Study is a ‘big statement’ for obese people
Niagara doctor hopes the drug Semaglutide will be available in Canada by the end of the year
A Niagara-based doctor says results from an international study he was a part of could be a “game changer” for people struggling to manage their weight.
The study, published in the New England Journal of Medicine this month, found a medication commonly prescribed for diabetics dealing with elevated weight is also effective for non-diabetic people.
“It’s really big news. This is a game-changer for a lot of reasons … it really says that obesity is a biological disease that can be treated,” said Dr. Sean Wharton, medical director at the Wharton Medical Clinic.
He called it a “big statement” that shows “there are effective medications for this patient population that has been struggling for a long, long time.”
Wharton’s clinic has an office in St. Catharines, as well as in Stoney Creek, Burlington and Toronto.
He and the other specialists there treat people with Type 2 diabetes or who are struggling with elevated weight management issues and have a body mass index higher than 27 (30 or more is considered obese).
The drug, called Semaglutide, has been prescribed for several years to help diabetics manage their weight. However, it is not approved in Canada yet for non-diabetics.
Wharton said manufacturer Novo Nordisk is applying to Health Canada, and he hopes to be able to prescribe it for his non-diabetic patients by the end of the year.
There are a small number of medications approved for those patients but, “from what we have seen, it does appear that this medication is much more effective than what we currently have on the market,” said Wharton.
Semaglutide mimics GLP-1, the hormone that, after you’ve eaten, tells your pancreas to produce insulin. That allows energy from the food to be stored for future use and signals to the brain you’ve just eaten.
Wharton said people with diabetes, and in some cases nondiabetics with elevated weight, don’t naturally produce enough insulin, which leads to elevated blood sugar levels and sometimes overeating.
“So what this medication is, it’s a boost,” he said. “A supplement of that GLP-1 hormone.”
Wharton was the Canadian member of the two-year study that also included doctors and researchers from the U.S., U.K., Israel and Italy.
There were 1,961 participants, including some Canadians, each of whom were non-diabetic and had a body mass index higher than 30.
Some received a weekly Semaglutide injection, the others got a placebo over 68 weeks. All of them underwent lifestyle intervention to improve their fitness and nutrition levels.
The study found those who received Semaglutide saw an average weight loss of 15.3 kilograms (33.6 pounds), while the placebo crowd lost 2.6 kilograms (5.7 pounds).
The ones on Semaglutide also saw greater improvement in their cardiometabolic risk factors, such as hypertension.
Side-effects, he said, include nausea and stomach upset, which are generally “quite tolerable” if it starts with a low dosage.
Wharton said it’s important to know that, for people struggling with elevated weight, the answer is never as simple as going on a diet.
“That needs to be very, very clear,” he said. “It’s not that eating extra calories causes obesity, it’s that obesity — which is a biological disease — causes you to eat extra calories.”
There are a wide variety of causes, including metabolic and genetic, and cultural or behavioural factors that have to be treated.
Medical and surgical intervention — bariatric bypass, changing the position of the stomach and small intestines — can be part of the treatment.
“Eventually, I think that we will have medications that come close to, and even surpass, the effect that we see with bariatric surgery,” said Wharton.
“This medication is coming closer to it. It doesn’t quite hit the magnitude of weight loss with surgery,” but it is another step along the way.