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Unlike scores of people who scrambled for the blockbuster drugs Ozempic and Wegovy to lose weight in recent years, Danielle Griffin had no trouble getting them.
The 38-year-old information technology worker from New Mexico had a prescription. Her pharmacy had the drugs in stock. And her health insurance covered all but $25 to $50 of the monthly cost.
For Griffin, the hardest part of using the new drugs wasn’t access. It was finding out that the much-hyped medications didn’t really work for her.
“I have been on Wegovy for a year and a half and have only lost 13 pounds,” said Griffin, who watches her diet, drinks plenty of water and exercises regularly. “I’ve done everything right with no success. It’s discouraging.”
In clinical trials, most participants taking Wegovy or Mounjaro to treat obesity lost an average of 15% to 22% of their body weight — up to 50 pounds or more in many cases. But roughly 10% to 15% of patients in those trials were “nonresponders” who lost less than 5% of their body weight.
Now that millions of people have used the drugs, several obesity experts told The Associated Press that perhaps 20% of patients — as many as 1 in 5 — may not respond well to the medications. It's a little-known consequence of the obesity drug boom, according to doctors who caution eager patients not to expect one-size-fits-all results.
“It's all about explaining that different people have different responses,” said Dr. Fatima Cody Stanford, an obesity expert at Massachusetts General Hospital
The drugs are known as GLP-1 receptor agonists because they mimic a hormone in the body known as glucagon-like peptide 1. Genetics, hormones and variability in how the brain regulates energy can all influence weight — and a person's response to the drugs, Stanford said. Medical conditions such as sleep apnea can prevent weight loss, as can certain common medications, such as antidepressants, steroids and contraceptives.
“This is a disease that stems from the brain,” said Stanford. “The dysfunction may not be the same” from patient to patient.
Despite such cautions, patients are often upset when they start getting the weekly injections but the numbers on the scale barely budge.
“It can be devastating,” said Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of the obesity treatment company FlyteHealth. “With such high expectations, there’s so much room for disappointment.”
That was the case for Griffin, who has battled obesity since childhood and hoped to shed 70 pounds using Wegovy. The drug helped reduce her appetite and lowered her risk of diabetes, but she saw little change in weight.
“It’s an emotional roller coaster,” she said. “You want it to work like it does for everybody else.”
The medications are typically prescribed along with eating behavior and lifestyle changes.
It’s usually clear within weeks whether someone will respond to the drugs, said Dr. Jody Dushay, an endocrine specialist at Beth Israel Deaconess Medical Center. Weight loss typically begins right away and continues as the dosage increases.
For some patients, that just doesn't happen. For others, side effects such as nausea, vomiting and diarrhea force them to halt the medications, Dushay said. In such situations, patients who were counting on the new drugs to pare pounds may think they’re out of options.
“I tell them: It's not game over,” Dushay said.
Trying a different version of the new class of drugs may help. Griffin, who didn't respond well to Wegovy, has started using Zepbound, which targets an additional hormone pathway in the body. After three months of using the drug, she has lost 7 pounds.
“I'm hoping it's slow and steady,” she said.
Other people respond well to older drugs, the experts said. Changing diet, exercise, sleep and stress habits can also have profound effects. Figuring out what works typically requires a doctor trained to treat obesity, Saunders noted.
“Obesity is such a complex disease that really needs to be treated very comprehensively,” she said. “If what we’re prescribing doesn’t work, we always have a backup plan.”
© Copyright 2024 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.
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virusrex
There is no treatment that works perfectly for everybody, and that is something well known for doctors but not so much for patients, It is extremely good that articles like this help propagating this knowledge so patients can know there is a chance with failure and that it is not a magical drug that will always work. For many GLP-1 receptor antagonists will mean the difference between failing and succeeding in changing their lifestyle for good (apparently even for tobacco and alcohol abstinence) but for others it will not work and they will have to keep trying other solutions together with their doctor.
This is one of the reasons these kind of treatments are to be taken under vigilance of a healthcare professional, not only to evaluate risks and side effects but also to help deciding when it has become clear it is not working and another approach needs to be tried.
Wick's pencil
There are also many cases of serious long term or permanent damage to health, and even death.
Hawk
Well, 13 pounds isn't nothing, but it's a shame it wasn't successful for her.
That's more promising. 20 pounds in less than two years, about. There's no one-size-fits-all for health and weight loss. Good luck to her.
divinda
This US article being released now sure is nicely timed with how the Biden administration announcing today that the costs for Ozempic, Wegovy, etc will be covered under Medicare and Medicaid.
US population = 335,000,000
Percent of population on Medicare & Medicaid = 38%
US obesity rate = 35%-40%
So about 44+ million potential new users for these drugs will be coming to market with their costs covered by US taxpayers.
But as stated in the article, "as many as 1 in 5" of these people won't actually lose weight from taking these drugs after spending a year+ trying. So for 8+ million of these Medicare/Medicaid people, these drugs will not be effective.
These drugs cost about $12,000 per year, so 100 billion+ taxpayer dollars will be spent on those inevitable failed outcomes (assuming they stop trying at just one year), not to mention the billions in additional costs that will come with treating all the side effects.
But at least the government and drug companies can justify that massive loss by pointing to things like this article and say "hey, we've always said since the beginning that it wouldn't actually work for everybody...."
virusrex
Of course not even remotely comparable with the much more numerous cases of serious long term or permanent damage to health, and even death, that come from patients that fail trying to change their lifestyle. When the drugs greatly reduce those risks that means it is justified using them even if there are much less important risks associated with their use. Is the same as every other therapeutic intervention, even excercise comes with risks.
Why would anyone assume this? The article clearly mentions:
It’s usually clear within weeks whether someone will respond to the drugs, said Dr. Jody Dushay
One to two months of trial before the doctor (that is involved in the treatment) is completely different from using it for one full year.
No real need, specially because it only takes a few weeks to know if the patients will respond, the actual justification is that trying it and failing still allows for 80% of the people to importantly reduce their risk for chronic disease, which of course means decades of life-long treatments for obesity, hypertension, diabetes, cardiac problems, etc. can be saved by this approach.
Hawk
Not according to this article:
"Medicare is the federal program that provides health insurance to Americans ages 65 and older. The U.S. Department of Health and Human Services’ new rule expanding coverage would affect 3.4 million Medicare recipients."
"Medicaid provides coverage to lower-income Americans. Around 4 million Medicaid recipients could gain coverage under the proposed rule. States would have the option to pay for it."
"Centers for Medicare & Medicaid Services officials estimate the expansion would cost about $40 billion over 10 years."
https://eu.usatoday.com/story/news/health/2024/11/26/weight-loss-drugs-cost-insurance/76588819007/
It also makes the point that the price of the drugs is far higher in the states than it is elsewhere.
Raw Beer
So I guess there must be a very strong incentive for doctors to prescribe these products, and no incentive at all to just tell patients to cut carbs.