The new class of obesity drugs, such as Wegovy and Zepbound, have surely sparked a revolution in the world of weight loss medicine. These GLP-1s are so potent that they often pave the way for an astonishing 20 percent weight loss, a feat that’s led to considerable anticipation about their larger adoption. Major companies such as Nestlé and Conagra are even contemplating fine-tuning their products to cater to GLP-1 users.
Yet, amidst this optimism, there’s a widespread assumption that these drugs work for everyone, an idea that’s unfortunately far from the truth. Several people have found these drugs less than effective. For instance, Anita from Arizona and Kathryn from Florida started GLP-1s expecting to lose weight but were disappointed by the absence of results. Therefore, aside from mild or severe side effects that some people experience, another key issue is the lack of response.
It’s unclear why these drugs don’t work as expected for some patients, with about a third possibly falling in this category. This unpredictability adds a layer of complexity to an otherwise promising solution. There are patients who tolerate the drugs well but either have a weaker response or no response at all. This inexplicable difference in the effects of the same drug, regardless of dosage, on different people remains a mystery.
There are various theories to explain this selectiveness, one being genetics. The drugs function by posing as the hormone GLP-1 that suppresses appetite, but genetic variation can cause inconsistencies in their functionality. Someone’s genetic makeup might alter how they metabolize these drugs, influencing their effectiveness.
Moreover, GLP-1s target a particular pathway that regulates appetite. If a patient’s weight gain isn’t driven by disruption in this pathway, the drugs might not work well. Different individuals may need different drugs that target the specific driver of their obesity.
Nevertheless, for those who either experience side effects or don’t respond to GLP-1s, there are alternative treatment options. These include older drugs, bariatric surgery, or switching between GLP-1s. For example, a drug called Qysmia can result in about a 14 percent weight loss. Meanwhile, despite the GLP-1 boom, bariatric surgeries are on the rise.
As we remember that these are early days in the development of obesity drugs, it shouldn’t be surprising that these drugs don’t work for everyone. They’re part of a field of medicine experiencing explosive growth, with more than 90 new drug candidates being tested.
The future holds considerable promise. As the understanding of obesity and its causes matures and expands, more treatment options are expected to become available. However, given the complexity of obesity, it seems unlikely that a silver-bullet, one-size-fits-all treatment will emerge. Similar to how there are over 200 drugs for high blood pressure, weight regulation is likely to require a broad variety of treatment options.
