[Reading Science] Is Humanity's Conquest of Obesity Not Far Away?

Next-Generation Obesity Treatments Developed One After Another
Challenges Such as High Costs Remain

Obesity Rate Among Korean Boys Higher Than OECD Average

[Asia Economy Reporter Kim Bong-su] Recently, groundbreaking obesity treatments have been emerging one after another, giving hope to those who desire a slim figure and good health. However, controversies over their high prices and effectiveness remain.

According to the international journal Nature on the 6th, at the Obesity Week conference held last November in San Diego, California, the presentation of Novo Nordisk's semaglutide obesity treatment drug "Wegovy" received great acclaim and was successfully conducted. The company reported astonishing results that even teenagers, who are known to respond poorly to obesity treatments, lost at least 20% of their body weight in over one-third of cases after taking the drug for 16 months. This drug had already proven similar effects in adults.

Recently, a large number of next-generation obesity treatments that dramatically reduce weight without serious side effects have been introduced. These mainly mimic the role of the hormone incretin, which lowers blood sugar and suppresses appetite in the human body. Some have already been approved as treatments for type 2 diabetes and are currently undergoing certification procedures for weight management.

Obesity treatment research began in earnest when Jeffrey Friedman, a professor at Rockefeller University in the U.S., discovered in 1994 that obesity is caused by a genetic defect leading to a deficiency of leptin (an appetite-suppressing hormone secreted by fat cells). Earlier, a research team led by Jens Juul Holst at the University of Copenhagen had identified the hormone GLP-1, which increases insulin production and lowers blood sugar to prevent diabetes. The obesity treatment drug liraglutide, developed based on this, showed an average weight loss effect of 8% in mid-2010s clinical trials, which was 5 percentage points higher than the placebo group, confirming its clinical relevance to weight loss.

Then, in early 2021, a next-generation obesity treatment drug called semaglutide appeared, bringing revolutionary changes. This treatment substance, a modified form of liraglutide, is designed to remain longer in the body and exert continuous effects. The extended action time on the brain's nervous system results in a stronger appetite control effect. Clinical results confirmed that people who took semaglutide once a week for 16 months experienced an average weight loss of 14.9%, an astonishing diet effect. The U.S. Food and Drug Administration (FDA) officially approved this drug as an obesity treatment for adults in the same year. Timo M?ller, a researcher at the Helmholtz Munich Diabetes and Obesity Research Center in Germany, explained, "Historically, it was impossible to safely reduce weight by more than 10% with chemical prescriptions," adding, "New prescriptions not only reduce weight but also improve cardiovascular health, which is the exact opposite of the past."

A more powerful obesity treatment drug, Tirzepatide, is also being researched. This drug mimics not only the GLP-1 receptor but also the function of the GIP (glucose-dependent insulinotropic polypeptide) hormone involved in insulin secretion. It was approved last year as a treatment for type 2 diabetes. Clinical results from the developer Eli Lilly showed an average weight loss effect of 21% when administered at the maximum dose. This figure approaches the effect of obesity surgery, which can reduce weight by up to 30%.

Additionally, research is ongoing on glucagon, an insulin secretion-stimulating hormone, and the gut hormone "peptide YY," known to be related to appetite. Some researchers are also studying the monoclonal antibody bimagrumab, which reduces fat while increasing muscle mass, as an obesity treatment.

The problem is that despite the effective obesity treatment performance of these next-generation drugs, their prices are prohibitively high. For example, Novo Nordisk's obesity treatment drug Wegovy costs $1,300 per month. In the U.S., many insurance companies refuse coverage, placing a heavy burden on users. There is also a lack of research on whether the drug must be taken for life and which individuals respond well or poorly to it. One study found that if semaglutide use is discontinued, two-thirds of the lost weight is regained within a year. Side effects such as nausea and vomiting also occur.

Long-standing debates about the relationship between weight and health are resurfacing. There is concern that overlooking the fact that being overweight does not necessarily mean poor health could lead to the overuse of obesity treatments. One study found that about 30% of obese individuals have healthy cardiovascular systems. There are worries that people’s awareness of obesity risks may diminish. Since obesity can be treated anytime with medication like surgery, people might neglect dietary improvements, potentially worsening their health.