Why some people don’t lose weight with Wegovy

Clinical trials have shown that people using weight loss vaccines, such as Wegovy and Mounjaro, lose between 16% And 21% of their body weight. But medications don’t work for everyone.

In these trials, a group of participants lost less than 5% of their body weight (weight loss 5% or more is considered “clinically significant”). These so-called non-respondents made up 10-15% of participants. Anecdotal evidence, provided by obesity experts for Associated Presssuggests that outside the highly controlled confines of clinical trials, up to 20% of people do not respond well to medications. Why might this be the case?

First, it is important to recognize that the causes of obesity are multiple. Our understanding of the genetic underpinnings of obesity has improved significantly over the past decade, revealing that for many people, genetic variations have a significant effect on their weight. For example, a Study 2021 found that 0.3% of the UK population (or more than 200,000 people) carry a genetic mutation in part of the brain circuits that regulate appetite, leading to an average of 17kg of extra weight at age 18 years old.

This genetic variability into the underlying causes of obesity could be an explanation for why some people respond poorly to these medications.

It is also important to recognize how these new obesity medications work. Anyone who has tried to lose weight through diet and exercise knows that these attempts are usually met with increasing feelings of hunger and fatigue.

This is the body’s normal response to weight loss. It aims to protect what the brain considers to be one’s “normal” body weight, which for some may be in the obesity range. Newer weight loss drugs work by turning off this physiological response, making it easier to lose weight through changes in diet and exercise.

In clinical trials, participants receive exercise support and access to dietitians and psychologists. These experts provide participants with personalized support on the lifestyle changes needed to maximize the benefits of these medications.

This support is rarely available outside of clinical trials, and its absence can limit the effectiveness of medications if necessary lifestyle changes are not supported by these experts.

Several studies have sought to identify factors that may predict weight loss responses to weight loss injections. A common factor for clinically significant weight loss is higher starting body weight.

Lots of hype

Since their introduction, hype around new weight-loss vaccines has caused demand to skyrocket among those for whom the drugs were developed (obese people) and those who are not obese but are looking to lose a few pounds.

In the United Kingdom, the National Institute for Health and Care Excellence (Nice) establishes guidelines on the clinical parameters necessary for a medicine to prescribe. For Wegovy and Mounjaro, the person must be obese and have at least one obesity-related health problem, such as sleep apnea or high blood pressure.

Due to the lack of effective alternative medications for weight loss, and probably because of the media coverage that these drugs received, there was off-license prescription reports of these medicines for people who do not meet the Nice criteria.

A likely consequence of this is that people whose body weight is lower than that stipulated by the guidelines are prescribed these medications for weight loss and, as such, lose less weight than others. clinical trials demonstrated.

Despite the minority of people for whom these drugs do not work, their introduction promises to bring significant health benefits to millions of people who previously struggled to lose weight.

This article is republished from The conversation under Creative Commons license. Read the original article.