Scientists conclude that drugs like Ozempic should be "the first option" against obesity.

BarcelonaDrugs such as Ozempic and Wegovy, which mimic a hormone that regulates blood glucose levels, generate a feeling of satiety, and are used for diabetes and obesity, have become one of the most effective tools to aid in weight loss. Now, the European Association for the Study of Obesity (EASO) has gone a step further, analyzing in a study the different therapeutic alternatives available to people with obesity and concluding that these drugs should be the main treatment for most patients. The success of these drugs, in fact, has long since boosted demand and has led to episodes of Supply problems in Catalan pharmacies.

"Although there are several options on the market, the reality is that semaglutide and tirzepatide are so effective that they should be the first option in almost all cases," says Andreea Ciudin, an endocrinologist at the Vall d'Hebron Hospital in Barcelona and co-lead author of the study published Nature Medicine. Originally, both semaglutide and tirzepatide were marketed to treat diabetes. The recent discovery is that both active ingredients also cause the patient to lose their appetite and, therefore, help with weight loss.

To conclude that this should be a priority treatment in most cases of obesity, EASO professionals have reviewed the scientific evidence published to date on the effects of different medications that help with weight loss and minimize the complications associated with obesity and have designed an algorithm to guide them. The tool takes into account the patient's medical history and searches for the drug that best suits their needs.

It should be noted that the number of medications available to treat obesity and its complications has increased in recent years, and experts predict that it will continue to grow. This range of possibilities opens the door to personalized therapies based on each patient's individual characteristics, so the study's authors saw the need for a tool to help professionals choose the best option for each case, taking into account the patient's characteristics. To develop the algorithm, they considered whether the person has complications associated with obesity, such as diabetes, cardiovascular disease, heart failure, or liver disease, among others.

The high "cost" of not treating obesity

"It is the first framework guided by the presence or absence of obesity-related complications, as weight loss is not the sole goal of treatment when complications exist," highlights researcher Barbara McGowan of Guys & St. Thomas's NHS Foundation Trust in the UK. Ciudin emphasizes that the algorithm can never replace the "clinical judgment" of professionals, as the tool is designed to assist them in decision-making.

Thus, the authors conclude that tirzepatide and semaglutide should be considered as the first drugs to consider for substantial weight loss, but emphasize that if the weight loss goal is lower and there are no additional complications, other drugs may be considered. They also noted the drug's high price, but also warn that the "cost of not treating obesity" is very high, with the risk of progressing to the aforementioned complications and permanently damaging vital organs.

These medications are expensive and have limited coverage, making them inaccessible to everyone. The healthcare system only funds drugs containing semaglutide, which often face supply problems in pharmacies, and does not cover treatment with tirzepatide, forcing patients to bear the entire cost. According to data from the 2023 Catalan Health Survey (ESCA), approximately half of the adult population aged 18 to 74 is overweight: 34.7% are overweight and 15.3% are obese, and these figures are expected to increase in the coming years.