGISTER / SIGN IN TO UNLOCK MORE ARTICLES Create an account or sign in to continue with your reading experience. Access articles from across Canada with one account. Share your thoughts and join the conversation in the comments. Enjoy additional articles per month. Get email updates from your favourite authors. THIS ARTICLE IS FREE TO READ REGISTER TO UNLOCK. Create an account or sign in to continue with your reading experience. Access articles from across Canada with one account Share your thoughts and join the conversation in the comments Enjoy additional articles per month Get email updates from your favourite authors Don't have an account? Create Account The closely-watched study showed that patients on Wegovy combined with bimagrumab lost 22.1% of their body weight in 48 weeks, with 92.8% of that coming from the body's fat stores, according to results shared Monday at the American Diabetes Association conference in Chicago. Those on Wegovy alone lost 15.7% of their weight, with 71.8% coming from body fat — indicating more muscle was lost when the experimental drug wasn't included in the regimen. 'This is the result we were hoping for,' said study lead Louis Aronne, a physician who directs the Comprehensive Weight Control Center at Weill Cornell Medicine. The trial was funded by Lilly, which bought bimagrumab for about $2 billion in 2023 from startup Versanis Bio. Lilly is now running additional studies of bimagrumab in combination with its own obesity shot, Zepbound. This advertisement has not loaded yet, but your article continues below. When people drop weight quickly, whether via obesity drugs or bariatric surgery, they tend to lose muscle alongside fat. That's raised concerns, particularly for people over 65, who take weight-loss drugs. It's also made muscle preservation an alluring target for drugmakers like Regeneron Inc. and biotech Veru Inc., which are seeking a foothold in the fast-growing and lucrative obesity market. Additional drug combinations may carry a risk of more side effects though, raising concerns from some doctors. Regeneron recently said that a combination of Wegovy and two other experimental drugs spurred more weight loss, while preserving muscle for patients enrolled in its trial. However, about 28% of patients dropped out of the trial and two patients receiving the drugs died. Regeneron said it 'has not identified a causal association' between the drugs and deaths. Still, Bloomberg Intelligence analysts called the result 'unnerving.' Toronto & GTA Toronto Maple Leafs Sunshine Girls Sunshine Girls MLB
Yahoo
26-05-2025
- Health
- Yahoo
Study directly compares Zepbound and Wegovy for weight-loss results
Weight-loss medications continue to grow in popularity as an anti-obesity tool — but are some more effective than others? The question was explored in a new study published this month in The New England Journal of Medicine. Researchers compared the safety and efficacy of tirzepatide (brand name Zepbound) and semaglutide (brand name Wegovy) in a 72-week clinical trial. Weight-loss Medications May Also Benefit Common Medical Problem, Study Finds The randomized, controlled trial — called SURMOUNT-5 — included 751 people throughout the U.S. and Puerto Rico who had obesity but not type 2 diabetes. "Doctors, insurance companies and patients are always asking, 'Which drug is more effective?'" said Dr. Louis Aronne, director of the Comprehensive Weight Control Center and the Sanford I. Weill Professor of Metabolic Research at Weill Cornell Medicine, in the release. "This study allowed us to do a direct comparison." Read On The Fox News App "The results are consistent with — in fact, almost identical to — what we've seen in trials in which these drugs were evaluated independently," added Aronne, who was a principal investigator in the trial. The study found that tirzepatide achieved greater weight loss, with participants shedding about 50 pounds (20.2% of their body weight). The group taking semaglutide lost an average of 33 pounds or 13.7% of their baseline weight, according to a press release summarizing the study outcome. Overall, 32% of the people taking tirzepatide lost at least 25% of their body weight; semaglutide users lost around 16%. Weight Loss, Diabetes Drugs Can Cause Mood Changes: What To Know About Behavioral Side Effects Tirzepatide users also reported a "greater reduction in waist circumference" than those on semaglutide. The likely reason for tirzepatide's greater effectiveness is that it uses a "dual mechanism of action," according to Aronne. "Whereas semaglutide works by activating receptors for a hormone called glucagon-like peptide 1, or GLP-1, tirzepatide mimics not only GLP-1, but also an additional hormone, glucose-dependent insulinotropic peptide (GIP)," the release stated. "Together, these actions reduce hunger, lower blood-glucose levels and affect fat cell metabolism." Weight-loss Drugs' Impact On Cancer Risk Revealed In New Study Additional trials are actively exploring whether tirzepatide also reduces the risk of heart attack and stroke, a benefit that has been linked to semaglutide. The study was led by an investigator at Weill Cornell Medicine and NewYork-Presbyterian. It was also conducted with the University of Texas McGovern Medical School, the David Geffen School of Medicine at the University of California, Los Angeles, the University College Dublin and Eli Lilly (maker of Zepbound). The participants all received guidance regarding nutrition and exercise. The reported side effects were very similar for the two drugs, with 44% of people experiencing nausea and 25% having abdominal pain. Weight-loss Drugs To Get Surprising Endorsement From Global Health Giant Dr. Ada Londono, M.D., a board-certified obesity and internal medicine primary care physician with PlushCare — a virtual health platform offering primary care, therapy and weight management services — said she was not surprised by the study's findings. "The results are consistent with prior trials, confirming tirzepatide's advantage over semaglutide's single GLP-1 action," Londono, who is based in New York City, told Fox News Digital. Beyond weight loss, semaglutide has also shown potential benefits for cardiovascular health, sleep apnea and kidney disease, she noted. "These findings highlight the need for continued research to understand tirzepatide's broader health impacts," she said. "It's encouraging to see ongoing studies exploring the full potential of GLP-1 medications beyond weight management." Londono said these treatments can come with side effects. Semaglutide Found To Have Shocking Benefit For Liver Disease Patients In New Study "Most people on these medications only report mild symptoms, but some have experienced more serious reactions, such as pancreatitis," she told Fox News Digital. "This underscores the importance of reviewing your medical history and discussing any concerns with your healthcare provider." The study did have some limitations — chiefly that it was not a blinded analysis and participants knew which medication they were receiving. This could introduce some level of bias, the researchers acknowledged. Londono pointed out that while the study's findings are "promising," it was funded by Eli Lilly, the manufacturer of Zepbound. "This may raise questions about potential conflicts of interest," she said. "Additionally, the open-label design and 72-week duration may limit objectivity and long-term insight." While the study primarily looked at the impact of the medications, experts agreed there are other factors that play a role in successful weight management. "Weight loss is biological, but it's also emotional, and whole-person support can make the difference between short-term results and sustainable health," Dr. Rekha Kumar, chief medical officer at the weight care program Found and a practicing endocrinologist in New York City, told Fox News Digital. Kumar emphasized the importance of working with a physician to choose a weight-loss medication that matches the patient's personal goals and health status. "For example, if a patient has fatty liver, we will choose the GLP-1 that is proven to work best for liver disease," she said. Looking ahead, the researchers plan to investigate new versions of weight-loss drugs, including retatrutide, which mimics the hormones GLP-1, GIP and glucagon, according to the release. Click Here To Sign Up For Our Health Newsletter "Even though drugs like tirzepatide and semaglutide work really well, better than anything we have ever seen, we still have people who don't respond to them," said Aronne. "So, moving forward, we want to keep trying to do better." A spokesperson from Novo Nordisk, the company that makes Wegovy (semaglutide), sent a statement to Fox News Digital. "Across the respective clinical trial programs and in SURMOUNT-5, both Wegovy and Zepbound have demonstrated clinically significant weight reduction," the company said. "It is important to recognize that the comprehensive management of obesity goes beyond weight reduction alone." For more Health articles, visit The spokesperson also pointed out that in a previous trial, adults who were obese or overweight and who took Wegovy along with diet and exercise lost an average of 15.2% of their weight (~35 pounds) at the two-year mark, compared with 2.6% (~6 pounds) for patients taking a article source: Study directly compares Zepbound and Wegovy for weight-loss results
