DECEMBER 2, 2024:
UNDATED (AP)- Unlike scores of people who scrambled for the blockbuster drugs Ozempic and Wegovy to lose weight in recent years, Danielle Griffin had no trouble getting them.
The 38-year-old information technology worker from New Mexico had a prescription. Her pharmacy had the drugs in stock. And her health insurance covered all but $25 to $50 of the monthly cost.
For Griffin, the hardest part of using the new drugs wasn’t access. It was finding out that the much-hyped medications didn’t really work for her.
“I have been on Wegovy for a year and a half and have only lost 13 pounds,” said Griffin, who watches her diet, drinks plenty of water and exercises regularly. “I’ve done everything right with no success. It’s discouraging.”
In clinical trials, most participants taking Wegovy or Mounjaro to treat obesity lost an average of 15% to 22% of their body weight — up to 50 pounds or more in many cases. But roughly 10% to 15% of patients in those trials were “nonresponders” who lost less than 5% of their body weight.
Now that millions of people have used the drugs, several obesity experts told The Associated Press that perhaps 20% of patients — as many as 1 in 5 — may not respond well to the medications. It’s a little-known consequence of the obesity drug boom, according to doctors who caution eager patients not to expect one-size-fits-all results.
“It’s all about explaining that different people have different responses,” said Dr. Fatima Cody Stanford, an obesity expert at Massachusetts General Hospital
The drugs are known as GLP-1 receptor agonists because they mimic a hormone in the body known as glucagon-like peptide 1. Genetics, hormones and variability in how the brain regulates energy can all influence weight — and a person’s response to the drugs, Stanford said. Medical conditions such as sleep apnea can prevent weight loss, as can certain common medications, such as antidepressants, steroids and contraceptives.
“This is a disease that stems from the brain,” said Stanford. “The dysfunction may not be the same” from patient to patient.
Despite such cautions, patients are often upset when they start getting the weekly injections but the numbers on the scale barely budge.
“It can be devastating,” said Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of the obesity treatment company FlyteHealth. “With such high expectations, there’s so much room for disappointment.”
That was the case for Griffin, who has battled obesity since childhood and hoped to shed 70 pounds using Wegovy. The drug helped reduce her appetite and lowered her risk of diabetes, but she saw little change in weight.
“It’s an emotional roller coaster,” she said. “You want it to work like it does for everybody else.”
The medications are typically prescribed along with eating behavior and lifestyle changes.
It’s usually clear within weeks whether someone will respond to the drugs, said Dr. Jody Dushay, an endocrine specialist at Beth Israel Deaconess Medical Center. Weight loss typically begins right away and continues as the dosage increases.
For some patients, that just doesn’t happen. For others, side effects such as nausea, vomiting and diarrhea force them to halt the medications, Dushay said. In such situations, patients who were counting on the new drugs to pare pounds may think they’re out of options.
“I tell them: It’s not game over,” Dushay said.
Trying a different version of the new class of drugs may help. Griffin, who didn’t respond well to Wegovy, has started using Zepbound, which targets an additional hormone pathway in the body. After three months of using the drug, she has lost 7 pounds.
“I’m hoping it’s slow and steady,” she said.
Other people respond well to older drugs, the experts said. Changing diet, exercise, sleep and stress habits can also have profound effects. Figuring out what works typically requires a doctor trained to treat obesity, Saunders noted.
“Obesity is such a complex disease that really needs to be treated very comprehensively,” she said. “If what we’re prescribing doesn’t work, we always have a backup plan.”
NOVEMBER 26, 2024:
WASHINGTON (AP) — Millions of Americans with obesity would be eligible to have popular weight-loss drugs like Wegovy or Ozempic covered by Medicare or Medicaid under a new rule the Biden administration proposed Tuesday morning (Nov. 26, 2024).
The costly proposal from the U.S. Department of Health and Human Services immediately sets the stage for a showdown between the powerful pharmaceutical industry and Robert F. Kennedy Jr., an outspoken opponent of the weight-loss drugs who, as President-elect Donald Trump’s nominee to lead the agency, could block the measure.
While the rule would give millions of people access to weekly injectables that have helped people shed pounds so quickly that some have labeled them miracle drugs, it would cost taxpayers as much as $35 billion over the next decade.
“It’s a good day for anyone who suffers from obesity,” U.S. Health and Human Services Secretary Xavier Becerra told The Associated Press in an interview. “It’s a game changer for Americans who can’t afford these drugs otherwise.”
The rule would not be finalized until January, days after Trump takes office. A bipartisan coalition of congressional members has lobbied for the drugs to be covered by Medicare, saying it could save the government from spending billions of dollars on treating chronic ailments that stem from obesity. While it’s unclear where Trump himself stands on coverage of the weight-loss drugs, his allies and Cabinet picks who have vowed to cut government spending could balk at the upfront price tag.
Under the proposal, only those who are considered obese — someone who has a body mass index of 30 or higher — would qualify for coverage. Some people may already get coverage of the drugs through Medicare or Medicaid, if they have diabetes or are at risk for stroke or heart disease.
Becerra estimated that an additional 3.5 million people on Medicare and 4 million on Medicaid could qualify for coverage of the drugs. But research suggests far more people might qualify, with the Centers for Medicare and Medicaid Services estimating roughly 28 million people on Medicaid are considered obese.
Medicare has been barred from offering the drugs under a decades-old law that prohibits the government-backed insurance program from covering weight-loss products. The rule proposed by the Biden administration, however, would recognize obesity as a disease that can be treated with the help of the drugs.
The anti-obesity drug market has expanded significantly in recent years, with the Food and Drug Administration approving a new class of weekly injectables like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound to treat obesity.
People can lose as much as 15% to 25% of their body weight on the drugs, which imitate the hormones that regulate appetites by communicating fullness between the gut and brain when people eat.
The cost of the drugs has largely limited them to the wealthy, including celebrities who boast of their benefits. A monthly supply of Wegovy rings up at $1,300 and Zepbound will put you out $1,000. Shortages of the drugs have also limited the supplies.
Kennedy, who as Trump’s nominee for HHS secretary is subject to Senate confirmation, has railed against the drugs’ popularity. In speeches and on social media, he’s said the U.S. should not cover the drugs through Medicaid or Medicare. Instead, he supports a broad expansion of coverage for healthier foods and gym memberships.
“For half the price of Ozempic, we could purchase regeneratively raised, organic food for every American, three meals a day and a gym membership, for every obese American,” Kennedy said to a group of federal lawmakers during a roundtable earlier this year.
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