Weight-loss drugs could help those who have moderate amount to lose, expert says

FRANCE 24 English

Novo Nordisk's weight-loss drug Wegovy will be available in France from this Tuesday. The drug will require a prescription and will not be reimbursed by French social security. FRANCE 24's Sharon Gaffney speaks to Adam Collins, Associate Professor of Nutrition at the University of Surrey. He says that the latest class of drugs is a useful tool for people who have a moderate amount of weight to lose.  Visit our website: http://www.france24.com  Like us on Facebook: https://www.facebook.com/FRANCE24.English  Follow us on Twitter: https://twitter.com/France24_en

Transcript

00:00Welcome to Apropos, where drugs like Wegovy have been hugely successful in markets like

00:08the U.S. at helping people to control their blood sugar levels and to lose weight.

00:13But they can have unpleasant side effects like nausea and vomiting.

00:18Administered as a once-weekly injection, studies suggest its usage can produce sustained reductions

00:25in body weight.

00:27Wegovy is available here in France if prescribed by a doctor as a treatment for obesity.

00:33Delano de Souza has more.

00:37A different molecule as diabetes drug Ozempic but in the same class.

00:42Novo Nordisk's weight loss medication Wegovy goes on sale in France from Tuesday.

00:48Clinical trials for the drug, which has been authorised for use in the European Union since

00:52January 2022, has seen drops of up to 15% of body weight.

00:58Injected weekly, the active ingredient in the medication which suppresses hunger is

01:02at a higher dose for Wegovy than Ozempic and it's a trend that's caught on.

01:07Media mogul Oprah Winfrey, whose battled weight gain over the years, has openly spoken about

01:12its benefits.

01:13Actress and producer Mindy Kaling has been rumoured to have taken the medication to lose

01:17weight but has remained tight-lipped.

01:20Comedian Amy Schumer admitted to taking Ozempic but said she quickly stopped due to side effects.

01:26Every drug has a side effect and we know that obese patients, when they lose a lot of weight,

01:31they lose their muscle mass and that's really also very serious.

01:36Danish pharmaceutical company Novo Nordisk recently came into the crosshairs of American

01:42lawmakers with prices of its medications 15 times higher in the United States

01:47than in the United Kingdom.

01:50Novo Nordisk has already made billions of dollars in profit off of these products and

01:54in the coming years will make billions more.

01:56Treat the American people the same way that you treat people all over the world.

02:04Stop ripping us off.

02:07Wegovy's price will not be fixed in France but, according to the company, will cost between

02:129 to 12 euros per day.

02:14According to British medical journal The Lancet, obesity affects one billion people,

02:19around the world.

02:23To discuss further, we're joined now by Adam Collins, Associate Professor of Nutrition

02:28at the University of Surrey in the UK.

02:31Thank you so much for being with us on the programme this evening, Alan.

02:35So we heard in that report there are many celebrities swear by them.

02:39Clinical trials suggest that drugs like Wegovy do succeed in reducing body weight.

02:46What exactly do they do?

02:49So as your piece suggested, it's basically mimicking a hormone that is naturally produced

02:56in response to eating, which feeds back to the brain and makes you feel full.

03:01So it stops you feeling hungry.

03:03So the difference is that this is producing or giving you about two to three times your

03:09normal dose and in a sustained way that doesn't normally get broken down in the same way as

03:16you're naturally producing one.

03:18So the end result is that people feel fuller for longer, don't feel hungry, eat less and

03:24obviously end up losing weight very effectively and getting them to lose weight by eating

03:29less.

03:30Are they the answer then for people who have struggled to lose weight?

03:33And if so, for who exactly?

03:37I think this produces quite a nice tool to add to our toolbox, which sort of fits in

03:45the sort of spectrum of interventions that we can use for weight loss.

03:49So at the very high ends of weight, we know that things like bariatric surgery are very

03:55effective for people that are morbidly obese to get them to lose significant amounts of

04:00weight.

04:00And we know at the lower end, when people just need to lose a small amount of weight,

04:05that actually diet and lifestyle can be very effective.

04:07But this could actually fulfil a need in the middle of that range where people have a sort

04:13of a moderate amount of weight to lose and possibly struggle to lose that through normal

04:18diet and intervention trials.

04:20And obviously, they're not really eligible for the more extreme interventions like bariatric

04:25surgery.

04:26So it's a very useful tool to have in our toolbox now.

04:30A useful tool, as you say.

04:31But if people stop taking these drugs, what then happens?

04:35Do they start putting the weight back on again?

04:37Or do they manage to sustain the weight loss?

04:40Well, like all diets, the problem really is not necessarily getting people to lose weight,

04:45but maintaining that weight once they lose it.

04:49And there's lots of biological drivers that force people to sort of put that weight back

04:54on, whether that's from diet, from exercise, or for other interventions.

05:00Now, the worry about these drugs is that because you're artificially altering what naturally

05:05produces in the body, you're taking these pharmacological doses of this natural hormone,

05:11that because you're so used to taking such high amounts, your body could become desensitized

05:17to the effects of normal doses and might even stop producing the naturally occurring version

05:26itself in response to eating.

05:28Now, that's OK if you still carry on taking the drug and injecting yourself or soon to

05:33come our way is taking it as a pill form.

05:37But what happens when you stop?

05:39Of course, you're now almost going cold turkey.

05:42It's like you've got none of this at all, because your body has stopped producing it

05:46and maybe is less sensitive to it.

05:49So of course, that hunger comes back with a vengeance and that is going to amplify perhaps

05:54all these other drivers of getting people to regain that weight.

05:58And that's certainly what you see in the trials, that when you stop taking it,

06:03you within six months, 12 months, people have put on over half the weight that they've lost.

06:09And that's in a clinical trial where they've got lots of support, lots of other mechanisms

06:15in play in terms of trying to get them to maintain that weight just by the fact you're

06:20drawing this treatment.

06:21And Adam, is there a risk that the taking of these drugs, it might normalize taking

06:27medication over healthy eating or doing more exercise?

06:31What kind of an impact could it have there?

06:34Well, I think this is another concern is that obviously, this is medicalizing the whole

06:39issue of weight management, obesity, and it sort of takes any effort out of it.

06:45So the person just says, oh, I can just take this drug.

06:48I don't have to worry about changing my diet and lifestyle because this is doing all the

06:53heavy lifting for me.

06:55But of course, then you've got no change in behavior.

06:57You've got nothing that is actually left.

07:00And when you take that away, that's actually going to not only help you maintain that weight,

07:05but obviously prevent you from regaining that weight.

07:07And maybe we're just sort of almost undermining the value of what we know works in terms of

07:15diet and lifestyle, getting people to eat more healthily, eat less food, maybe reduce

07:23all the types of foods that people passively overconsume and becoming more active, not

07:27necessarily doing lots of exercise, but just being generally more active.

07:31This is almost like making people say that you don't need to do that anymore because

07:35it's just all done by this magical drug.

07:39Yeah, and as we heard in the report, there is no such thing as a magical drug.

07:42These drugs, though, they have been taken by people with diabetes for years.

07:47Are there particular risks that are different for people who take them in order to lose

07:53weight?

07:54Well, I think one of the risks, and I think generally they're quite safe.

07:58I mean, there are some side effects.

08:00People have suggested that it has increased risk of other things, but I don't think that's

08:06really well proven.

08:07And we don't know because people haven't been taking this for long enough to really

08:11show that.

08:13But I think one of the concerns is sort of going back to what I said about this idea

08:17of what happens when you stop taking it, is that when you're taking people, and often

08:23it's very popular for people that maybe just want to lose a little bit of weight or maybe

08:27don't even need to lose weight at all, but have this desire to be slim and taking this

08:32drug is a quick fix.

08:34That almost like setting yourself up to be like addicted to this drug, because if you

08:39don't carry on taking it, then you might end up regaining that weight and maybe even

08:45becoming a higher weight than you were to start with, and almost like a driver of you

08:50gradually becoming heavier and heavier over time.

08:53All this cycling of losing weight, regaining that weight.

08:57I think that's a problem that I can see potentially happening by people inappropriately

09:04taking it.

09:04People at the lower end that perhaps only need to lose a small amount of weight, they're

09:09the ones that perhaps shouldn't be using this drug because it's like a sledgehammer to

09:14crack a nut.

09:15You should be doing something more appropriate and more moderate in terms of possibly more

09:22diet and lifestyle interventions.

09:24Yeah, because one in eight Americans as well have taken this drug as they're attempting

09:30to lose weight.

09:31Does that surprise you?

09:32Here in France, it will have to be prescribed by a doctor.

09:36Yeah, and it's the same in the UK, but of course people can get access to this through

09:43other means, whether that's through a doctor that they can pay to go and see privately

09:50that might be able to prescribe it for them, or other means by which they can get hold

09:55of it.

09:55Worryingly, on the black market where you've got no real assurances actually whether that's

10:01the drug that you intend to take or not, and there's been some cases where people have

10:06obviously been taking fake versions of this drug and got into serious health issues as

10:13a consequence.

10:15So yeah, I think there's lots of things to worry about with this drug if you're thinking

10:19of it as a magical cure or a very quick fix to get people to lose weight.

10:26Yeah, because obesity rates, Adam, as well, I guess you could look at this as a positive

10:31thing.

10:32They've been rising for decades in the US, but they actually fell slightly between 2020

10:37and 2023.

10:39Is that because people have started using these kinds of drugs?

10:44Possibly.

10:45I mean, people are arguing, have we reached peak obesity?

10:49Someone like states maybe we've reached the maximum rate of obesity that we possibly could

10:54see.

10:56I don't know.

10:57I mean, how high can you go?

10:59I don't know.

11:00But yes, this is obviously going to have an impact and it will make a difference to our

11:06treatment of obesity for sure.

11:08But there is also some moralistic and social concerns about it, because let's say that

11:15you are saying this is a drug that effectively gets people to lose weight.

11:20Then if you are overweight or obese and you haven't got access to this drug, then you

11:26could be stigmatised and say, well, you're overweight and obese and you haven't done

11:30some anything about it.

11:32And that can really raise issues of inequality and access to health care, particularly as

11:38Bernie Sanders was saying in the US where it's very expensive and it's not widely

11:43accessible for everybody.

11:45So there's a sort of elitist aspect to it.

11:49So if you're rich and you've got influence, you can get hold of it, even if you're not

11:53really suitable for its prescription.

11:57And whereas people perhaps haven't got that means financially or access to it could lose

12:04out.

12:04And those tend to be the ones that are possibly exposed to things that are driving them to

12:10be obese, possibly having the worst diet and lifestyle as a consequence of their environment.

12:17So, yeah, I think there's lots of things you need to unpick from all of this.

12:22But there's no doubt it's a very effective tool and something that's now added to our

12:27toolbox.

12:28It is a welcome addition, really.

12:31Adam, we'll have to leave it there for now.

12:33But thank you so much for your time on the programme.

12:34That's Adam Collins.

12:35He's Associate Professor of Nutrition at the UK-based University of Surrey.

12:41And that is it.

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