Team Metabolic Health

Biopharmaceutical companies Apellis and Sobi announced positive topline results from the phase 3 VALIANT study. VALIANT investigated the use of systemic pegcetacoplan in patients with C3 glomerulopathy (C3G) or primary immune complex membranoproliferative glomerulonephritis (IC-MPGN), rare and debilitating kidney diseases that can lead to kidney failure and have no approved treatments. Apellis and Sobi are codevelopers of systemic pegcetacoplan.

VALIANT was led by Carla Nester, MD, MSA, FASN. Participants comprised 124 patients aged 12 years or older with C3G and IC-MPGN. The study met its primary end point, demonstrating that treatment with pegcetacoplan resulted in a statistically significant and clinically meaningful 68% (P<.0001) reduction in proteinuria (log-transformed ratio of urine protein-to-creatinine ratio) compared with placebo at 26 weeks. Pegcetacoplan also demonstrated statistical significance on the key secondary end points of composite renal end point (a combination of proteinuria reduction and estimated glomerular filtration rate stabilization) and proteinuria reduction of at least 50% compared with baseline.

Pegcetacoplan is a targeted C3 therapy designed to regulate excessive activation of the complement cascade, a part of the body’s immune system, which can lead to the onset and progression of many serious diseases. Pegcetacoplan is approved in the United States and several other countries for the treatment of paroxysmal nocturnal hemoglobinuria.

Detailed data from VALIANT will be presented at an upcoming medical congress. All patients who completed the VALIANT study are now enrolled in the VALE long-term extension study.

Apellis, which has exclusive US commercialization rights for systemic pegcetacoplan, plans to submit a supplemental new drug application to the US Food and Drug Administration in early 2025. Meanwhile, Sobi, which has exclusive commercialization rights outside of the United States, will file a marketing application with the European Medicines Agency in 2025.

Credit: docwirenews

Team Metabolic Health

Hypertension or high blood pressure is known as the “silent killer” because despite being one of the most common fatal conditions worldwide, most people are unaware they have the condition because it presents with very few or no symptoms.

Diagnosis is therefore often not made until the disease has progressed enough to cause symptoms, at which stage it often has life threatening outcomes such as stroke. Because of the lack of specific symptoms, adults should have their blood pressure measured every five years.

Blood pressure

Blood pressure is the pressure exerted against the walls of blood vessels as the heart pumps blood through them. An increased blood pressure means too much strain is being placed on the artery walls which can lead to complications such as a stroke, kidney damage or heart attack.

Blood pressure is measured in millimetres of mercury (mm Hg) using an instrument called a sphygmomanometer. There are two numerical figures of blood pressure – the systolic pressure and the diastolic pressure. The systolic pressure is the higher figure and indicates the pressure of the blood when the heart beats.

Diastolic pressure is the lower figure and indicates the pressure of the blood when the heart rests between two beats. A normal blood pressure level is one of around 120/80 mm Hg while a pressure over 140/90 mm Hg is considered high.

Risk factors and symptoms

The risk of hypertension is increased in people who are overweight or obese, those of African or Caribbean origin and those with a diet high in salt but low in fresh fruits and vegetables. People who do not get enough exercise, who smoke or drink too much alcohol or who are aged over 65 years are also at an increased risk. High blood pressure also runs in families.

Diagnosis and treatment

Hypertension is measured using a sphygmomanometer which may be used to regularly monitor the blood pressure level in someone who is diagnosed with the condition. There are several groups of antihypertensive medication that can be used to control blood pressure.

Over time, high blood pressure can damage organs such as the kidneys, eyes and brain and these are routinely examined for hypertension-induced damage.

Credit: news-medical.net

Team Metabolic Health

Taking a power nap has many benefits for your brain, heart, stress levels, and mood. A short nap of 10 or 20 minutes in the middle of the day can do wonders for your productivity, alertness, and memory. A power nap will leave you feeling refreshed and increase your energy levels.

Far from being a sign of laziness, the most productive workers use short naps to increase their effectiveness. In fact, more and more companies allow for a midday nap because it can enhance cognitive function. So, if you feel like taking a short snooze in the afternoon, then it’s good to know that you can benefit from a 30-minute power nap.

In this article, you will find out why napping is good for you. You will also learn how long a power nap should be.

What is a Power Nap?

A power nap is a short sleep in the daytime, usually lasting between 10 and 30 minutes. Many people prefer taking a nap in the early afternoon when they naturally feel drowsy or sleepy.

Researchers from Harvard Medical School say that an afternoon nap can help deal with the body’s natural wake and sleep cycle (circadian cycle). Your body experiences a drop in wakefulness in the afternoon, and a nap is perfect to restore alertness. (1)

Scientists also say that a power nap can benefit people who don’t get enough sleep at night. Your afternoon nap can be a good way to “catch up” on lost sleep and restore alertness. In fact, the American Psychological Association says that an afternoon nap is as effective as caffeine in boosting midday alertness.

What is the Perfect Nap Length?

Many studies have tried to establish the perfect nap length. The Journal of Sleep Research reported that short nap length of 10 minutes can give instant benefits. Longer naps lasting 30 minutes also had many benefits that were felt later in the day. Some studies have shown that a 5-minute nap doesn’t have any cognitive benefits. However, napping for 10, 20, or 30 minutes all helped to improve alertness.

Some studies show that a 10-minute nap is the most effective length of time to nap for.

Generally speaking, a short power nap of 10-20 minutes is good for a quick improvement of your alertness and energy level and will enable you to get back to work quickly.

A nap of about 30 minutes will provide you a mental sharpness similar to the 10-20 minute nap, with that sharpness lasting a bit longer, but the downside is that people tend to feel groggy immediately after this kind of nap.

A longer nap of 60 minutes is good for your cognitive memory. It can help you remember faces, names and facts, but the downside is some grogginess upon waking.

A long nap of 90 or more can provide you a full sleep cycle which improves procedural memory (such as riding a bike or playing the piano) and creativity. Waking up after it usually has minimal amount of grogginess.

So to summarize, if you are looking for a quick boost or recharge, you are looking at a short nap length of about 10-20 minutes. However if you are looking for deeper sleep rejuvenation, you are looking at a longer nap of about 60-90 minutes.

The Benefits of a Power Nap

Let’s look in more detail how power naps can work for you to improve memory, increase learning, become more efficient and generally function better.

Power Nap Improves Alertness

One of the instant benefits of taking an afternoon power nap is that you will feel more alert.

Researchers have found that a brief power nap of between 5 and 15 minutes can make you immediately feel more alert. One study showed that the effects of a short nap can last for up to 3 hours. A longer nap of 30 minutes also helped to improve alertness with the effects lasting for many hours.

One 2019 study found that a 30-minute nap at 1:00 p.m. boosted cognitive function and restored alertness. The study also showed that an afternoon nap can help to improve physical performance and reduce fatigue.

Some studies show that napping is as effective as drinking coffee to increase alertness. However, other studies reveal that the benefits of a 15-minute nap can be enhanced by having a coffee just before your nap or washing your face.

Another study showed that taking a cup of coffee after a 15-minute nap can help make you more alert when driving.

Power Nap Improves Productivity

Enjoying a short nap in the afternoon can also help boost your productivity at work.

The journal PLoS One found that the best time to nap is between 2 p.m. and 4 p.m. which is when you may feel the sleepiest. Researchers have found that napping for 15 to 45 minutes between 12:30 and 14:00 is the most effective time to increase productivity. (8)

However, a long nap seemed to negatively impact on alertness and productivity.

One study found that napping for 30 minutes or less was good to enhance learning ability and performance.

A small study found that 20 minutes nap in the mid-afternoon had positive effects upon maintaining daytime vigilance level, and improved performance level and self-confidence of the participants in their task performance.

Power Napping Improves Memory

The benefits to your cognitive function of taking a nap after lunch can also help to boost your memory.

Studies have shown that regular napping can benefit your long-term and short-term memory.

A 2019 study published in the journal Sleep found that napping can help to improve memory function over the long-term. Taking a nap was more effective than taking a break and helped young adults retain more information when studying.

Studies have also shown that a quick nap during the day can benefit short-term memory. For example, a study involving 145 female shift workers found that those who napped had better alertness and cognitive function than the non-nappers.

Another study reported that napping after lunch benefits short-term memory, accuracy, and alertness.

Further reading: Proven Brain Foods to Boost Brain Power, Focus and Memory.

Power Naps Boost Endurance Performance

Dozing after lunch for 20 minutes or so can also improve your energy levels and increase your performance.

The European Journal of Sport Science in 2018 reported that athletes who napped for between 20 and 30 minutes performed better. Napping in the afternoon was a good way to reduce the effects of sleep deprivation.

Power Nap Promotes Good Heart Health

A meta-analysis on the effects of napping on your heart health found that a short nap can lower your risk of heart disease. The perfect length of time for a nap to promote good heart health was under 30 minutes. Interestingly, regularly napping for an hour or more during the day was associated with an increased risk of heart disease.

One of the reasons why a power nap is good for your heart is that it helps improve your circadian rhythm. This has been shown to lower stress levels and blood pressure – both of which can impact on your health.

The researchers believe that an afternoon nap may contribute to stress-releasing process, which can help reduce mortality from coronary heart disease.

A large research from the Harvard School of Public Health and the University of Athens Medical School found that midday napping reduced coronary mortality by about one third among men and women. The study found that people who regularly took naps at least three times per week for an average of at least 30 minutes, had a 37% lower coronary mortality than those not taking naps.

Find out how the cardiac diet can be good for your heart.

Power Nap May Help Control Blood Pressure

Enjoying a short siesta can also be good to manage high blood pressure.

For example, one study found that blood pressure drops during a short afternoon sleep when compared to being awake.

Other studies have shown that power napping in the afternoon can be more beneficial for your blood pressure than just relaxing while awake. (16)

Learn about other natural ways to manage hypertension naturally and prevent strokes or heart disease.

Power Nap Boosts Your Immunity

Having a power nap after lunch is also good for your health in general because it can boost your immune system.

Researchers have come to realize that getting enough sleep is necessary to strengthen your immune system. There is also evidence that a brief nap can also give your immunity a needed boost.

One study found that napping is a good way to offset some of the negative effects sleep deprivation has on your immunity. Getting a 30-minute nap helps to normalize your body’s immune response.

A power nap is one of the great hacks to quickly get your immunity working as it should. You can also learn what else you can do to prevent infection due to a weakened immune system.

Power Naps to Help Relieve Stress

A 30-minute power nap can also be good to deal better with stress and avoid the consequences of being constantly stressed.

Getting enough sleep helps your body produce hormones that are associated with lower stress levels. Taking a nap can help to normalize hormone levels if you haven’t had enough sleep.

The Journal of Clinical Endocrinology & Metabolism reported that napping has a stress-releasing effect. From various reports, it seems that the ideal nap time to relieve stress is around 30 minutes. The researchers also found that this nap length helped boost immunity and cardiovascular health. (18)

A study involving night-shift workers found that taking two 15-minute naps helped to relieve tension and calm the nerves.

Other studies have found that short naps are good for helping to reduce psychological and physiological strain.

Learn more about why getting an afternoon nap is just one of the effective remedies for dealing with anxiety and stress.

Power Nap Could Help Improve Depression and Boost Mood

Having a short sleep in the afternoon can be one of the ways to improve your mood and manage depression.

One trial involving people with depression found that napping after a sleepless night was beneficial. The patients napped for 10 minutes during the day and researchers noted they had fewer symptoms of depression after the nap.

Another study found that a power nap has many benefits for people with depression. The study found that napping between 2 p.m. and 3:30 p.m. helped to improve the general well-being of depressed people.

Taking a nap in the afternoon can also boost the mood of people who don’t have depression. One small study found that a short 20-minute nap helped to boost mood and have a positive effect on cognitive function.

For more ways to deal with mild depression naturally, please read this article on natural remedies for anxiety and depression. You may also find that serotonin supplements can help if you suffer from depression.

Power Napping Increases Testosterone in Men

A power nap after lunch can be good for male sexual health because it boosts testosterone levels.

Studies into the effects of hormone production during sleep have found that levels of testosterone increase while sleeping. This is one reason why men who regularly nap seem to have higher testosterone levels in the afternoon.

Tips for the Perfect Nap

Power naps can really help to improve your mood, alertness, learning ability, and general well-being.

What can you do to enjoy the perfect power nap? And when is the best time to go for a nap?

Most studies show that your body naturally becomes drowsier in the 2 or 3 hours after lunch. So, generally, power naps are best enjoyed in the early afternoon or not long after eating lunch.

Most of us feel tired between 1 and 4 pm, so try to fit your nap during those hours. Don’t make it later otherwise it can interfere with your ability to fall asleep at bedtime.

Here are some ways to enjoy the perfect nap:

Don’t nap too long. A power nap is never meant to be too long. Usually, napping between 10 and 30 minutes is the ideal length of time for a nap. If you nap too long, you may feel drowsy for the rest of the day.

When taking shorter naps, it is recommended to sleep partially upright to make it easier to wake up and to avoid falling into a deeper sleep.

Create the right environment. You will fall asleep for a short nap easier if you are in a dark place that isn’t too warm.

Time your caffeine right. Some power nappers find that taking a cup of coffee right before napping is effective. Studies have shown that this helps you to wake up more alert after your power nap.

Try relaxing beverages. You can avoid the stimulating effect of caffeine by taking a relaxing herbal tea before or after your power nap.

Have a light snack. Did you know that there are some foods that make you sleepy? Take a glass of warm milk or eat a banana to help you fall asleep faster.

Remove distractions. Make sure that you won’t be distracted during your 10, 20, or 30-minute power nap. So, put your phone on a flight mode if using it as an alarm clock.

Try the 4-7-8 exercise to fall asleep. Learn more here about this exercise that will help you fall asleep in no time at all.

Try to nap at a regular time. If your schedule allows for it, try to schedule a power nap for the same time every day. This way you teach your body to expect the nap and you may find it easier to fall asleep.

Credit: https://www.healthyandnaturalworld.com/

Team Metabolic Health

Staying hydrated during the summer season has always been important but it’s even more vital as temperatures rise to record highs.

To keep your electrolytes at a normal level, there are seven elements that should be included in the foods and drinks you consume, in moderation, according to Cleveland Clinic:

• Magnesium
• Sodium
• Calcium
• Potassium
• Phosphate
• Chloride
• Bicarbonate

Pix Credit: Getty Images

Drinking water is “the best way for us to hydrate,” says Nicole Antes, a registered dietitian nutritionist, but when water is filtered, it can lose some of its healthy minerals. Antes recommends adding trace mineral drops that include minerals like sodium, potassium and magnesium to increase the benefits you get from drinking water. You can also buy mineralized water for those same perks.

And if you’re looking for other beverages, or foods, to stay hydrated, Antes has a list you can reference.

6 drinks and foods to keep you hydrated

Reach for foods that are naturally rich in minerals, Antes tells Make It. Six of the best beverages and foods that she recommends are:

Coconut water: Coconut water is “naturally high in potassium.” One disclaimer that Antes has is to “be mindful [of] where you’re sourcing your coconut water from, because these days a lot of them have added sugar or different kinds of flavorings.”

Aloe vera juice: While it’s not “probably not as popular, [aloe vera juice] is a great mineral-rich beverage,” high in vitamin C, she says, “It’s typically pretty low in sugar.” Though, it’s also important to pay attention to the added sugar content.

Dark leafy greens: Leafy greens have high water content, especially lettuce which is more than 90% water, according to WebMD.com. But green leafy vegetables are also nutrient-dense with B vitamins and fiber, which can be helpful for your overall health.

Celery: Celery is about 95% water and is rich in magnesium, potassium and phosphorus.

Cucumber: A cucumber is around 95% water and contains a substantial amount of phosphorus, potassium, and magnesium, as well as vitamins B and C.

Citrus fruits: Fruits like lemons and limes “are really high in natural electrolytes,” Antes says.

Recently, variations of drinks that are low in sugar and rich in natural electrolytes are gaining popularity. People have taken to calling them Nature’s Gatorade.

Antes’ take on the phenomenon is one of her favorite mocktails for hydration and it includes just three ingredients:

8 ounces of coconut water

An eighth or a fourth of a teaspoon of Celtic or pink Himalayan salt

A squeeze of a lemon or lime

“It’s a great way to get all the electrolytes, have a fun drink and then not have to worry about added sugar, dyes [and] things like that,” Antes says. “You can also do it using water, a little bit of orange juice and then a pinch of salt as well.”

Credit:

Team Metabolic Health

Is little amount of alcohol healthy for liver health? Dr Shiv Kumar Sarin busted the myths.

Alcohol has the reputation of harming the liver and causing serious illness. However, how much truth is in it? In an interview with ANI, Insta-popular gastroenterologist Dr Shiv Kumar Sarin explained why alcohol is the socially accepted poison. The doctor set his opinion straight away in the initial part of the question – no amount of alcohol is safe for the liver. He added that when we drink alcohol, we directly harm the liver and make it susceptible to diseases.

The doctor set his opinion straight away in the initial part of the question – no amount of alcohol is safe for the liver. (HT FIle/ Representational Image)

But what about other doctors saying that a small amount of alcohol is healthy?

Dr Shiv Kumar Sarin laughed it off and said that we may always find doctors who say that a little amount of alcohol is fine, but that’s not true. He quoted the World Health Organisation and mentioned that the WHO says – no alcohol, in any amount, is harmless.

How does alcohol affect the liver?

Dr Shiv Kumar Sarin explained that unlike the other foods which when consumed get absorbed by the intestine, alcohol gets absorbed by the stomach instead. This makes the alcohol faster to be absorbed by the liver. Hence, alcohol can have a direct impact on the liver health.

What happens when we consume fatty foods with alcohol?

Dr Shiv Kumar Sarin addressed a common notion that states that when we consume alcohol with fatty foods, it balances the harm caused to the body. However, according to the doctor, fatty foods can also deposit fat in the liver, while alcohol causes serious liver damage. Hence, consuming fats with alcohol simultaneously is more harmful.

Does fat and alcohol affect liver in different ways?

Dr Shiv Kumar sarin said that in one gram of sugar, there are four calories, while in alcohol there are seven calories per gram – which is almost double of sugar. Hence, consuming them together is lethal for the body, and most importantly, for liver health.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Credit: Hindustan Times

Team Metabolic Health

Eli Lilly’s weight loss drug reduced the risk of developing Type 2 diabetes by 94% in obese or overweight adults with pre-diabetes compared to a placebo, according to initial results from a long-term study.

The late-stage trial on tirzepatide also found that patients experienced sustained weight loss over the roughly three-year treatment period.

Tirzepatide is the active ingredient in the company’s highly popular weight loss injection Zepbound and diabetes drug Mounjaro.

Eli Lilly’s highly popular weight loss drug reduced the risk of developing Type 2 diabetes by 94% in obese or overweight adults with prediabetes compared with a placebo, according to initial results from a long-term study released Tuesday. 

The late-stage trial on tirzepatide, the active ingredient in the company’s weight loss injection Zepbound and diabetes drug Mounjaro, also found that patients experienced sustained weight loss over the roughly three-year treatment period. Adults on the highest weekly dose of the drug saw a 22.9% decrease in body weight on average after 176 weeks, compared with 2.1% for those who received a placebo. 

The results suggest that Eli Lilly’s treatment could meaningfully delay a potential diagnosis for people with prediabetes, or those with blood sugar levels that are higher than normal but not high enough to be classified as Type 2 diabetes. 

More than 1 in 3 Americans have prediabetes, according to the latest government data, which health experts say can be reversed with lifestyle changes such as diet and exercise. People who are overweight or have obesity are at a higher risk for prediabetes. 

The new data also shows the potential long-term health benefits of taking a buzzy class of obesity and diabetes medications called GLP-1s, which mimic hormones produced in the gut to tamp down appetite and regulate blood sugar. As Eli Lilly’s Zepbound and Mounjaro and injections from rival Novo Nordisk have skyrocketed in popularity over the last two years, the companies have raced to study other clinical uses for their drugs.

The results are “another reminder of the huge investment which Lilly has made to prove not only do you lose weight but when you do on this medicine, it converts to health benefits. This is our fourth study this year that does such a thing,” Eli Lilly CEO David Ricks told CNBC in an interview, adding that tirzepatide has shown promise as a treatment for heart failure, sleep apnea and fatty liver disease in three other clinical trials.

Eli Lilly tested tirzepatide in more than 1,000 adults over 176 weeks in the phase three trial, followed by a 17-week period where patients stopped treatment. It is the longest completed study on the drug to date, according to the company. 

The drugmaker will submit the latest results to a peer-reviewed journal and present them at an upcoming medical conference in November. Eli Lilly published 72-week weight loss results on a larger group of patients from the same trial, called SUMOUNT-1, back in 2022. 

Patients in the trial who stopped taking tirzepatide during the 17 weeks began to regain weight and saw an increase in progression to diabetes. But those participants still had an 88% lower risk of developing diabetes compared with a placebo, according to the latest phase three results.

“On the drug, we can keep healthy body weight down for three years and ward off diabetes,” Ricks told CNBC. “When you come of the drug, a percentage of people do begin to gain weight and then…begin the advance again toward diabetes.” 

Still, Ricks noted that patients don’t “snap all the way back as if they were never on the drug.”

The safety data on tirzepatide during the trial was consistent with previous studies on the drug, according to Eli Lilly. The most common side effects were gastrointestinal, such as diarrhea, nausea, constipation and vomiting, and were generally mild to moderate in severity.

Eli Lilly’s Zepbound works by imitating two naturally produced gut hormones called GLP-1 and GIP. 

GLP helps reduce food intake and appetite. GIP, which also suppresses appetite, may also improve how the body breaks down sugar and fat.

Credit: CNBC

Team Metabolic Health

Weight loss and diabetes may just be the beginning for drugs like Ozempic, Wegovy, Mounjaro and Zepbound as reports increasingly suggest they may have far-reaching benefits for treating conditions as diverse as heart disease, liver disease, Parkinson’s, sleep apnea and addiction, sparking research among firms competing in pharma’s latest gold rush.

GLP-1 drugs are being investigated for a range of other health conditions including addiction, liver disease and Parkinson’s. (Pix Credit: Getty)

Key Facts

Novo Nordisk’s Ozempic and Wegovy and Eli Lilly’s Mounjaro and Zepbound — brand names for drugs semaglutide and tirzepatide — are far and away the most famous members of a booming class of medications known as GLP-1 agonists, which mimic the function of a gut hormone involved in regulating blood sugar and appetite, glucagon-like peptide-1.

GLP-1 drugs were initially approved to treat diabetes and, more recently, obesity, and with more and more people using the drugs, signs of other potential benefits are starting to emerge and Novo gathered enough data to prove this and scored approval from the Food and Drug Administration in March to add cardiovascular benefits to Wegovy’s label (experts expect Zepbound will be shown to have similar heart benefits), with research showing semaglutide could slash the risk of heart problems like heart attack and stroke by 20%, regardless of weight lost.

Lilly is also eying a label expansion for Zepbound after a late-stage trial found that the drug “meaningfully improved sleep apnea symptoms,” and if approved the drug would become the first pharmaceutical treatment for the underlying causes of the condition, rather than treating symptoms.

Companies like Novo and Lilly, as well as hopeful competitors like Boehringer and Zealand Pharma, are exploring GLP-1 drugs as a potential treatment for fatty liver disease, a longstanding graveyard for pharmaceutical development until the FDA authorized the first treatment, and other research, as trials suggest GLP-1s could be effective at treating kidney disease.

Studies also indicate the GLP-1 class could also lower the risk of developing an array of different cancers and possibly help with a range of brain disorders too, where they potentially help boost mood, cognitive function and alleviate symptoms for conditions including Parkinson’s, Alzheimers, dementia, depression, bipolar disorder and anxiety, areas that have long been notorious sticking points for pharmaceutical development.

Substance use disorders and addiction is another promising avenue following reports of diminished cravings among people taking GLP-1 drugs, though scientists are still working to figure out why — the drug could feasibly act on parts of the brain and nervous system as these also produce the GLP-1 hormone or have relevant hormone receptors for it — and confirm whether the medications can indeed curb addiction.

Have Weight Loss Injections Been Linked To Any New Side Effects?

While the clinical trials required to bring a drug to market are extensive, rigorous and ensure products are safe and effective, they rarely provide a complete picture of a medication. The sheer number of people who take a drug after approval, especially popular ones like semaglutide and tirzepatide, can dwarf the number of people involved in a trial and companies and regulators alike monitor how they fare in the real world. While it is exciting when reports and data gathered from more people using drugs indicate new possible benefits and uses, especially in areas like mental health and liver disease that have long evaded the efforts of pharmaceutical researchers, there is also the possibility that new information on negative effects can emerge as well. For weight loss and diabetes drugs like Ozempic and Wegovy, mental health issues and an uptick in suicidal thoughts have been the subject of significant scrutiny, though recently-released reviews from agencies like the FDA and the European Medicines Agency have cast doubt on the connection and said such a link is unlikely. Other research has indicated GLP-1 drugs could reduce bone density and suggested Ozempic and Wegovy could increase the risk of developing a rare form of blindness, though Novo have criticized the study as lacking sufficient data to establish a link. Medicines regulators have also begun changing guidance included on a drug’s label as more becomes known, including new warnings for patients undergoing surgery and anesthesia as the drugs can boost the risk of aspiration (inhaling something other than air) as material rises up from the stomach during the operation. There is also ongoing debate whether GLP-1s can raise the risks of developing certain types of cancer, notably thyroid cancers, though the matter is far from settled.

Big Number

$100 billion. That’s how much the weight loss drug market could be worth by 2030, analysts estimate, though some believe the market could possibly be worth much, much more than that. Novo and Lilly have already raked in billions from the drugs for obesity and diabetes and they have ballooned into some of the most valuable companies in the world off the back of these drugs, despite their inability to meet demand and persistent shortages.

Crucial Quote

Novo and Lilly hold an effective duopoly over the GLP-1 market right now, particularly regarding obesity. Experts like Citi analyst Peter Verdult told Forbes the wealth of data the pair are able to gather on semaglutide and tirzepatide will help them solidify their dominant positions and see off competitors still racing to bring drugs to market. Adding things like cardiovascular benefits to Wegovy’s label will raise the bar for new entrants to compete, especially as there’s a clear limit to the advantages brought by improving something like the amount of weight loss as research indicates Zepbound has done with Wegovy. “Now some may say, well that’s fine, I’ll just piggyback on it, because it’s the same molecules, same mechanism of action and everyone takes it for granted. But the bottom line is if you’re a drug rep, you can’t promote that,” Verdult said.

Credit: Forbes

Team Metabolic Health

Liver disease is frighteningly common worldwide.

Metabolic dysfunction-associated steatotic liver disease, or MASLD, is an umbrella term describing conditions related to a buildup of fat in the liver. Formerly known as nonalcoholic fatty liver disease, this condition affects 1 in 4 people worldwide. Among those with type 2 diabetes, insulin resistance, obesity or all three, the prevalence of MASLD increases to 3 in 4 people.

As a diabetologist, the possibility of liver disease is on my mind every time I see a patient. Understanding your risk of developing this common yet underrecognized condition is essential to treating it.

What is MASLD?

MASLD is a complex disorder with both environmental and genetic contributions. In its early stages, liver cells accumulate fat in a process called steatosis. Major sources of this fat include adipose tissue as well as fatty acids the liver makes in response to insulin resistance and excess caloric intake. This fat accumulation can enlarge the liver and interfere with its normal functioning.

Over time, fatty acids activate enzymes, which can produce toxic byproducts capable of causing liver cell injury, inflammation and scarring. This condition is better known as MASH, or metabolic dysfunction-associated steatohepatitis. Progression to MASH is more common in the presence of other risk factors such as type 2 diabetes, insulin resistance and metabolic syndrome.

Left unaddressed, MASLD and MASH can progress to liver scarring, failure and, in some cases, cancer. They also increase risk of death from cardiovascular disease and liver-related complications.

In the U.S., MASH is the leading cause of liver transplants due to hepatic cancer among women and in those 65 and older. It is also on track to overtake hepatitis B and C as the main reason people develop liver cancer and thus need a liver transplant.

Liver disease and type 2 diabetes

Three out of four people with type 2 diabetes have MASLD. Linking liver disease, type 2 diabetes and obesity is the key role insulin resistance plays in their genesis.

Obesity is associated with increased fat deposits around the internal organs and higher levels of fatty acids delivered to the liver. Accumulation of fat in the liver increases its resistance to insulin.

Normally, insulin suppresses glucose production in the liver when blood sugar is high. When the liver becomes resistant to insulin, it produces more glucose despite elevated blood sugar levels, which in turn contributes to the development of type 2 diabetes.

A 2015 meta-analysis found that people with MASLD have a nearly twofold greater risk of developing type 2 diabetes than those without the disease. MASLD is also more likely to progress to MASH in the presence of type 2 diabetes.

MASLD disproportionately affects certain ethnic groups. For instance, 1 in 5 people of Hispanic descent in the U.S. have MASLD, with or without diabetes. This is thought to be related to genetic mutations that affect how the liver cells process fat. One particular mutation more common in Hispanic people promotes steatosis by interfering with the cells’ ability to clear fat deposits.

Treating MASLD and MASH

The silver lining is that management of obesity and type 2 diabetes – such as through lifestyle changes – is very similar to management of MASLD. The most critical early interventions for type 2 diabetes can also help with MASLD, and this is not surprising given how closely interrelated these two conditions are.

The best way to reverse the early stages of MASLD is with weight loss through healthy eating habits and regular exercise. The aim is to shed at least 5% to 10% of initial body weight, maintain that weight loss through sustainable and realistic lifestyle choices, and avoid excess alcohol intake to limit additional liver injury.

New medications to treat diabetes, such as GLP-1 receptor agonists like Ozempic and Mounjaro, as well as SGLT2 inhibitors like Jardiance or Invokana, have also shown benefit in early stages of MASLD. These drugs promote weight loss, which in turn improves MASLD. In addition, studies have shown that Ozempic and Mounjaro could reverse MASH, even with inflammation and fibrosis.

Older medications used for diabetes, such as pioglitazone, typically can also help reduce the progression of MASH by reducing insulin resistance.

Liver disease progresses in stages of increasing damage.

In people with severe obesity or who have not had success with lifestyle changes and weight loss drugs, bariatric surgery is another highly effective option to treat MASLD, as it is associated with significant and sustained weight loss.

New drugs are also in the pipeline. The Food and Drug Administration recently approved a new medication called resmetirom to treat MASH with advanced liver scarring.

However, a cure for this chronic disease remains elusive. This is why it is essential to diagnose MASLD as early as possible and use proven measures that can be maintained long term. Treatments and lifestyle changes need to be deployed as early as possible, before inflammation and scarring have firmly set in. MASH gets trickier to treat in more advanced stages when liver damage becomes irreversible. For instance, while Ozempic may help treat early MASH, it doesn’t benefit patients with more advanced stages of liver scarring.

Ignorance is not bliss

Very few people are aware of MASLD and its health implications, including those living with it. While roughly over 35% of U.S. adults have MASLD, less than 5% are aware they have liver disease.

MASH can be difficult to diagnose because it either causes no symptoms or can be mistaken for other conditions. Patients may have the condition for years and not be aware that it is slowly and meticulously causing damage. In that sense, MASH is strikingly similar to type 2 diabetes or high cholesterol.

Young people are increasingly being diagnosed with early-onset MASLD. Indeed, MASLD with MASH is the most common pediatric liver condition, affecting nearly 8% of children and adolescents and over 34% of children with obesity in the U.S. These children and adolescents are at high risk of developing type 2 diabetes and have a significantly increased lifetime risk of cardiovascular disease and cancer.

Health care costs for people with type 2 diabetes and MASH are estimated to reach US$55 billion over the next 20 years, accounting for 65,000 liver transplants, 1.37 million cardiovascular-related deaths and 812,000 liver-related deaths.

These grim statistics need not be if MASH is tackled early and aggressively.

If you are one of the millions of Americans with prediabetes or diabetes and are also overweight, you most likely have some degree of MASLD or MASH. Being aware of MASLD and getting checked is the first step to addressing it.

Promptly determining the best way to treat your MASLD or MASH is the next step. An early referral to a liver specialist will help you halt the progression of this challenging and common condition and take advantage of the treatment breakthroughs researchers have made in the past few years.

Credit: theconversation.com

Team Metabolic Health

A network of proteins found in the central nervous system could be harnessed to increase the effectiveness and reduce the side effects of popular diabetes and weight-loss drugs, according to new research from the University of Michigan.

The study, appearing today in the Journal of Clinical Investigation, focused on two proteins called melanocortin 3 and melanocortin 4, found primarily on the surface of neurons in the brain, that play a central role in regulating feeding behavior and maintaining the body’s energy balance.

Melanocortin 3 and melanocortin 4 impact everything from sensing long-term energy stores to processing signals from the gut regarding short-term fullness, or satiety, said U-M physiologist Roger Cone, who led the study.

The drugs known as GLP-1 agonists, which include semaglutides (e.g., Ozempic) and tirzepatides (e.g., Mounjaro), have received substantial attention recently for their effectiveness in treating not only type 2 diabetes, but also obesity, heart disease and potentially addiction. They work by mimicking a natural hormone that the gut produces when it is full, triggering the brain to reduce feeding behavior.

“So the obvious question for us was: How do these GLP-1 drugs, which work by manipulating satiety signals, function when we prime the melanocortin system?” said Cone, professor of molecular and integrative physiology at the U-M Medical School and director of the U-M Life Sciences Institute, where his lab is located.

Working in mouse models, Cone and his colleagues tested the effects of several hormones that reduce food intake. They compared the results in normal mice with mice that genetically lacked the MC3R protein, in mice that were given chemicals to block the activity of MC3R, and in mice that were given a drug to increase the activity of MC4R. (Because MC3R is a natural negative regulator of MC4R, meaning it decreases the activity of MC4R, blocking MC3R and increasing MC4R activity has similar effects.)

In all cases, Naima Dahir, first author of the study and a postdoctoral research fellow in Cone’s lab, and colleagues found that adjusting the melanocortin system—either by inhibiting MC3R or increasing MC4R activity—made the mice more sensitive to GLP-1 drugs and other hormones that affect feeding behavior. The mice that were given a GLP-1 drug in combination with an MC4R agonist or MC3R antagonist showed up to five times more weight loss and reduced feeding than mice receiving only the GLP-1 drugs.

“We found that activating the central melanocortin system hypersensitizes animals to the effects of not just GLP-1s, but to every anti-feeding hormone we tested,” Cone said.

The researchers also measured activity in parts of the brain thought to trigger nausea in response to GLP-1 drugs and observed no increased activation when GLP-1 drugs were combined with alterations to the melanocortin system. In contrast, priming of the melanocortin neurons significantly increased GLP-1 drug activation of neurons in hypothalamic feeding centers in the brain.

The findings indicate that pairing the existing GLP-1 drugs with an MC4R agonist could increase sensitivity to the desired effects of the drugs by up to fivefold, without increasing unwanted side effects. Ultimately, this approach could enable patients who are sensitive to the side effects to take a lower dose, or could improve the results in patients who have not responded to the existing drug dosages. Further drug development and clinical testing are needed before this can occur.

While this research has been conducted only in mouse models, Cone is optimistic that the results will translate well to humans.

“The melanocortin system is highly conserved in humans,” he said. “Everything we’ve observed in the mouse over the past decades studying these proteins has also been found in humans, so I suspect that these results would also be translatable to patients.”

In addition to Cone and Dahir, the study authors include Yijun Gui, Yanan Wu, Alix Rouault, Savannah Williams, Luis Gimenez, Stephen Joy and Anna K. Mapp, University of Michigan; Patrick Sweeney, University of Illinois; and Tomi Sawyer, Courage Therapeutics.

Credit: Medical Xpress

Team Metabolic Health

A growing set of evidence suggests that using semaglutide could lead to decreased substance use, and a large new study shows a promising link between the medication and tobacco use. But experts emphasize that much more research is needed before using the medications off-label for smoking cessation.

A new study suggests that there’s a link between semaglutide use and lower rates of treatment for tobacco use disorder among people with type 2 diabetes.  (Pix Credit: AP/File)

In a study published Monday in the journal Annals of Internal Medicine, researchers tracked the medical records of more than 200,000 people who started medications to treat type 2 diabetes, including nearly 6,000 people using semaglutide medications such as Ozempic.

Over the course of a year, people who started using semaglutide were significantly less likely to have medical encounters for tobacco use disorders, prescriptions for medications for smoking cessation or counseling for smoking cessation than those who started other diabetes medications such as insulin and metformin.

The study authors note that the reasons individuals might be less likely to seek medical treatment for tobacco use disorder vary widely; it could suggest that their tobacco use decreased or that they’ve become less willing to seek help to quit smoking, for example.

There might be a mix of medication-driven and patient-driven change, said Dr. Disha Narang, an endocrinologist and director of obesity medicine at Endeavor Health in Chicago, who was not involved in the new research.

“If I have a patient with type 2 diabetes who is on one of these agents and they do have a history of smoking, oftentimes, our visits involve a conversation about tobacco cessation,” she said. “These folks might start paying special attention to their long-term health and changing some habits because they are being treated for diabetes.”

Also, the new study did not measure the severity of tobacco use, such as the number of cigarettes consumed per day, cravings or withdrawal.

Understanding how semaglutide affects these factors is “crucial” to determining whether the medications could be used for smoking cessation, said Dr. Nora Volkow, director of the National Institute on Drug Abuse and a co-author of the new report. Also, more work would be needed to understand appropriate dosage and adverse effects before using the blockbuster drugs in new way, she said.

But other early research suggests that semaglutide and other GLP-1 medications could interact with the brain’s reward system in a way that helps modulate cravings, whether for food, nicotine, alcohol or other drugs.

“The main driver of why many of us overeat relates to those reinforcing positive responses that we get from eating certain foods. And it’s the same circuit for foods as for drugs,” Volkow said.

Although key questions remain, Volkow said she is struck by how consistent the findings have been when it comes to the relationship between semaglutide use and decreased substance use – across different substances and among different patient groups. The new study found similar links among those with and without obesity.

“A signal like this one cannot be ignored, particularly because of how consequential it could be if, in fact, we can have now a new medication for treating smoking cessation,” she said. “That could have a tremendous impact on health.”

Smoking rates in the United States have decreased over time, but cigarette smoking remains the leading cause of preventable disease and death, according to the US Centers for Disease Control and Prevention. A recent study from the American Cancer Society found that smoking contributes to nearly 1 in 5 new cancer cases and nearly a third of cancer deaths each year.

But fewer than 1 in 10 adult cigarette smokers succeed in quitting each year, according to the new study, and options for smoking cessation treatment haven’t changed much in decades.

Credit: CNN

Team Metabolic Health

Many patients are eager to discontinue Wegovy or Zepbound when their weight loss plateaus. But doctors say it’s difficult to go cold turkey.

Susana Parks was delighted when she lost 40 pounds on Eli Lilly’s obesity drug, Zepbound. But now that she is at her goal weight, she has questions: Can she stop taking the drug? And if she does, how can she maintain her weight loss?

“I can’t stop cold turkey or I will gain it back — that is clear,” said Ms. Parks, 60, of Bend, Ore. “Do I go to a lower dosage? Do I take it every two weeks instead of weekly? How do I maintain?”

These questions are becoming common, obesity medicine specialists say, as more and more people lose weight with obesity drugs. Some struggle to pay for the medicine, have difficulty finding it to purchase or just don’t want to stay on a drug longer than they believe they need to.

When doctors are confronted with these queries, here is what they advise — and what they can’t say.

(Image Credit: Reuters)

What will happen if I stop taking the new weight-loss drugs after losing weight?

Dr. David Cummings, a weight-loss specialist at the University of Washington, has been asked this question by many patients. He explains that the makers of the drugs conducted large studies in which people took the drugs and then stopped.

“On average, everyone’s weight rapidly returned,” Dr. Cummings said. And, he said, other medical conditions, like elevated blood sugar and lipid levels, return to their previous levels after improving.

He also tells patients that while on average, weight is regained when the drugs are stopped, individuals vary in how much weight and how quickly it returns.

Hearing that, Dr. Cummings said, some patients want to take a chance that they will not need the drugs once they lose enough weight. He says some tell him, “I will be the one. I just need some help to get the weight off.”

So far, though, Dr. Cummings has not seen patients who have succeeded.

Will lowering my dose help me keep the weight off?

Doctors say they have no data to guide an answer to that question.

It “has not been studied in a systematic fashion,” said Allison Schneider, a spokeswoman for Novo Nordisk, the maker of Wegovy. The drug is based on the medication semaglutide, which the company also sells for diabetes treatment as Ozempic.

The same is true for tirzepatide, which Eli Lilly sells as Zepbound for weight loss and Mounjaro for diabetes.

When doctors do offer advice, it tends to be tentative.

“There is no magic bullet,” said Dr. Mitchell A. Lazar of the University of Pennsylvania’s Perelman School of Medicine.

What might happen if I experiment with my dose?

Ms. Parks said she was not interested in continuing to lose weight. For her, a 40-pound weight loss was perfect.

She’s grateful she got Zepbound — her doctor, she said, resisted prescribing it, her insurance would not pay for it and the drug was in such short supply that she called pharmacy after pharmacy each month to refill her prescription, paying out of pocket each time.

While Dr. Lazar does not treat Ms. Parks, when he heard about her case, he said she could try reducing her dose.

Or, he said, “she can monitor what she is eating now and do her best to eat the same amounts after she lowers or stops her dose.”

But, he added, that may be difficult without the help of the drug.

For the moment, Ms. Parks is adjusting her dose. When her weight fell to 150 pounds — she’s 5 feet 8 inches tall — she decided to try taking Zepbound every other week, instead of every week. She told her doctor what she was doing. Her doctor, Ms. Parks said, “had no opinion one way or another.”

Her new dosing schedule, Ms. Parks added, also saves her money.

After a week without the drug, she said, she gets hungry. It happens every time, predictably. Then she takes her next dose.

So far it is working — her weight has been steady.

Dr. Caroline Apovian, a weight-loss specialist at Brigham and Women’s Hospital, said there’s a lesson here for people struggling with their weight.

“It teaches patients that it’s really not under your control,” said Dr. Apovian, who used to consult for Novo Nordisk.

Does that mean I have to take Wegovy or Zepbound forever?

“Most patients want to lose as much as they can but don’t want to be stuck on the medicine for the rest of their lives,” Dr. Cummings said. “The most common question is, ‘How long do I have to take it?’”

“The proper answer is probably forever,” he said.

Some patients tell Dr. Cummings it sounds like he is giving them a life sentence, and others simply do not believe him.

In a study of electronic health records by Truveta, a health care data company, more than half of patients without diabetes stopped taking the drugs within a year. But about a third who stopped restarted.

Faced with these concerns, doctors stress that obesity is a chronic disease and, like high blood pressure and other chronic diseases, must be treated for life. But beliefs persist that obesity is different from a disease like high blood pressure — the perception is that weight can be controlled by lifestyle and willpower.

Is there any risk of losing too much weight on the drugs?

Patients also want to know if they risk losing weight indefinitely, becoming dangerously thin.

Unlikely, obesity medicine experts said.

Eventually, with the new weight loss drugs, patients reach a plateau where they stop losing weight.

Ms. Schneider of Novo Nordisk said that in the Wegovy trials, weight loss stopped after about 60 weeks.

When that happens, said Dr. Ania Jastreboff of Yale, who is on advisory boards for Novo Nordisk and Eli Lilly, hunger returns. So do food cravings, even though patients are still taking the drugs. But the person will naturally eat only enough to maintain the lower weight.

Do side effects return if people stop and then restart the drugs?

Many describe experiencing side effects like nausea and vomiting when they first start taking Wegovy or Zepbound. For most, but not all, patients, the side effects diminish as they adjust to the drugs.

But, Dr. Apovian warned, those side effects may return if patients stop and then restart the drugs. The longer they are off the drug, she added, the more likely it is that the side effects will return.

Credit: The New York Times

Team Metabolic Health

Overweight and obesity rates have reached crisis levels and are risk factors for diabetes, heart disease, cancer, dementia, and other diseases.

The CDC estimates that that almost a third of Americans are now overweight and 42% of adults “have obesity,” now categorized as a disease. Childhood obesity is up—one in five kids are estimated to be affected.

This isn’t just an American crisis. The World Obesity Federation predicts that 51% of the world’s population will be overweight or obese within the next 12 years.

Causes include sedentary lifestyles, as more people work and play in front of computer screens, the food and beverage environment, eating more out of home, fewer safe places for physical activity, genetics, and taking certain medications.

The new generation of weight-loss drugs may be attracting cohorts that were unresponsive to strategies such as portion control. (Bloomberg/Getty Images)

GLP 1 drugs in action

Along have come new, highly popular GLP 1 weight loss drugs, including Ozempic, Wegovy, and Mounjaro. Oprah Winfrey did a TV special: Shame, Blame and the Weight Loss Revolution. After years of up and down weight, Oprah says it’s not your fault: Obesity is a disease. She’s losing weight on one of the new drugs and helping move the market. However, insurance coverage, including Medicare, will have the biggest impact on usage.

Brian Kay of Numerator, a research firm, reports that some 12% of respondents in their household panel are using one of the new GLP 1 drugs for diabetes and/or weight loss. About 75% say they are consuming smaller portion sizes and – based on Numerator’s purchase data – their grocery bills are down 6 to 9%.  Alcohol and ice cream purchases have decreased while fish and yogurt are up. However, the main reason consumers report discontinuing the drug is cost – and then grocery spending returns to previous levels.

All this has major financial implications for the food and beverage industries, restaurants, food service operators, health insurance companies, and Medicare. And the total cost in health care, lost productivity, corporate insurance, and long-term care is enormous.

How we got here

In recent decades, food consumption has increased dramatically. The portion sizes for bagels, cheeseburgers, ice cream, restaurant servings of spaghetti, meatballs, and more are ever larger.

Many restaurant chains compete on volume meals, and consumers often equate volume with value. One result is considerable waste. ReFED, a research group, estimated that 70% of food wasted in restaurants is left on plates.

The journal Addiction describes “hyper-palatable foods” as a kind of food engineering in which fat, sodium, sugar, and other additives can also drive people to crave and overeat. Northeastern University’s Network Science Institute indicates that 73% of the U.S. food supply is ultra-processed.

Getting consumers to change their behavior is a tall order. Many are confused, misguided, or indifferent about eating healthier.

A Navy officer once told me about the difficulty of re-enlisting highly trained non-commissioned officers who became too heavy to meet Body Mass Index guidelines. “We make ‘em taller. You’d be surprised how many 5’10” guys are now 6’2”—at least on paper.”

A decade ago, the McKinsey Global Institute found that portion control was the most promising strategy for promoting a healthier lifestyle. In response, the Portion Balance Coalition (PBC) was formed as an alliance of major food and beverage companies, nonprofits, academics, and government to reduce obesity and improve health. It is led by the Business for Impact Center at Georgetown University.

Credit: fortune.com

Team Metabolic Health

Drugs like Ozempic, Wegovy, and Zepbound are reshaping treatment for obesity and diabetes, and their benefits might extend further. Emerging research suggests that GLP-1 drugs could also help manage addiction, sleep apnea and even cancer.

These medications, which regulate hormones, slow digestion and reduce hunger, are showing promise in preventing cancers linked to obesity, such as breast, colon, liver, and ovarian cancers, according to research from the American Society of Clinical Oncology (ASCO).

Dr. Arif Kamal, the chief patient officers at the American Cancer Society, noted that GLP-1 drugs might significantly lower cancer risks and provide better protection for diabetics compared to insulin.

The ASCO research found that GLP-1 drugs could cut the risk of obesity-related cancers by 39%, compared to 22% with bariatric surgery over 10 years. Originally designed for diabetes, these drugs are now also approved for weight loss under names like Saxenda, Wegovy and Zepbound.

The link between obesity and cancer is complex, involving hormones like estrogen, which is elevated in fat cells and drives cancer growth. Kamal compared obesity’s impact on cancer to tobacco’s historical effect, emphasizing the significance of GLP-1 drugs in reducing cancer risk.

Cindy Lin, the co-author of the study, pointed out that GLP-1 drugs might offer protective effects beyond weight loss, including better glycemic control and anti-inflammatory benefits.

Credit: Straight Arrow News (SAN)

Team Metabolic Health

Drugs like Ozempic, Wegovy and Zepbound have transformed treatment for obesity and diabetes. Now researchers are excited about their potential impact on other conditions, including addiction and sleep apnea — and even cancer.

Scientists see this class of drugs, called GLP-1 agonists, as a breakthrough because of how they act on the brain to regulate the body’s hormones, slow digestion, and tamp down hunger. And in several recent studies, they show early promise in preventing many common cancers — including breast, colon, liver, and ovarian — known to be driven by obesity and excess weight.

“It’s a hopeful story, which is, frankly, what people need,” says Arif Kamal, an oncologist specializing in breast cancer as well as chief patient officer at the American Cancer Society.

GLP-1 drugs, like Wegovy and Ozempic, may not be good only for diabetes and weight-loss. They are also showing promise for preventing some cancers. (UCG/Universal Images Group/Getty Images)

Though research on GLP-1 drugs is still in its relative infancy, so far studies fairly consistently show their benefit in staving off certain cancers. One research letter published in JAMA Oncology last year, for example, suggests GLP-1 drugs might reduce the risk of colon cancer, even among people who are not overweight. A more recent analysis in JAMA Network Open suggests GLP-1s provide far more protection against cancer for diabetic patients than insulin treatments.

Another recent study presented at the American Society of Clinical Oncologists meeting in June, showed both bariatric surgery and GLP-1 medications dramatically reduce the risk of the 13 obesity-related cancers. Among those who had bariatric surgery, that risk declined by 22% over 10 years compared to those who received no treatment. But among those taking GLP1 medications, risk dropped by a whopping 39%.

“And I think a 39% risk reduction is one of the most impactful risk reductions we’ve ever really seen,” says Kamal.

GLP-1 agonist drugs were originally developed to treat diabetes nearly two decades ago. Over the past decade, regulators started approving them as treatments for weight loss – first as liraglutide, sold under the brand Saxenda and, more recently, in the form of semaglutide or tirzepatide, under brands like Wegovy and Zepbound.

When it comes to cancer prevention, scientists are finding the link between obesity in cancer is complex and intertwined; the obesity-related cancers are heavily concentrated among organs involved in digestion and metabolism, like the liver and pancreas, for example, as well as among gynecologic cancers, including breast and uterus. Reproductive organs are highly sensitive to the hormone estrogen, which plays a role in allowing cells to grow rapidly during pregnancy, for example.

But Kamal says there’s also an especially close relationship between estrogen and cancer. “What we do know is that estrogen in particular — and possibly some other hormones, but estrogen for sure — drives the growth of many cancers,” he says. And fat cells increase production of estrogen.

That means women today are increasingly susceptible to cancer. Historically, men faced a much higher risk of developing cancers — in large part because they were more likely to engage in high-risk behaviors like smoking or drinking, Kamal says. But in recent years, the high prevalence of obesity among both men and women is closing that gender gap.

Obesity is also likely the most significant driver behind increasing cancer rates among younger adults, he says, just as tobacco was in generations past.

“Unhealthy weight is the smoking of our generation,” Kamal says.

That’s why indications that GLP-1 drugs may help slash that risk is so significant.

What’s more, that ASCO study suggests that GLP-1 drugs have a notable impact on cancer risk, even when patients don’t lose a lot of weight as a result of taking them. In other words, the medications seem to act on a number of the body’s mechanisms to reduce vulnerabilities to cancer.

“We think the protective effects of GLP-1s are probably multifactorial,” says Cindy Lin, resident physician at Case Western Reserve and co-author of the June ASCO study. “Part of it is weight [loss], but other factors may be contributing as well — better glycemic controls, anti-inflammatory effects.”

More research is necessary and inevitable — especially studies looking at the newer weight-loss formulations of GLP-1 medications, says Benjamin Liu, another resident physician at Case Western and co-author of the ASCO study.

He says he’s encouraged by the data so far. “It’s very exciting to have, especially since it’s more of a noninvasive strategy compared to bariatric surgery, and a lot more patients will be open to it.”

Credit: npr.org

Team Metabolic Health

Eli Lilly raised its annual sales forecast by $3 billion on Thursday, driven by surging demand and ramped up manufacturing capacity for its popular weight-loss drug Zepbound, lifting its shares more than 10% premarket.

The drugmaker also raised its annual profit forecast and said sales of its Zepbound crossed $1 billion for the first time in a quarter. The milestone for Zepbound comes a day after Danish rival Novo Nordisk reported a rare miss on quarterly sales of its weight-loss drug Wegovy and trimmed its full-year profit forecast.

Lilly and Novo are racing to increase manufacturing capacity to meet unprecedented demand for their popular weight-loss drugs that have been shown to help patients lose as much as 20% of their weight on average. It has invested an additional $5.3 billion in May on a manufacturing site in Indiana for production of tirzepatide, the active ingredient in Zepbound, as well as its diabetes drug Mounjaro.

Credit: The Economic Times