• WHO warns that obesity has reached "epidemic proportions" in Europe
  • Obesity "Only with drugs, which are not financed by the SNS, we will not be able to eliminate it"

One of the fashionable compounds used to lose weight has shown clinical utility in several aspects beyond the simple fact of 'subtracting' those extra kilos. Semaglutide, the drug that regulates blood sugar and insulin, better known as Ozempic, has been the subject of analysis at the European Congress on Obesity.

Although its properties have gone from mouth to mouth (today from reel to reel on social networks), doctors have analyzed its effect through data from a Step Teens clinical trial. From it, they have drawn two important conclusions: almost half of the adolescents who used semaglutide reached normal weight or overweight and the use of the drug shows that liver damage derived from obesity can be reduced.

From the medical community extreme care is taken to trivialize the messages about the effect of those extra kilos, since with the passage of time they become disease. Almost 60% of adults and one in three children are overweight, according to the World Health Organization (WHO). "The situation is really worrying in children," said Julianne Williams, one of the co-authors of the latest WHO report. Obesity in childhood and adolescence is associated with obesity-related complications, including an increased risk of cardiovascular disease, dyslipidemia, type 2 diabetes, nonalcoholic fatty liver disease, and obstructive sleep apnea, as well as impaired quality of life.

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Apothecary Garcia.

Saxenda and Ozempic: drugs for weight loss, science without miracles

  • Writing: BOTICARIA GARCÍA

Saxenda and Ozempic: drugs for weight loss, science without miracles

The data of the efficacy to reduce the overweight of the young people of 12 to 18 years involved in the study have seen the light in Obesity, although the general data of the Step Teens trial already saw the light last year in The New England Journal of Medicine. Now, in a new secondary analysis, Aaron S. Kelly, co-director of the University of Minnesota's Center for Pediatric Obesity Medicine, points to the effects of treatment on improving body mass index (BMI) categories: Nearly three-quarters (74%) dropped at least one weight category.

Adolescents (201) with a mean weight of 107.5 kg, with cases of obesity to severe obesity, were included in this analysis. Participants randomly received once-weekly subcutaneous semaglutide 2.4 mg (n=134) or placebo (n=67) for 68 weeks. Both groups received lifestyle counseling during that time: healthy nutrition guidelines and a goal of 60 minutes of moderate- to high-intensity physical activity a day.

By the end of the trial, 74% of participants treated with Ozempic had dropped at least one rung on the obesity scale, compared to 19% treated with placebo. "This shows that nutrition and exercise intervention alone is much more expensive to treat obesity at these stages," the researchers said in the study. In addition, 45% of the participants fell two places on the scale. Overall, semaglutide treatment reduced the proportion of participants with the most severe degree of obesity from 37% to 14% after more than one year on treatment.

"The findings support the early use of the drug in the treatment of obesity in adolescents and demonstrate its potential to improve and reduce BMI." Another point that the authors point out is that, although it was not the object of analysis, they found better results in the female collective. "To certify this, more data is needed."

Currently, the lines of approach to address obesity in children are interventions through diet and physical exercise. Pharmacotherapy options are quite limited. Until recently, the FDA in the US had approved only four drugs for weight control in adolescents: liraglutide, orlistat, phentermine/topiramate extended-release capsules (all for those over 12 years of age) and short-term phentermine (for those over 16 years of age) and only one (liraglutide) is approved by the European Medicines Agency (EMA).

Ozempic reduces liver damage

Conclusions have also been drawn from the same trial about the impact on the liver. This sub-analysis was conducted by Daniel Weghuber, from the Department of Pediatrics at the Paracelsus Medical University of Salzburg (Austria).

It should be borne in mind that increased body weight and BMI is associated with a higher incidence of non-alcoholic fatty liver disease (NAFLD) and its advanced forms, such as steatohepatitis, which can lead to liver failure. Weight loss can improve liver parameters such as alanine aminotransferase (ALT) enzyme levels in patients with these pathologies.

Measurements of this enzyme are considered the first step in NAFLD screening in children at risk. Consistently high levels lead to increased clinical testing for these diseases, while low rates indicate improvement in the underlying cause of liver damage.

In this regard, the authors conclude that "in the Step Teens trial, treatment with semaglutide was associated with a significant reduction in levels of the liver enzyme alanine aminotransferase compared to placebo."

Weghuber adds that "fatty liver disease is the most common liver disease in adolescents without any pharmacological treatment currently available. The results of this work are encouraging and will inform studies specifically designed to test semaglutide in adolescents with NAFLD."

  • Health
  • Obesity

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