The Future of Weight Loss: Pills vs. Injections

Why Experts Say Injections Aren’t Going Anywhere

The race to develop effective weight loss drugs is intensifying. Major pharmaceutical companies like Roche, Eli Lilly, Novo Nordisk, and Pfizer are working on weight loss pills. These pills could potentially replace injections, offering a simpler solution for obesity treatment. However, experts believe injections will still play a crucial role.

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Key Facts

Blockbuster injections like Ozempic, Wegovy, Mounjaro, and Zepbound contain semaglutide and tirzepatide. These drugs are GLP-1 agonists, mimicking a hormone that regulates blood sugar and appetite.

Peptide and protein-based drugs, like these GLP-1 agonists, are usually injected. This is because enzymes in the gut break them down, preventing them from entering the bloodstream effectively. University of Toronto endocrinologist Daniel Drucker explains that almost all protein therapeutics, such as insulin, are injectable due to these challenges.

Despite these hurdles, oral formulations are being developed. Novo Nordisk has already marketed Rybelsus, a pill form of semaglutide for diabetes. Companies like Lilly and Pfizer are also making progress with small molecule GLP-1 agonists like orforglipron and danuglipron, which show promise in weight loss.

Challenges and Preferences

Dr. Laura Davisson from West Virginia University notes that weight loss pills may not be suitable for everyone. People might struggle with adherence, especially if the pills need to be taken more than once a day or have dietary restrictions.

Dr. Eduardo Grunvald from the University of California San Diego Health suggests that some might still prefer a weekly injection over daily pills. This preference highlights the need for multiple treatment options.

Effectiveness of Oral Weight Loss Drugs

Clinical trials show that oral drugs can be as effective as injections, offering similar weight loss results. However, oral medications might need more frequent dosing or lower efficacy to manage side effects. Despite these potential drawbacks, oral drugs will likely find a market. Dr. Davisson emphasizes the need for various obesity treatments, stating that even less effective oral medications can be useful.

Oral medications eliminate some issues associated with injections, such as manufacturing costs and refrigeration needs. Stanford endocrinologist Sun Kim points out that injections can be daunting for some patients, who would benefit from oral alternatives.

Availability of Weight Loss Pills

Weight loss pills are still years away from widespread availability due to the lengthy testing process. Novo Nordisk leads the pack with Rybelsus, the only authorized oral GLP-1 drug. However, they face production challenges and regulatory hurdles before launching it as a weight loss pill. Lilly and Pfizer are developing once-daily pills, and Roche has promising early-stage results from two candidates.

Environmental Impact

Dr. Kim also highlights the environmental benefits of oral medications. Injectable therapies generate significant waste, with each dose requiring a new pen. Reducing this waste with oral drugs would be an environmental win.

Financial Considerations

Dr. Shauna Levy from Tulane University notes that oral medications could be cheaper for patients but less profitable for companies. Despite the proven effectiveness of oral GLP-1 medications, companies are prioritizing injectable versions due to higher profitability.

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References

• University of Toronto
• West Virginia University
• University of California San Diego Health
• Stanford University
• Tulane University