Anti-obesity drugs: one in four adults would need them. Trump: 'Maybe I need them too'

More than a quarter of the world's adults could benefit from drugs to lose weight, reveals a study published in The Lancet Diabetes & Endocrinology and conducted at Mass General Brigham in Boston and Washington University School of Medicine in St. Louis. Over the past 30 years, obesity has more than doubled worldwide, bringing with it an increase in weight-related diseases such as diabetes, cardiovascular disease and cancer. A new holy grail that of anti-obesity drugs - at the centre of major investments and interests by pharmaceutical companies - has also infected US President Donald Trump. The tycoon has often publicly fantasised about friends and associates taking what he calls 'the fat drug'. In an interview with the New York Times Trump said he has never taken GLP-1 drugs such as Wegovy and Ozempic. "No, I haven't," he replied when asked directly. "I probably should," he added.

 The experts who carried out the study collected data from 99 countries on 810,635 adults to determine how many people worldwide would benefit from the use of GLP-1 receptor agonists, the weight-loss drugs. And they found that more than one in four adults would be eligible for the use of GLP-1 for weight control, with women, the elderly, and low- and middle-income countries among the most eligible. These critical parameters could be instrumental in developing policies for the use of GLP-1s worldwide to combat obesity and related diseases. The power and promise of GLP-1s have been recognised by the World Health Organisation, which is actively working to make them standard and accessible drugs. The researchers used household health survey data collected in 99 countries between 2008 and 2021, covering a total of 810,635 adults aged 25-64 years. Globally, 27% of adults were eligible for GLP-1 for weight control, four-fifths of whom were from low- and middle-income countries. In Europe and North America 42.8% of adults were eligible and in the Pacific Islands 41%. Women were also more eligible (28.5%) than men, as were older people (38.3%) than their younger peers (17.9%). Last year, type 2 diabetes was the leading cause of death for women in South Africa. There are parts of the world where women can really benefit from these drugs, the researchers conclude: 'global access to GLP-1s is a matter of health equity'.

Meanwhile, a review of a series of studies published in the 'British medical journal' has revealed that people who stop taking Glp-1 anti-diabetes and obesity drugs to lose weight risk regaining it all within a year and a half. The effect of these drugs, Glp-1 agonists, which are taken by millions of people worldwide, is well established and the contribution to weight loss is clear, as the Washington Post reports, but the review looks at what happens to people who stop treatment. The peer-reviewed paper analyses 37 studies involving 9,300 people and several drugs in this class. In particular, six studies focused on semaglutide and tirzepatide. Subjects who stop taking the therapies are on the way to returning to their initial weight within 20 months - just over a year and a half - if they do not change their diet in a stable manner and if they do not engage in physical activity. For the same amount of weight lost, dieters - without the help of drugs - take up to four times longer to return to their starting point. The effect of drugs, in essence, vanishes in the absence of lifestyle adjustments, according to researchers at Oxford University. The return to the past also applies to values such as blood pressure and cholesterol, which change again within about 17 months.

According to the data, reported by the Washington Post, patients who took the drugs - even the best-known ones - on average lost 16-17 kilos over the course of the treatment. They gained some 10-11 of them back in the first year after stopping the therapy. "What is striking among the data is how quickly the weight was regained," notesSam West, research physiologist at Oxford and co-author of the study. Giles Yeo, professor of genetics at Cambridge, pointed out a limitation of the research: the studies considered assessed the effects after stopping treatment for a relatively short period. The long-term consequences, therefore, cannot be precisely defined. A study from 2024 found that people who exercised while taking a slimming drug maintained a lean physique compared to those who did not exercise during treatment. Slimming drugs, therefore, should be considered as a tool for building healthier lifestyles and not as a single tool.