(Originally published in The Huffington Post)
There is a new “blockbuster” weight loss drug on the market, Saxenda, and it is available in many U.S. pharmacies this month. It is perhaps the most important weight loss medication ever developed. Novo Nordisk Inc., a very big and very old Danish pharmaceutical company, has launched the new drug after months of anticipation by consumers, clinicians and market watchers.
Saxenda is very different from all other weight loss drugs. For one thing, it is a once-a-day injection, like some diabetes medications, instead of a pill. For another, it works in an entirely different way, mimicking a naturally-occurring hormone that your intestine secretes when you eat food.
In research conducted only in the last few decades, scientists have discovered that the gut releases a hormone when you eat food that helps regulate the levels of sugar in your blood and slows down the emptying of your stomach. This results in feelings of satiety and a reduction in sensations of hunger and desire to eat.
The hormone-mimicking drug in Saxenda, Liraglutide, was originally marketed as Victoza, prescribed to treat diabetes. It was discovered that a “side effect” of Victoza was weight loss. Saxenda is essentially a double dose of Victoza, and after much testing, the FDA approved it for weight loss in December of 2014.
One-year studies show that over 60 percent of people using Saxenda had a 5 percent reduction in weight while trying to lose weight, as opposed to 34 percent taking a placebo. Thirty-one percent taking Saxenda lost more than 10 percent of their weight.
One of the most important attributes is that it can be used effectively long term, for chronic management of obesity. It is not like the appetite suppressant weight loss drugs that only work for a while. Like other medications used for diabetes, it introduces a hormone that compensates for a deficiency.
Like The Anderson Method, which is a behavioral weight loss program for people with chronic obesity, Saxenda is not for lightweights, people without a serious weight control problem or who only need to lose a few pounds. Saxenda is appropriate for people who are clinically obese with a Body Mass Index (BMI) of 30 or a BMI of 27 with another medical condition, like high blood pressure or diabetes. For example, someone who is 5’4″ would have to be at least 157 pounds with a medical condition, or 174 pounds without an additional medical condition.
Like many medications, Saxenda has warnings that are frightening. Though rare, some of the possible adverse effects are serious. This is not something to be treated casually. You need to work closely with your doctor if you want to use Saxenda. The adverse effects are not experienced by everyone, but should they occur, this is not for you. The most common are nausea and diarrhea. The serious ones are thyroid tumors and pancreatitis. If you have one of several conditions, like a history of thyroid cancer, this is not for you.
The term “Blockbuster” has been used to describe it because of its “box office” potential. It is expected to be a huge moneymaker. We are talking about “billions and billions” as Carl Sagan would say. The cost will run about $1,000 per month and it remains to be seen if medical insurance will play any part in paying for it. No doubt those who have the means will be getting it right away and others will be waiting for the patent to run out.
Saxenda is not a magic cure, just like bariatric surgery does not fix everything for an obese person. We have to change our behavior. Behavioral therapy is the answer to that. But solving the problem would be so much easier for my clients if they did not have the extraordinary biological drives that I am certain are due to some hormonal disorder that results in extraordinary hunger, cravings and compulsion. Behavior therapy alone has worked for me and many of my clients, but it is not enough in some cases.
I have believed that there is a biological imbalance that is part of the disease of obesity and I have prayed for something that would help resolve it. Saxenda may be the first medical intervention to answer those prayers and I am sure there will be more and better advances in the future.