Weight loss: Why people stick with Wegovy longer than older drugs

• New research shows that people are much more likely to adhere to newer semaglutide medications for long-term weight loss than older anti-obesity drugs.
• Semaglutides such as Wegovy, Ozempic, and Rybelsus were developed to treat type 2 diabetes but are also being prescribed for obesity.
• Accessibility to these newer drugs is an issue with frequent shortages, high costs, and inconsistent insurance coverage.
• While new drugs can make a significant difference when it comes to weight loss, experts say lifestyle changes are necessary for long-lasting results.

In recent years, semaglutide medications sold under the brand names Wegovy, Ozempic, and Rybelsus have been a game-changer when it comes to treating not just type 2 diabetes but also obesity.

Now, new research out of the Cleveland Clinic shows that people prescribed Wegovy tend to stick with it longer than older weight loss drugs with 40 percent still taking it a year later — a threefold increase from older anti-obesity drugs.

The findings were published last week in the medical journal Obesity and experts say they offer some intriguing insights into the long-term use of anti-obesity medications.

The study’s lead author told Medical News Today that positive results from the newer drug could help explain the long-term adherence.

Better results, better adherence for weight loss drugs

Glucagon-like peptide-1 receptor agonists, or GLP-1 analogs, have been developed in recent years as a treatment for type 2 diabetes.

Semaglutide medications fit into this category. Wegovy have also been approved by the U.S. Food and Drug Administration (FDA) to treat obesity.

These drugs can help people curb unhealthy eating habits by stimulating hormones, which suppresses the appetite. They also help the stomach empty more slowly, leading to a more long-lasting feeling of being full.

Hamlet Gasoyan, PhD, the lead author of the study and a researcher with Cleveland Clinic’s Center for Value-Based Care Research, set out to explore whether patients were willing to stick with these prescriptions to treat their obesity.

“We wanted to conduct this study since there is very little known about patients’ long-term use of anti-obesity medications and the factors associated with non-persistence,” he told Medical News Today.

“We were expecting to see that individuals receiving novel AOM (anti-obesity medication) agents and those experiencing greater 6-month weight loss would be more likely to continue with their AOM treatment at one year, but we did not expect to see such a large difference in later-term persistence between semaglutide and the older-generation AOMs,” Gasovan said.

Gasoyan and his colleagues concluded from the data that people who experienced more successful weight loss were more likely to stick with their semaglutide prescription than those who were prescribed older anti-obesity drugs.

“This is encouraging and important information for clinicians, patients, and policymakers,” he emphasized.

Wegovy a game-changer for those who can afford it

While the significance of this class of medications is hard to downplay, there are a few stumbling blocks for those who may benefit.

First off, the soaring popularity of these drugs has made them scarce.

Secondly, they can be prohibitively expensive for those who don’t have a comprehensive drug plan and insurance coverage may depend on what the drug is specifically prescribed for.

Gasoyan says that monthly list prices for anti-obesity medications ranges from $200 for phentermine-topiramate (which is not part of the semaglutide class) to $1,300 for semaglutide.

“Drugmakers of some of these medications have savings programs or coupons for commercially insured individuals which can reduce the patient’s out-of-pocket payments, but these are generally limited to 12 months or less,” he explained. “Most state Medicaid programs, as well as Medicare Part D prescription drug plans, do not cover AOMs. Many insurance plans cover Ozempic when it’s used as a treatment for diabetes.”

Weight loss drugs are not a magic bullet

This wave of effective anti-obesity medications couldn’t come along at a better time as the U.S. Centers for Disease Control and Prevention reports that nearly 42 percent of U.S. adults are obese – an increase of more than 10 percent from the year 2000.

Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California who was not involved in the study, told Medical News Today that clinicians generally use body mass index as a metric when deciding a course of treatment.

“Typically, patients who have a body mass index greater than 30 are candidates for medical weight loss medication and if it’s higher than 40, then they’re better off getting surgery for weight loss,” he explained.

That said, achieving healthy and lasting weight loss is more complicated than simply taking a medication or getting surgery, Ali noted.

“No matter what doctors do, whether it’s medication or surgery, these are just tools. If the patient adheres to adopting a better lifestyle with healthier eating habits, then they can have a great deal of success,” he said. “If the patient doesn’t change what they’re doing, they’ll have a hard time no matter what we prescribe.”

As a relatively new class of drugs, there isn’t much long-term data on adherence when it comes to semaglutides. However, the Cleveland Clinic study provides some early insights on whether or not people will stick to their prescriptions.

“We are getting a better understanding of the persistence rates with AOMs in clinical practice as well as some of the key factors related to long-term use of medications for chronic weight management, and it’s very encouraging to see that patients who have access to more effective AOMs are more likely to continue with their treatment,” said Gasoyan.

“Our findings also indicate that there is more work to be done to address the barriers to continued use of AOMs. For example, the persistence with AOMs at one year in our study also varied based on insurance carrier among privately insured individuals.” he added. “To this end, we plan to examine the role of specific insurance design features in continuous access to AOM as well as interventions to help increase persistence in the future.”

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