• How a Diabetes Medication Became a Weight Loss Medication

    by Scott Isaacs, MD
    on Jul 16th, 2018

Liraglutide Injection (Saxenda) is the newest weight loss medication on the market today. But this “new” medication has an old history. Liraglutide has been sold under the name Victoza for the treatment of type 2 diabetes for many years. Liraglutide is a synthetic version of the hormone glucagon-like peptide-1 (GLP-1). GLP-1 works for diabetes by enabling the body to produce a burst on insulin whenever you eat a meal. Native GLP-1 has a very short life in the bloodstream as it is degraded by enzymes within minutes. Liraglutide has been chemically modified to resist this enzymatic degradation increasing its time in the blood to several hours.

There are several other GLP-1 medications that are similar to liraglutide:

Early on, researchers noticed that GLP-1 medications did more than just control high blood sugar. Patients who took GLP-1 medications also lost weight. And it appeared that the weight loss effect of GLP-1 medications was happening through a different mechanism than blood sugar control.

It turns out that there are receptors for the hormone GLP-1 in the appetite center in the brain. Stimulating this receptor with natural GLP-1 or with any of these synthetic hormones sets forth a cascade of brain chemicals that shuts off appetite and makes you feel full.

People who take Saxenda lose on average lose 10-15% of their body weight in about 6 months. And continuing the medication prevents weight regain which can occur if the medication is stopped. Saxenda is approved for chronic use which makes sense because obesity is a chronic disease that needs to be treated long-term. Short term treatment of obesity tends to give temporary results and makes people very frustrated when the weight is regained.

The most common side effects of Saxenda are nausea, vomiting, abdominal pain, diarrhea and constipation. This medication is given by self-administered daily injection. Because it is a peptide hormone, it cannot be given as a pill because it would be digested in the stomach. However, an oral version using new technologies is in development. A once-a-year version is also in development.

You will see warnings about a rare side effect of pancreatitis and there is a warning about the risk for medullary thyroid cancer. This is a very rare form of thyroid cancer that was seen in mice and rats during the trials and is a class warning on all of these medications. So if you have a personal history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (a genetic syndrome that includes medullary thyroid cancer) you should not take GLP-1 medications. These do not raise the risk for other more common types of thyroid cancer.

In my experience, Saxenda and other GLP-1 medications can be very helpful for weight loss. I have found this class of medications especially helpful for people with insulin resistance, diabetes or prediabetes. It is also a useful medication for people who binge eat or those who just never seem to get full. But it can be helpful for anyone with obesity or overweight with medical conditions caused by excess weight.

If you’d like to learn more about anti-obesity medications, please feel free to call us or schedule an appointment with Dr. Isaacs using the online booking tool on this website.

Author Scott Isaacs, MD Endocrinologist and Weight Loss Specialist

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