Revealed: The Key Factors For Weight Loss On New Blockbuster Drugs, First Hard ‘Real-World Data’ & The Advantage of Being a Woman

Semaglutide vs. Liraglutide

• A new study published in JAMA Network has offered some more insight into Nova Nordisk’s semaglutide and another injectable medicine called liraglutide and the factors linked to weight loss.
• The study found that the following factors were linked the increased odds of having 10 percent or more weight reduction one year after starting the blockbuster medications: patients who took semaglutide, a higher maintenance dose, those treating obesity, who took the medication for longer, who had a higher BMI initially, and females.
• Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
• An article published in the National Library of Medicine explains that Liraglutide is the first once-daily GLP-1 receptor agonist, “an analog with 97% percent homology to human glucagon-like peptide (GLP-1) and acts as a GLP-1 receptor agonist.”
• If you’re considering taking a weight loss drug, talk with your care team about whether that’s a good option for you. And make sure you consider good diet and exercise practices as a part of your treatment plan.

A new piece of published research examining one-year weight reduction with Nova Nordisk’s semaglutide—sold under brand names Ozempic, Weygovy, and Rybelsu—and another injectable medicine called liraglutide—sold under brand names Saxenda and Victoza—in clinical practice, is providing insight into the factors associated with weight loss. The cohort study published in JAMA Network included 3,389 adult patients with obesity who began treatment with semaglutide or liraglutide, both injectable medications, between July 1, 2015, and June 30, 2022. Among the patients, the mean percentage of body weight change from baseline to one year was -5.1 percent for semaglutide compared to −2.2 percent for liraglutide treatment, the study authors found. RELATED: Weight Loss Revolution: Incredible New Drugs Could Lead to Reduction in Cancer Incidence, Some Doctors Predict "Factors positively associated with achieving at least 10% weight reduction at year 1 included semaglutide (vs liraglutide), obesity as a treatment indication (vs type 2 diabetes), persistent medication coverage, high dosage, and female sex," the study's findings state. Upon the new research being published, Hamlet Gasoyan, Ph.D., lead author of the study and a researcher with Cleveland Clinic's Center for Value-Based Care Research, explained, "In patients with obesity who were prescribed semaglutide or liraglutide, we found that long-term weight reduction varied significantly based on the medication's active agent, treatment indication, dosage and persistence with the medication." He later added, "Our findings could help inform patients and providers regarding some of the key factors that are associated with the probability of achieving sustained weight loss of a magnitude large enough to provide clinically significant health benefits. "Having real-world data could help manage expectations regarding weight reduction with GLP-1 RA medications and reinforce that persistence is key to achieve meaningful results."

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When the study began, the average baseline body mass index (BMI) among participants, 1,718 who were on semaglutide and 1,671 on liraglutide, was found to be 38.5. Additionally, a total of 1,853 patients (54.7 percent) were female and 1,536 (45.3 percent) were male, and 2,785 (82.2 percent) had T2D [Type 2 Diabetes] as a why they were being treated. "In terms of race and ethnicity, 689 patients (20.3 percent) were Black, 237 (7.0 percent) were Hispanic, 2,320 (68.5 percent) were White, and 116 (3.4%) were of other race or ethnicity," the study authors explain in the published research. "Most patients were privately insured (2,202 [65.0percent]), 631 (18.6%) had Medicare, and 468 (13.8%) had Medicaid as a primary payer; and 958 (28.3%) resided in an area in the most disadvantaged quartile of the ADI." Overall, the study found that the following factors were linked the increased odds of having 10 percent or more weight reduction one year after starting the blockbuster medications:

• patient who took semaglutide
• a higher maintenance dose
• who were treating obesity
• patients who took the medication for longer, between 90 and 275 days vs. those who took it for less than 90 days
• a higher BMI at the start of taking the medication
• females were more likely to lose weight over males.

How Does Semaglutide Work?

Integral to blood sugar control, GLP-1 is a hormone released by the gut in response to food. It causes the pancreas to release insulin. A rising blood insulin level causes all the body tissues to start absorbing glucose (blood sugar) from the bloodstream, thereby lowering blood glucose levels. GLP-1 also prevents the release of glucagon, which is a hormone that raises blood sugar levels by stimulating liver cells to release glucose and helps people feel full for longer. These effects can also cause people to lose weight. Modern studies on GLP-1 have shown that it has a role beyond glucose control. It modulates the immune system cells, including NK cells, in a way necessary for weight loss. Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body . Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients. Although semaglutide has been approved for blood sugar control in people with type II diabetes, under the brand name Ozempic, and for weight loss under the brand name Wegovy, it has not been approved for use as an immune booster and cancer preventative. Thus, it should not be prescribed for that purpose. Those taking it to control their diabetes or weight, however, can expect the additional benefit of improving their immunity. as per a recent study, and lowering their cancer risk, as a link between weight and cancer does exist.

How Does Liraglutide Work?

According to MedlinePlus , "Liraglutide injection (Victoza) is used with a diet and exercise program to control blood sugar levels in adults and children 10 years of age and older with type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) when other medications did not control levels well enough. "Liraglutide injection (Victoza) is also used to reduce the risk of a heart attack, stroke, or death in adults with type 2 diabetes mellitus and heart and blood vessel disease." MedlinePlus explains how the Liraglutide injection is among a class of medications known as incretin mimetics, which work by "helping the pancreas to release the right amount of insulin when blood sugar levels are high," adding, "Insulin helps move sugar from the blood into other body tissues where it is used for energy. Liraglutide injection also slows the emptying of the stomach and may decrease appetite and cause weight loss." An article published in the National Library of Medicine also points out that Liraglutide is the first once-daily GLP-1 receptor agonist, "an analog with 97% percent homology to human glucagon-like peptide (GLP-1) and acts as a GLP-1 receptor agonist."

Obesity & Cancer Risk

It's important to understand that obesity increases an individual’s risk of developing a range of dangerous health conditions, including several types of cancer. In addition to increasing the likelihood of developing certain cancers, obesity is associated with worse treatment outcomes. In a previous interview with SurvivorNet, Dr. Stephen Freedland of Cedars Sinai Medical Center said, “Some of the best data we have is that obesity increases the risk of not just getting prostate cancer, but actually dying from prostate cancer. Obese men are 35 percent more likely to die from prostate cancer.” Sugar, The Western Diet And Cancer Prevention While obesity or a person’s high weight will not always cause them to develop cancer, other conditions associated obesity, like diabetes and heart disease, can lead to complications from cancer treatment if a person already has cancer. In addition, these conditions can sometimes prevent patients from receiving the recommended first-line therapies, as well as increase a patient’s risk of undergoing surgery. Dr. Andrea Tufano-Sugarman of NYU Langone Health explained to SurvivorNet the benefits of losing weight. “While all cancers cannot be prevented,” she said, “losing weight is a great way to reduce one’s risk.” Dr. Tufano-Sugarman said that this is especially true for women; they lower their risk of developing breast cancer and endometrial cancer when they lose weight and keep it of. Even without losing weight, adopting a more nutritious diet can help. "Food choices, independent of weight loss, may also help to reduce risk,” Dr. Tufano-Sugarman said. "Research has shown that the Mediterranean diet (rich in fruits, vegetables, nuts and legumes, fish and olive oil) is associated with a decreased risk of cancer. Whereas diets rich in red meat may be associated with an increased risk of colorectal and prostate cancer." How Can Diet Affect My Cancer Risk? Contributing: SurvivorNet Staff