Childhood obesity has increased tenfold since 1975. for ten. In fact, we expect there will be more obese than already thin children worldwide by 2022. And that’s just the tip of the iceberg: In 2016, the last year for which we have full data, more than 650 million people suffered from obesity, and as a result, many more people die from obesity today than in traffic accidents.

It’s an epidemic; quiet, but ultimately epidemic. And worst of all, our tools to combat it are truly inept. Now a new drug can change the playing field.

An epidemic we don’t know how to control. If we look at the whole picture, we can see that our inability to cope with these problems from a medical point of view is not unique to obesity. Overall, noncommunicable diseases (mainly due to our lifestyles) are the leading cause of death worldwide.

However, we have effective drugs to treat some of them: an obvious example is statins and their key role in controlling cardiovascular disease. In the case of overweight control, until recently, approaches have focused on pharmacological treatments based on what has been called “anorexigenic”: drugs that reduce appetite due to their antidepressant nature, but have quite significant side effects.

New generation drugs. However, in recent years, new generation diabetes drugs have shown surprising effectiveness in controlling obesity. In 2021, the FDA approved semaglutide, which can achieve about 15% weight loss. That 15% wasn’t much, but the health benefits (if it wasn’t for the extra complication) were huge.

Since then, results have only improved. The latest addition to the pharmacological arsenal (from the United States) is tirzepatide. The New England Journal of Medicine published a study showing 21% weight loss with weekly injections of 15 milligrams of this drug. In terms of actual weight: Equivalent to reducing the average weight of the participants from 104 to 82 kilograms. All this with mild and temporary side effects.

How does it work? In general, newer antidiabetics are drugs that act on hormonal mechanisms that regulate blood sugar control. If we focus on tirzepatide, it is the first drug that can activate a very specific part of these mechanisms: GLP-1 and GIP receptors. These two elements are part of “incretins”: a set of hormones produced in the gut that regulate the body’s response to food consumption (by increasing insulin secretion and lowering blood sugar). Tirzepatide mimics this natural process of the sugar cycle and intervenes at this very basic level, providing much more precise control than previous drugs.

Not in Spain. Even. Without getting into the lifestyle aspects (where there’s a lot to cut back on), the reality is that the race to find drugs that can control obesity is very good news. As we have said before, we have a very serious problem and any help is minimal. Fortunately, the results are surprising.

Unfortunately, all these developments are still very concentrated in the United States. It is very difficult to approve such drugs in Europe. There is no doubt that they will come sooner or later, but it seems that the continent is waiting to see what impact such drugs (and the resulting medicalization of obesity) have at the social, economic and cultural level. We will get the answer sooner than we anticipated.

Image | Towfiqu Barbhuiya