It’s not clear why some folks on these medication lose quite a lot of weight whereas others don’t lose any. “We nonetheless don’t perceive many of the variation in response,” says Ewan Pearson, professor of diabetic medication on the College of Dundee in Scotland. There are a number of identified predictors of how sufferers will fare, although. For example, ladies are likely to lose extra weight than males on GLP-1 medication, probably as a result of they’ve a unique fats distribution in comparison with males, or as a result of their smaller common dimension may imply increased publicity to the drug.
And whereas GLP-1 medication have been first authorised as a diabetes remedy to enhance blood sugar ranges, they’re much less prone to produce vital weight reduction in folks with kind 2 diabetes. Researchers have steered genetics, altered microbiomes, and different medicines that promote weight acquire as attainable causes for this. “So much will depend on an individual’s physiology and biology. We will’t anticipate {that a} drug might be a one-size-fits-all for everybody,” says Amy Rothberg, an endocrinologist on the College of Michigan.
GLP-1 medication result in weight reduction by slowing the motion of meals within the abdomen and by interacting with receptors within the mind to advertise a sense of fullness. Some folks taking them report much less “meals noise”—they now not have cravings or take into consideration meals on a regular basis. Consequently, they eat much less. Sufferers begin on a low dose that’s step by step elevated every week. Schmidt says some folks could not reply to the decrease doses however do ultimately see weight reduction because the medicine is ramped up.
With out life-style modifications, these medicines are prone to be much less efficient for weight reduction. Novo Nordisk, which makes Ozempic and Wegovy, and Eli Lilly, which makes Mounjaro and Zepbound, stress that the medication are meant for use alongside a nutritious diet and train. In trials of semaglutide and tirzepatide, the medicines have been paired with a reduced-calorie food regimen and elevated bodily exercise. Scientific trials are sometimes the best-case situation relating to a drug’s efficacy as a result of they contain cautious monitoring of members and plenty of follow-up visits with suppliers. In actual life, sufferers could not comply with their weight-loss plan as diligently or see their physician as recurrently.
And whereas these medication assist curb urge for food, they don’t magically get rid of all temptations. In spite of everything, there’s a main social element to consuming meals. “We could eat as a result of it seems good, tastes good, we’re within the firm of others, or as a result of it’s obtainable,” Rothberg says. An individual who has these environmental pushes or stimuli competing with the drug received’t lose as a lot weight as the one that doesn’t must take care of these elements, she argues.
Variations in metabolism, or how folks break down meals and convert it into vitality, may be at play. An individual’s age and hormone perform, in addition to the quantity of bodily exercise they get, can affect metabolism.
Researchers are additionally wanting into whether or not genetic elements could clarify among the variability in response. In 2022, Pearson and his colleagues revealed a paper that recognized a gene known as ARRB1 that appears to be concerned in glucose management. Once they checked out genetic information from greater than 4,500 adults, they discovered that individuals with sure variants on this gene have decrease blood sugar ranges whereas taking GLP-1 medication.
