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Weight Loss Injections: A Comprehensive Guide to GLP-1 Analogues

Weight loss can be a challenging and frustrating process for many people. Despite following strict diets and rigorous exercise routines, some individuals struggle to shed off excess weight. This has led to the development of various medical interventions, including weight loss injections. Glucagon-like peptide-1 (GLP-1) is one such hormone involved in blood sugar control that has shown promising results in weight management. In this article, we'll explore GLP-1 analogues and their effectiveness as weight loss injections.

GLP-1 Analogues GLP-1 analogues are synthetic drugs that mimic the effects of GLP-1, a hormone produced naturally in the gut in response to food intake. GLP-1 plays a vital role in regulating blood sugar levels and insulin secretion. It also promotes satiety and delays gastric emptying, which helps in weight loss. Two GLP-1 analogues currently used as weight loss injections are semaglutide and tirzepatide.

Semaglutide

Semaglutide (Ozempic) is a once-weekly GLP-1 analogue that has shown remarkable results in clinical trials. It is more effective than exenatide, another GLP-1 analogue, in reducing body weight. In June 2021, the US Food and Drug Administration (FDA) approved semaglutide injection, sold under the brand name Wegovy, for long-term weight management in adults. Wegovy was also approved for medical use in the European Union in January 2022. A recent review identified semaglutide as one of the most promising candidates in the anti-obesity market, citing its impressive weight loss results and weekly administration.

Tirzepatide

Tirzepatide is a newer GLP-1 analogue that combines the effects of GLP-1, glucose-dependent insulinotropic polypeptide (GIP), and glucagon receptors. In phase III clinical trials, tirzepatide demonstrated significant weight loss in patients with obesity and type 2 diabetes. The trials found that after 71 weeks, patients had lost an average of 16% of their starting body weight. On 13 May 2022, tirzepatide was approved for type-2 diabetes, although not specifically for weight loss, under the name Mounjaro.

Liraglutide

Liraglutide (Saxenda) is another GLP-1 analogue that has been approved for weight management. It is administered once daily and has shown promising results in clinical trials. In a trial of more than 3,700 participants, those who received liraglutide injections lost an average of 8.4% of their body weight over 56 weeks. Liraglutide has been approved by the FDA for weight management since 2014.

Exenatide

Exenatide (Byetta) is another GLP-1 analogue that is currently available as a treatment for Type 2 Diabetes. Exenatide is a long-acting analogue of GLP-1, which promotes a feeling of fullness after eating and delays stomach emptying. Some patients have reported substantial weight loss while taking exenatide. However, exenatide must be injected subcutaneously twice daily, which can be inconvenient for some patients. Moreover, some patients may experience severe nausea when starting therapy.

Clinical Trials

Clinical trials have shown that GLP-1 analogues and agonists are highly effective at inducing weight loss in patients with obesity. In a randomized, double-blind, placebo-controlled trial of semaglutide in patients with obesity, those who received semaglutide lost an average of 14.9% of their body weight over the course of 68 weeks, compared to 2.4% in the placebo group.[9] Similarly, in a randomized, double-blind, placebo-controlled trial of tirzepatide in patients with obesity, those who received tirzepatide lost an average of 16.0% of their body weight over the course of 72 weeks, compared to 2.3% in the placebo group.

Side Effects

The most common side effects of GLP-1 analogues and agonists are gastrointestinal in nature, such as nausea, vomiting, and diarrhea. Other side effects may include headache, dizziness, and hypoglycemia.[11] In addition, GLP-1 analogues and agonists have been associated with an increased risk of pancreatitis and pancreatic cancer in some studies, although the evidence is conflicting and the overall risk appears to be low.

Summary

  1. GLP-1 analogues and agonists, such as semaglutide and tirzepatide, are promising options for the treatment of obesity. Clinical trials have shown that these medications are highly effective at inducing weight loss in patients with obesity, and they have been approved for medical use in the US and the European Union.
  2. Vilsbøll T, Krarup T, Madsbad S, Holst JJ. Both GLP-1 and GIP are insulinotropic at basal and postprandial glucose levels and contribute nearly equally to the incretin effect of a meal in healthy subjects. Regul Pept. 2003;114(2-3):115-121. doi:10.1016/s0167-0115(03)00116-0
  3. Sandoval D. Peptides that regulate food intake: glucagon-like peptide 1-(7-36) amide (GLP-1) [published correction appears in Encyclopedia of Neuroscience, 2009;2:835-836]. In: Squire LR, ed. Encyclopedia of Neuroscience. Vol 3. Academic Press; 2009:677-682. doi:10.1016/b978-008045046-9.00337-2
  4. Pi-Sunyer X, Astrup A, Fujioka K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11-22. doi:10.1056/NEJMoa1411892
  5. Gejl M, Gjedde A, Egefjord L, et al. In Alzheimer's disease, 6-month treatment with GLP-1 analog prevents decline of brain glucose metabolism: randomized, placebo-controlled, double-blind clinical trial. Front Aging Neurosci. 2016;8:108. doi:10.3389/fnagi.2016.00108
  6. Astrup A, Rössner S, Van Gaal L, et al. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet. 2009;374(9701):1606-1616. doi:10.1016/S0140-6736(09)61375-1
  7. Pi-Sunyer X, Astrup A, Fujioka K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373(1):11-22. doi:10.1056/NEJMoa1411892
  8. Neeland IJ, Turer AT, Ayers CR, Powell-Wiley TM, Vega GL, Farzaneh-Far R, Grundy SM, Khera A, McGuire DK, de Lemos JA. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA. 2012 Oct 17;308(15):1150-9. doi: 10.1001/2012.jama.11132. PMID: 23073952.
  9. Jendle J, Nauck MA, Matthews DR, Frid A, Hermansen K, During M, Zdravkovic M, Strauss BJ, Garber AJ, LEAD-2 and LEAD-3 Study Groups. Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue. Diabetes Obes Metab. 2009 May;11(5):1163-72. doi: 10.1111/j.1463-1326.2009.01132.x. Epub 2009 Mar 26.
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