Are we losing sight of overall health? Here's what the science says.

The frenzy of recent drugs within the GLP-1 (Glucagon-like peptide 1) and GIP (Gastric inhibitory polypeptide) analog class, known by the trade names Ozempic and Wegovy, is remarkable, however it is totally unknown in pharmaceutical history. But not unique. Blockbusters

The volume of prescriptions and the budget allocated to them by public medical insurance schemes is exploding, viz Profits for the companies that produce them..

Part of the recognition of those drugs is resulting from social networks, but they aren't all the time the very best source for health information. When it involves the subject of weight reduction, each fantasy and prejudice come into play. This harms the well-being of everyone, but especially those that are already stigmatized.

As experts in philosophy of drugs (Université de Montréal), nutrition and food science (Université Laval), sociology of drugs (Université de Montréal) and endocrinology (Institute de Recherche Clinics de Montréal), we feel that stepping back is essential Review each the guarantees and limitations of those latest treatments.

The better of each worlds

GLP-1/GIP analogues were originally developed to regulate glycemia (blood sugar levels) in individuals with type 2 diabetes, thereby stopping complications related to the disease. When studies were conducted to judge their safety and efficacy, these drugs were found to induce weight reduction as well. This led to latest research showing that the drug can result in overdose. Significant weight lossfrom 15 to 25 percent of the initial weight.

The mechanism of motion of those drugs on blood sugar regulation is evident: they mimic incretin hormones, leading to increased insulin secretion. On the opposite hand, the load loss was explained only after the actual fact: along with the pancreas, these molecules also act on the brain by regulating the sensation of satiety and not directly on the stomach by reducing the speed of gastric emptying. . Both of those combined effects reduce appetite and result in weight reduction.

Thus a brand new use for the drug appeared, when the Novo Nordisk company began marketing the identical drug under two different names: Ozempic for the treatment of type 2 diabetes, and Vigovi for the treatment of obesity.

A brand new era

GLP-1/GIP analogues are a welcome therapeutic advance at such a time. Prevalence of type 2 diabetes And obesity is exploding and affecting younger and younger people.

These diseases particularly affect women, members of ethnic groups and socio-economically disadvantaged populations. Both the physical and mental suffering they cause and the prices related to their treatment are considerable. So the appearance of recent weapons within the treatment arsenal is a ray of hope.

Drastic lifestyle changes are definitely effective. But they're very difficult to implement and sustain over time for reasons that transcend the person sphere. On the one hand, genetic predisposition plays a crucial role in the event of type 2 diabetes and obesity. On the opposite hand, because these are the conditions. MultifactorialTheir management should be comprehensive to be effective and long-lasting: it must include medical interventions but additionally dietary, functional, psychological, social, environmental and even institutional interventions.

These sorts of support services exist, but only in large university hospital centers where many individuals don't have access. Nor do many have easy accessibility. Healthy and varied food optionsSports facilities or social and psychological support.

Treating the results but not the causes.

To be effective over the long run, GLP-1/GIP analogs should be taken repeatedly: without drastic lifestyle changes; Weight that was lost is regained within a year of stopping.and glycemic control is once more compromised.

In other words, drugs treat the results of type 2 diabetes and obesity but not their causes. And yet a few of these reasons are modifiable: for instance, in line with Statistics CanadaLess than half of the Canadian population (49.2 per cent for adults; 43.9 per cent for youth and kids) gets the really helpful amount of weekly physical activity. According to the identical source, Food insecurity Affects 14% of Quebec's population (22% in Alberta).

Pharmacological treatment, even when it allows an individual to eat less, doesn't necessarily mean that the person will. Eat better. Similarly, shedding pounds doesn't mean that one will change into more lively or healthier. So these latest drugs don't treat type 2 diabetes or obesity. Nor do they prevent these diseases from progressing, although they do help limit lots of the complications they offer rise to.

Prescribe and treat.

A drug like Monjaro is as effective in weight reduction as bariatric surgery. Very easy to manage and far less dangerous, it will probably be an actual game changer within the treatment of obesity. Prescribed directly by family doctors and distributed in pharmacies, it would even be more accessible and convenient for many who need it.

This raises the query of costs and reimbursement, but not only: prescribing will not be the identical as treatment. Here, manufacturers are following the recommendations of health authorities: Before this treatment a Careful assessmentThen management, and above all close and regular monitoring of weight loss plan, physical activity, mental health, and, if essential, socioeconomic support.

This requires not only time that GPs don't have, but additionally coordination with other players within the healthcare network. The issue will not be whether the treatment will work, but what might occur if it does. Losing 25% of your body weight in only just a few months has serious consequences, which aren't all the time useful: there's a lack of body fat, but additionally of muscle mass, which is related to severe fatigue. It happens from Nor should we underestimate. The challenge of adapting physically and psychologically For a physical change of this scale. Losing weight doesn't solve every little thing, and expectations should remain realistic.

What lessons can we learn?

The clinical effectiveness of GLP-1/GIP analogues in reducing complications related to type 2 diabetes and obesity is undeniable. However, these drugs aren't suitable for everybody, they usually are definitely not miracle cures that can make it possible for anyone to regain health without making any changes in lifestyle or environment.

We must bear in mind that their success is the results of each business and medical failure: stopping our societies from disease, promoting healthy lifestyles, and creating an environment conducive to health for all.