Weight loss medications over the years: a history of safe medical obesity treatments

It feels like recently we’ve been hearing constant news, praise, and scientific discoveries in regard to medical weight loss. Be that the birth of Ozempic and its active ingredient semaglutide totally changing the game for obesity treatment, or the growing interest in tirzepatide, dual-acting medications like Mounjaro; weight loss medication has well and truly exploded in the medical world.

Obesity has been creating health problems for millions of people around the world for years, and in the United Kingdom we’ve been topping the charts in Europe for our alarmingly high population of obese adults. The birth of GLP-1 weight loss injections catapulted medical weight loss interventions into the conversation in 2022, but doctors and clinical researchers have been exploring ways to solve the obesity crisis for decades.

Medical treatments for obesity have been available for some time, and when paired with clinical support, have been seen to produce incredible weight loss results, changing the lives of many. As a matter of fact, Bodyline Clinic has been treating those living with obesity and weight health related complications with medical weight loss treatments for over 17 years.

Starting out in clinics dotted around the Northwest of England and developing into remote clinical services for patients around the country, we are equipped with a wealth of clinical expertise in the medical weight loss field.

In this article, we’ll be delving into the history of weight loss medications, from oral tablets to dual-acting GLP-1 and GIP injections, and discussing the measures clinical providers such as ourselves must take to ensure safe and effective weight loss when treating obesity medically.

The near impossible fight against obesity

The attempt to combat obesity and its related weight health problems is a global one. In fact, the prevalence of obesity has tripled from 1975 to 2022, and is estimated to impact over one billion people worldwide according to the World Obesity Federation.

For reference, obesity is usually defined as having a body mass index (BMI) of 30 or above. BMI between 25 and 30 is classified as ‘overweight’. You can calculate your BMI using online calculators, though it’s important to bear in mind that BMI is a controversial tool for measuring weight health.

In the UK, the problem is magnified, particularly as our health services are nationalised. The Health Survey for England 2021 estimated that 25.9% of adults in England are obese and a further 37.9% are overweight but not obese.

Obesity can lead to a multitude of physical and mental health problems. Risk of the development of medical conditions such as heart disease, diabetes, high blood pressure, and certain types of cancer all increase in people living with obesity.

One shocking fact that research has now shown is that obesity has a greater link to cancer risk than smoking, being attributed to be the underlying cause in up to 8% of all cancer cases.

Obesity can be the cause of cancer in the liver, gallbladder, bowel, breasts, kidney, and pancreas to name a few, all with a high enough risk of mortality when caught at later stages.

With that sobering fact, it can be tempting to say that people just need to eat less and move more and that will solve our problems.

Well, yes, in a very simplistic and rudimentary sense eating less and moving more can help people lose weight and potentially reduce their risk of obesity related health risks. But it’s just not that simple.

There are so many factors that can impact a person’s ability to combat obesity. Some people are more likely to be obese due to genetics, medical history, or hormonal imbalances going unnoticed, making it very difficult for them to lose weight with diet and exercise alone. All this and not mentioning culture, ethnicity, lifestyle, and job roles, each impacting our predisposition to weight gain.

Fundamentally, the world as we know it with easy access to processed food, paired with the fact that evolutionarily we are not wired to lose weight, obesity is incredibly difficult to fix and then maintain; we can lose weight, but so often we just put the weight back on again.

Extreme measures for weight loss

In 2002, the UK’s National Institute for health and Care Excellence (NICE) first advocated the use of bariatric surgeries as treatment for morbidly obese patients.

Bariatric surgeries include gastric band surgery, gastric bypass surgery, or gastric sleeve surgery. They work by altering the digestive system, essentially shrinking the stomach to reduce the number of calories a person can consume. Bariatric interventions on the NHS are only performed on individuals with a BMI of over 40, or over 35 with weight health related problems.

These surgeries are often successful when done safely. In England, on average, 6500-7000 procedures are performed annually and tend to result in weight loss of 20-30% of the patient’s initial weight. The weight loss is sustained if patients develop healthy habits and continue to seek support from their consultant beyond the surgery.

However, with Turkey’s surgery culture of more lax requirements and cheaper private costs, there has been an increase in people from the UK who do not fit the NHS’s requirements for gastric surgery flying to Turkey and getting it performed there.

This can be very dangerous and has resulted in deaths and severe complications on return to the UK. Doctors are reporting very unwell patients regularly landing at UK airports on flights from Turkey and having to be taken straight to hospital.

Turning to gastric surgery for weight loss should always be last resort and done with the supervision of a doctor and surgeon who can treat you before, during, and long after a procedure.

The little pink pill

Phentermine, also known as the ‘pink pill’, was first introduced in the United States in 1959 as a treatment for obesity. The oral tablet is a centrally acting appetite suppressant that works in the appetite centre of the brain to reduce calorie intake.

The medication is only prescribed by registered clinicians for the short-term treatment for obesity and is to be taken in three-month bursts in combination with a reduced-calorie diet and exercise. Phentermine is only available with a prescription from a registered clinician and is not recommended for long-term use to prevent reliance on the medication.

Phentermine can help users lose between 5-7% of their initial body weight across a 6 month period.

At Bodyline Clinic, our doctors and nurse prescribers are regulated by the Care Quality Commission (CQC), and we have been providing Phentermine to thousands of patients within our fully supported medical weight loss programmes.

Phentermine is one of Bodyline’s most commonly prescribed appetite suppressant medications and is usually tolerated well with minimal side-effects. However, those who are not eligible for Phentermine can get similar results from another oral tablet called Diethylproprion.

Both Phentermine and Diethylpropion have been seen to produce incredible weight loss results in a short period of time, however it is vital they are used with clinical support. Short term weight loss can only be maintained when a person’s habits have changed for the better.

Habit formation is the key to sustainable weight loss – and this is the case for all medical weight loss interventions, even the newest ones.

Contact Bodyline today to find out more about our safe and effective weight loss programmes and range of treatment options.

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How a diabetes drug trial changed the world as we know it

A new class of weight loss therapies are now breaking the mould and producing completely game changing weight loss results and health outcomes, and it all started from a diabetes drug trial.

Pharmaceutical and healthcare company Novo Nordisk was trialling a new type-2 diabetes treatment called semaglutide, with the purpose of controlling blood sugar levels and insulin resistance. After unprecedented weight loss results in trial participants, the marketed injectable medication called ‘Ozempic’ was trialled on individuals with obesity without type-2 diabetes.

The results were groundbreaking – when combined with diet and exercise, users were seen to lose 15% of their initial body weight on average over a 68-week period. To put that in perspective, a 200lb adult would have lost around 30lbs – reducing the health risks of obesity and boosting their confidence in one go.

These results overtook the existing weight loss injection Saxenda, approved in the UK in 2014, which contains liraglutide.

Ozempic’s active ingredient semaglutide mimics the glucagon-like-peptide-1 hormone, known as GLP-1, which is naturally produced in the gut following mealtimes and tells our body we are full. The GLP-1 receptor agonist, semaglutide, is administered once a week by injection, and dosage is increased gradually.

Dr Morgan Toerien, one of Bodyline’s wellness practitioners explains it like this:

“GLP-1s like semaglutide work for obesity because an obese individual is either not making enough of these hormones to produce that full feeling naturally, or their body is resistant to the hormones so that they need a higher dose to get the same effect.

“If their body is not producing enough for them, using these therapies essentially introduces more into our bodies so that there’s enough of it to do the job, make us feel fuller, and reduce our calorie intake.

“This means it doesn’t matter whether you’re not making enough or whether you’re resistant to it; by adding more, it’s restoring the natural physiological process that our bodies are meant to perform.”

The success of the trials meant that Novo Nordisk re-marketed the drug as ‘WeGovy’ and packaged it in different dosages for prescribers to titrate the medication as part of safe practice. As a result, semaglutide was approved by NICE to treat obesity in the UK for those with a BMI of above 35, or above 30 with weight health related problems.

Both eligibility and titration are vital for patient safety, to ensure minimal side effects and potential adverse reactions. Though the medication is only a few years old, there have already been safety concerns due to black market variants being sold on social media and through unregulated online pharmacies, leading to people falling seriously ill.

Semaglutide should only be prescribed by regulated and registered clinicians like doctors and nurse prescribers according to NICE guidelines. These checks and balances are vital to ensure safety and best possible patient outcomes.

More information about recognising safe providers can be found here.

The King Kong of weight loss injections

Semaglutide enjoyed the top spot for game-changing weight loss for some time, but it wasn’t long before another medication surpassed its results and efficacy by targeting two hormones instead of one.

Tirzepatide was also originally formulated as a diabetes treatment, but once its results produced ‘unmatched’ glycaemic control and weight management, it quickly followed the same route as semaglutide and was approved for obesity treatment in 2023.

Labelled as Mounjaro, tirzepatide has a dual-acting mechanism, mimicking two hormones to increase the likelihood of weight loss. Alongside GLP-1 receptor agonists, tirzepatide also mimics gastric inhibitory polypeptide (GIP), which is also known as glucose-dependent insulinotropic polypeptide. Like Ozempic and WeGovy, it comes in the form of a once-weekly injectable pen.

Tirzepatide was approved by the Medicines and Healthcare products Regulatory Agency (MHRA) late 2023 and is to be titrated and used within a supported programme of diet and exercise.

The GIP/GLP-1 combination has shown weight loss results far surpassing its opponents. Clinical trials reported participants saw an average 20% body weight reduction when paired with diet and exercise. For a starting weight of 200lbs, that’s a loss of 40lbs.

But why does it work so much better? Dr Morgon Toerien explains:

“By combining the two hormones, we can treat a broader base of deficiencies. We’re not just working on one pathway but working on two pathways.

“Think of it a little bit like trying to fill a paddling pool with one hose or trying to fill it with two hoses. If you’ve got two different hoses, your chances of getting it filled quicker are better. With tirzepatide, patients can hedge their bets in terms of whichever one of their hormones is more likely to be deficient or more likely to be resistant to, and one will be in the package.

“However, the two things together also have a synergistic effect. The effect is magnified, and not just a duplication. It isn’t just that you’ve got two hormones, therefore, you’re twice as likely to lose weight. You’re likely to lose much more than twice as much.”

Mounjaro has been increasing in popularity, and at Bodyline we have seen a significant uptick in our medical weight loss programme patients who are eligible and opting in for this injectable medication.

The unparalleled weight loss results meant the medication was described as the ‘King Kong’ of weight loss medication, and as social media users document their progress, its popularity is ever growing.

Looking ahead to the future of weight loss

From one hormone to two hormones, the natural progression of these weight loss injections can be predicted.

The future of weight loss medications lies in the trial outcomes of triple-acting hormone receptor agonists – Retatrutide. Containing GIP and GLP-1s along with glucagon receptors, retatrutide has already seen outcomes of up to 24.2% average weight reductions in a period less than a year. That’s a loss of almost 50lbs for a person starting at 200lbs!

This phase 2 clinical trial sees the medication working by helping the body burn more fat alongside its appetite suppressing effects, an unprecedented triple threat. This drug has not yet been approved for obesity treatment, and is still being trialled, but researchers are extremely excited about its potential in obesity treatment and so are we.

Safety first

As we have emphasised throughout this article, safety when prescribing weight loss medications is paramount to their success.

The team at Bodyline provides medical weight loss interventions under proper medical supervision to ensure their safe and effective use. We prioritise the holistic approach to weight loss, offering individual guidance, advice, and support based on lifestyle, medical history, and physical ability.

Alongside prescribing therapies, our patients receive sustainable services incorporating healthy eating habits, regular physical activity, and lifestyle modifications crucial for long-term success.

With the guidance and support of medical weight loss programmes like Bodyline, you can embark on a safe and effective weight loss journey that prioritizes your well-being. Contact Bodyline to find out more.

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Contact Bodyline to find out more how we can treat and support you to improve your health and wellbeing.

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