In high school biology, units dealing with metabolism and endocrinology often discussed insulin and glucagon, which had opposing effects in monitoring blood glucose levels. You can imagine that precise control of insulin and glucagon levels would be very important to good health, particularly to manage the symptoms in diabetic patients. The glucagon-like peptide-1, or GLP-1, is actually a cleavage product of a larger protein that produces glucagon as one of the four distinct products. Produced by the small intestine, GLP-1 has direct effects that include:
GLP-1 agonists are designed to mimic these effects through a structure that is similar to the native GLP-1, and are meant to be injected subcutaneously, which sounds painful but probably isn't too far off from what diabetic patients do to check their blood sugar, or other individuals might experience when they use an epipen.
In addition to these profound effects in reducing weight and managing diabetes, it was found that people suffering from obesity and heart failure taking semaglutide showed incredible improvement in their heart health, had the energy to exercise more, and reduced their risk of future heart attacks and strokes than those on placebos.
I was watching this Doctor Mike video about fake "direct to consumer pharmaceutical advertising" commercials from Saturday Night Live, and he pretty much covered all my thoughts whenever these commercials show up during TV shows or sports events. The commercial spends about 10 seconds telling you the name of the drug and what it is supposed to do while listing general symptoms of some disease, and then the remaining time is spent listing all the ways it can kill you. It is no different for Wegovy and Mounjaro and every other drug, in that they have to tell you that side effects include pancreatitis, gastroparesis (a slowing of the emptying of the stomach), and bowel obstruction, along with a potential for thyroid cancer. Other side effects of GLP-1 agonists include nausea, vomiting, and diarrhea, which, while not as terrible as, say, thyroid cancer, is still rather unpleasant (and seems to be shared by a lot of drugs advertised on TV, hmmm).
Another potential issue with GLP-1 agonists, particularly if used as a treatment for obesity, is the regaining of lost weight soon after discontinuing the medication. In this video from Harvard Medical School, it was stated that patients that discontinued semaglutide use would regain most of their lost weight within a year. Along with the other previously mentioned adverse effects, having to essentially take this drug forever could increase those risks for the patient. In related news, scientists at MIT recently developed a vibrating capsule to treat obesity, and it seems that mildly shaking the stomach is probably better than thyroid cancer and bowel obstruction (though I guess there's a chance the pill gets stuck).
The above article from MIT had a good point about the potentially prohibitive cost of GLP-1 agonists, especially if they must be taken perpetually to be effective. The goal of their research was to create a cost-effective and safe option for people who can't afford those types of drugs, similar to the motivation behind my friend Max's research into natural remedies for complex human diseases. I would be curious to see how their future clinical trials go after the favorable results they observed in animals.
In the future, as supply chains start moving quicker and patients become more educated about their options, people can benefit from this medical breakthrough that has plenty of positive potential despite the challenges we discussed here. And since this is a new year, don't forget to also exercise and eat right, which is definitely something I should do more of too, after I finish this last cookie.