Can a pill cure obesity? That’s exactly what a new drug developed by the pharmaceutical company, Eli Lilly, seems to be doing. The once-a-week medicine, called Tirzepatide, reduces food intake and increases energy expenditure, leading to up to 24 kg weight loss after a year.
Although experts say that the findings are amazing and may lead to a reduction in the rates of bariatric surgery – weight loss surgeries that modify the digestive tract to allow lower intake of calories – it is not a magic pill. It is not meant for shedding the few extra kilos that you have been working on for years.
Not an OTC pill
“It is not an over-the-counter pill that you can pop. It is not meant for the general population. It is only meant for people with conditions such as obesity, diabetes, hypertension, cardiovascular disease, dyslipidaemia etc,” said Dr (Prof) Surendra Kumar, advisor in the department of endocrinology and metabolism at Sir Ganga Ram Hospital.
Subscriber Only Stories
The study span and results
The trial conducted by the company is yet to be published in a peer-reviewed journal but included 2,539 people across nine countries. One-fourth of the trial participants received a placebo (a compound with no therapeutic agent), with the three other groups receiving 5mg, 10mg, and 15mg of the medicine. After 72 weeks of treatment, the study found that participants lost 16 per cent or an average 16 kg of weight with 5mg, 21.4 per cent or 22kg of weight with 10 mg, and 22.5 per cent or 24 kg of weight with 15 mg of the medicine.
Almost 96 per cent of the people on the two higher doses of the medicine achieved at least five per cent reduction in their body weight as compared to only 28 per cent people in the group that received the placebo, according to results of the study released by Eli Lilly. If the 20 per cent body weight reduction mark was looked at, 55 per cent of those on 10 mg of the drug and 63 per cent of those on 15 mg of the drug were able to achieve it as compared to 1.3 per cent of the people in the placebo group. At baseline, the people enrolled for the study weighed 105 kg but weren’t diabetics.
A person is considered to be obese when their body mass index – a ratio of weight to height – is 30 or more. Those with a BMI of 25 to 30 are considered to be over-weight, with 18.5 to 25 being the normal range.
Patients who were pre-diabetic at the beginning of the study will be followed up for two more years on treatment to see whether the reduction in the weight impacted their progress in Type-2 diabetes after three years of treatment. Type-2 diabetes is a condition where the body either produces less or resists insulin, which is needed for controlling blood sugar levels. Obesity is linked to a higher risk of Type-2 diabetes.
“This is essentially a diabetes drug and there are a number of drugs of similar class available for the last 10 years. Some of these drugs were also used for weight-loss in Western countries. But this one leads to nearly 15 per cent loss in weight, which is very, very high. This level hasn’t been seen with the other drugs,” said Dr Anoop Misra, executive chairman and director, diabetes and endocrinology, Fortis C-DOC Hospital.
“The drug works by decreasing appetite, altering some hormones, slowing the intestinal movement. It does four to five things. This is just a smidge less effective than bariatric surgery now. Some people are saying that rates of bariatric surgery will go down once this drug becomes available,” he added.
Watch out for checks in India?
However, he added some caveats.
“This drug is not available in India at present. Whenever it becomes available, it is likely to be very expensive. And, it will not be completely without side effects. More importantly, we have to wait and see whether the drug gets approved for diabetes or obesity in India – It is likely to be approved for diabetes first. Having said that, it is a very promising drug,” said Misra. India is known as the diabetes capital, with an estimated 77 million living with the condition in the country.