Losing weight is difficult. We all know what. Our bodies are physiologically designed to put on and retain weight. It is not just about willpower and more often than not, we need some medical assistance to help us achieve and maintain a healthy weight. Now a new class of medicines known as GLP-1 Analogues (Glucagon-Like-Peptide) looks to revolutionize the medical treatment for obesity. Offering a medical treatment that is not only safe, but also just as effective as stomach stapling surgery. Read on to find out more!
Why is obesity treatment necessary?
For a long time Obesity was thought of as a lifestyle choice. People who suffer from obesity were thought to have “chosen” to eat too much and are too lazy to exercise. These mistaken beliefs are reinforced by social media showing dramatic changes in weight by people who have undertaken a significant lifestyle change. With an underlying message of “if they can do it so can you”.
Obesity is a disease
Science has told us a very different story. We now know Obesity shares many characteristics with Diabetes.
- The risk of developing Obesity and the risk of developing Diabetes are largely genetically determined. A study of identical twins reared apart experiencing completely different diets and lifestyle habits had a BMI correlation of 70%! Compare this to non-identical twins who were brought up in the same household eating the same diet and doing the same exercise who had a BMI correlation of only 33%.
- Weight, just like blood sugar, is determined by a range of hormones in our bodies. And just like we cannot control Insulin which determines blood sugar, we similarly cannot control Leptin and Ghrelin which control weight.
- Mild Diabetes can be controlled by significant lifestyle change but this is difficult and more often than not, the person suffering from Diabetes will need medical help. This too applies to Obesity.
Because of all these, obesity is now recognized as a chronic disease by the World Health Organization as well as the US CDC. Like any other disease, there should be no stigma and no shame should the person suffering from it require some medical help to get it under control.
And get it under control we must. Unchecked obesity will lead to all manner of health problems including heart attacks, strokes and even cancer.
What are GLP-1 Analogues?
GLP-1 Analogues are a class of medicines that have been used very successfully to treat obesity. They were initially used to treat Diabetes.
How do GLP-1 Analogues work?
GLP-1 analogues look almost exactly like a hormone found naturally in the body called Glucagon. Natural Glucagon only lasts a few minutes in the body. By making tiny changes to the structure, GLP-1 Analogues act like Glucagon but they stay in the body for up to 1 week.
It works by acting on the hunger control centers in the brain. It tells the brain to suppress appetite and hunger. At the same time increasing the sensation of satiety and fullness.
It then promotes the use of fatty acids stored in the liver and cells. In this way, it reduces the excess adipose tissue stored in the body.
How effective are GLP-1 Analogues?
The 2 most common GLP-1 Analogues currently prescribed for weight loss are Liraglutide and Semaglutide.
Liraglutide is marketed under the brand name Saxenda.
In studies, 65% of people on Saxenda lost at least 5% of their initial bodyweight with 33% of people on Saxenda losing 10% of their initial bodyweight.
Semaglutide is marketed under the brand name Wegovy
In studies the average weight loss with Semaglutide was 15% to 18% of initial bodyweight. With nearly 1 in 3 patients losing 20% of their initial bodyweight. This is almost equivalent to the weight loss achieved by sleeve gastrectomy which is a surgery to remove a large portion of the stomach.
How fast do GLP-1 Analogues work?
Most patients will lose at least 5% of their initial bodyweight within 3 months of starting the treatment.
How safe are GLP-1 Analogues?
In a nutshell much safer than current treatment options for Obesity.
The commonest side effects from GLP-1 Analogues are nausea, diarrhea, constipation or headaches. In 93% of the time, these side effects were described as mild or moderate.
In rat studies of Liraglutide, there was noted an increase in the number of Thyroid Cancers in rats receiving Liraglutide. This caused a bit of a stir. However, in post marketing surveillance, there so far has been no cases of Thyroid Cancer noted among patients prescribed Liraglutide. The prevailing theory is that rats have GLP-1 receptors in the prostate while humans do not.
How long can I be on GLP-1 Analogues for?
Studies for Liraglutide (Saxenda) for weight loss extend to more than 3 years. While studies for Semaglutide (Wegovy) for weight loss extent to more than 1 year.
Both medicines have also been used in the management of Diabetes and have been used safely long term.
Who can use GLP-1 Analogues for weight loss?
GLP-1 Analogues are indicated for use in people with BMI > 30 OR BMI > 27 with an obesity related complication (examples include fatty liver or painful knees).
It is also indicated for people who have tried intensive lifestyle therapy for weight loss but have been unsuccessful.
These are just guidelines and your Doctor would be the best person to advise you on whether GLP-1 Analogues are right for you.
How much do GLP-1 Analogues costs?
Liraglutide marketed as Saxenda costs S$128.40 per pen of 18mg in our clinic.
How long a single pen lasts depends on the dose that is prescribed. The maximum dose is 3mg per day so 1 pen lasts 6 days.
Semaglutide has recently been introduced into Singapore and we will update on the selling price when we receive the information.
What do I do now?
If you have been struggling with weight loss and would like to consider GLP-1 Analogue treatment please contact your Doctor.
If you wish to see us drop us an email at doc@drtanmedicalcenter.coms.sg
Or visit our website to make an appointment
Have a question? Put it in the comments section below and we will get back to you.