They are the medications of the moment and without a doubt the golden goose of the pharmaceutical industry. Drugs like Ozempicthe Wegovy or the Mounjaro have proven to be a very effective weapon to achieve significant weight losses in patients, which undoubtedly makes them very attractive for those people who suffer from obesity. The problem is that since they are so recent, we do not know exactly their long-term adverse effects. And this is a serious problem.
Although these drugs are currently available on the market, science has the obligation to continue investigating their effectiveness and also the long-term side effects. Therefore, three new and exhaustive Cocharne scientific reviewsrequested by the WHO itself, confirm it: they work and they achieve significant weight loss, although there is then a rebound effect. But beyond this there are several problems that surely are not discussed as much.
The same reviews as praise its effectiveness They issue a strong warning: strong involvement of pharmaceutical companies in practically all of the studies analyzed raises serious concerns. The evidence on long-term safety, side effects and how financial ties might be influencing outcomes remains, according to the researchers, “limited or uncertain.”
Side A. The analysis done by Cochrane evaluated three of the main agonists of the GLP-1 receptor. These drugs, which were originally intended for the treatment of type 2 diabetes, mimic a natural hormone that our body secretes, GLP-1. By increasing their concentration, what is achieved is that the patient you feel full for much longerand therefore do not eat as much food.
The results of these drugs are really positive. The undisputed star is Mounjaro, which managed to reduce on average 16% of body weight after taking it after 12 to 18 months. But Ozempic, which is undoubtedly the most famous, is not far behind, since it reduces weight by around 11% in a period of 24 to 68 weeks, and the most important thing is that the effect persists for two years.
Side B. Throughout the research, several blind spots emerge that are sometimes not counted, as patients are left with almost miraculous weight loss. And taking it is not a bed of roses, as it has side effects such as nausea or digestive discomfort which are very frequent.
But also, and this is key, the studies found practically no difference between the drugs and the placebo in terms of major cardiovascular events, mortality or quality of life. That is, with current evidence, they make you lose weight, but there is no evidence that they make you live longer or be happier.
Conflicts of interest. This is the central point of the warning issued by the scientific review, since they have seen that most of the studies in the reviews were financed by the companies that manufacture the drugs themselves, so there may be a significant bias in the results. It cannot be logically compared to the results offered by completely independent results, which is what this review demands.
Great unknowns. As we say, these drugs are known to have a short-term effect, which is significant weight reduction. But the question it raises is… What will happen in the future among patients who take it regularly? This is where a lot of data is still missing.
These are the effects we know as ‘Type C Adverse Drug Reactions’. Precisely because they are chronic. There are very clear examples, such as that benzodiazepines produce long-term tolerance or dependence.
Additionally, most trials were conducted in middle- and high-income countries, with little or no representation from regions such as Africa, Central America, or Southeast Asia. Because body composition and diet vary globally, the authors caution that it is not known how these drugs will work in more diverse populations.
A bittersweet taste. GLP-1 drugs are promising, but the scientific basis on which clinical and policy decisions are based is largely built by their own manufacturers. This is also added to the need to wait for possible long-term complications to arise that determine the non-recommendation of using this treatment.
But this is not something that stops countries from betting on this treatment as is the case in the United States where Donald Trump reached an agreement with different pharmaceutical companies to reduce the price of these medications by a good percentage with the aim of making them more accessible.
Images | David Trinks
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