The weather is warmer, and the ladies who love beauty have put weight loss on the agenda, but exercise has suffered legs, dieting and holding their mouths. While rotten, falling off the scale has become the ultimate dream of many weight loss people, "one injection a week, ×× pounds a month" hypoglycemic drug simeglutide is regarded as a magic lamp on the bumpy road to weight loss. However, can hypoglycemic drugs really lose weight? Can people who don't have blood sugar problems use it? Let's listen to what Zeng Tianshu, chief physician of endocrinology expert at Wuhan Union Medical College Hospital, said.

Type 2 diabetes medications

It became a star drug for weight loss

In recent years, managing weight well is not only a demand for beauty lovers, but also the key to preventing obesity-related chronic diseases. For people who already suffer from chronic diseases related to obesity, weight loss is even more imminent. While everyone understands that a good diet, exercise habits and a regular lifestyle are the most important foundations for maintaining good health, it can be very difficult to actually do. In this case, more people often hope that there is a miracle drug that can easily solve the problem of obesity once and for all.

In recent years, there is a class of drugs in the field of weight loss "popular", that is, glucagon-like peptide-1 (GLP-1) drugs, especially the drug called semeglutide has set off a weight loss boom in the past year, many beauty lovers are flocking to it, and even medical beauty bloggers have also contributed to the wave. But the question is, so far the instructions of GLP-1 drugs in China only state that this class of drugs are used for the treatment of type 2 diabetes, how does it achieve weight loss?

GLP-1 is a kind of "incretin" naturally secreted by the body, which can bind to receptors on pancreatic islet cells and stimulate insulin secretion, thereby lowering blood sugar, while reducing food intake and delaying gastric emptying by acting on the central appetite system. Simply put, it makes people feel full, suppresses the desire to eat, and naturally achieves the effect of weight loss.

In fact, there are a variety of hypoglycemic drugs that have a certain weight loss effect, such as metformin. However, from the perspective of drug regulation, certain conditions must be met to write the indications for weight loss on the drug label. By the end of 2022, the US Food and Drug Administration (FDA) approved 6 weight loss drugs, namely lorcaserin, phentermine-topiramate combination preparation, naltrexone-bupropion combination preparation, and orlistat, liraglutide, and semeglutide.

The first three drugs mainly act on the central nervous system to suppress the appetite of patients, so as to achieve the effect of drug dieting and weight loss, but the relative side effects are large. Orlistat acts on the digestive tract to inhibit fat absorption, the effect is relatively weak, and it is easy to cause diarrhea and other digestive tract reactions to cause inconvenience to patients. Liraglutide and semeglutide are well-known drugs for type 2 diabetes.

Can it be used without blood sugar problems?

China's drug regulatory authorities have not approved!

A 2020 study of adolescent obesity published in the New England Journal of Medicine expanded the drug's application for weight loss. These findings have led to the approval of liraglutide by drug regulatory agencies in several countries or regions for the treatment of long-term weight loss treatment in obese adults and adolescents. As a follow-up to liraglutide, the GLP-1 weekly preparation semeglutide has achieved weight loss effect superior to liraglutide in non-diabetic adult obese patients, and only needs to be injected once a week.

However, so far, China's drug regulatory authorities have not approved the indications for weight loss of the above drugs in mainland China. In the first drug label catalogue (2022 edition) issued by the Guangdong Pharmaceutical Association, it is clearly pointed out: "Liraglutide is used to treat patients with BMI> 25kg/㎡ and at least one obesity complication; Or simple obese patients with BMI > 30kg/㎡. "Semeglutide" is used for the treatment of patients with BMI> 27kg/㎡ and at least one obesity complication; or simple obese patients with BMIs >30kg/㎡".

The obesity complications mentioned here mainly refer to cardiometabolic complications, including diabetes, hypertension, dyslipidemia, sleep apnea syndrome, or a history of atherosclerotic diseases. According to this principle, doctors need the patient's fully informed consent when using it for weight loss treatment in non-diabetic obese patients.

Scratch the point!

These 7 groups of people do not try

2. Patients who have suffered from medullary thyroid cancer or type <> multiple endocrine tumor syndrome are banned;

2. Patients with a history of pancreatitis are banned;

3. Patients with pre-existing diabetic retinopathy are banned;

4. Women who are pregnant and lactating are banned, and those who plan to become pregnant should stop taking the drug in the first two months;

5. Those who are allergic to this drug are banned;

6. Patients with renal insufficiency should be used with caution;

7. Patients with hypoglycemia should be used with caution.

Common adverse effects of semeglutide include nausea, vomiting, diarrhea, constipation, and dyspepsia.

Phase 3 clinical data showed that nausea occurred in 0.5% and 1.17% of patients in the 0.19 mg and 9 mg groups, diarrhea in 12.2% and 13.3% of patients, and vomiting in 6.4% and 8.4% of patients, respectively. Most events were mild to moderate in severity and of short duration, with a median duration of 2 to 3 days. 3.9% and 5% of patients, respectively, discontinued due to adverse events. After stopping the use of the drug, if you cannot ensure a healthy lifestyle, you will regain some weight.

Therefore, semeglutide injection is not available to everyone, do not blindly follow the trend, if you need to use, you need to follow the doctor's advice.