As we approach the end of each year, for whatever reason, we start to see articles about the year just past.
Even science journals are not immune to top ten lists and highlight articles. Indeed, Science is one of the most prestigious journals in the world and every year they run a feature on the “Breakthrough of the Year.”
They declared the family of weight loss drugs this year’s most important breakthrough.
As the article in Science points out, obesity is a public health crisis. Chronic obesity can lead to Type 2 diabetes, heart disease, arthritis, fatty liver disease, and some cancers. In the United States, 70 percent of adults are considered overweight. In Europe, more than 50 percent struggle with excess weight. In Canada, approximately 65 percent have weight issues.
Individuals have tried many different approaches, from diets and surgery to a wide variety of pills such as amphetamines and diuretics, with little success. The most recent fad was fen-phen, which held promise until long-term use was shown to trigger catastrophic heart and lung conditions. Weight loss drugs seemed doomed to failure due to their side effects.
But a new class of drugs has hit the market. It mimics a gut hormone called glucagon-like peptide-1 (GLP-1).
This is not an overnight story or even really just a 2023 story. Researchers discovered GLP-1 in the early 1980s and gradually worked out its biochemistry. It modifies blood sugar and was pursued as a possible control for diabetes.
In the 1990s, it was discovered that injecting GLP-1 into the brains of rat made them eat less. Of course, humans aren’t rats, but a study of 20 healthy young men found intravenous injections had a similar impact on their appetite. Various derivatives, such as a similar peptide from the Gila monster, were tested as treatments for Type 2 diabetes.
The drugs didn’t really catch fire until two years ago, when Novo Nordisk’s next iteration, semaglutide, was introduced to the market as Ozempic for diabetes and Wegovy for weight control. And while two percent of the population is now using these compounds, researchers continue to search for iterations which have fewer side effects and better results.
The 2023 breakthrough of the year – drugs to treat what is predominantly a first-world problem.
Todd Whitcombe is a chemistry professor at the University of Northern B.C.
