Tech Talk
As I like to say, I’m not overweight, I’m undertall.
Better Living Through Chemistry: How pharmaceuticals are changing the game for weight loss
By Michael E. Duffy
L ike many Americans each January, my spouse and I decided to lose some excess pounds this year. As everyone knows, we (as a country) are not in great shape. According to the National Institutes of Health, “nearly 1 in 3 adults are overweight. More than 1 in 3 men and more than 1 in 4 women are overweight. More than 2 in 5 adults have obesity (including severe obesity). About 1 in 11 adults (9.2%) have severe obesity.” That’s based on measures of the Body Mass Index (BMI), defined as one’s weight in kilograms, divided by one’s height in meters squared. For me, that works out to a number above 30, which labels me as obese (a normal BMI is below 25, overweight from 25 to 30, and severely obese above 40). As I like to say, I’m not overweight, I’m undertall. The BMI is somewhat controversial because, for dertall. e, for
from Novo Nordisk) and tirzepatide (Mounjaro, from Eli Lilly) are now approved for weight loss, as Victoza and Zepbound, respectively. All these “weight-loss versions” of diabetic drugs are alike in that they provide a higher dose of their respective ingredient than the version for diabetics. And they all share the same downside: You have to keep taking them to keep weight off. Which is good news for the drug companies, and bad news for people wanting to lose weight. But who picks these brand names? Wegovy? Ugh. Victoza? Really? Zepbound is the only one that sounds remotely cool. (As it turns out, there are rules: tinyurl.com/mkyk5s2v ) Which is most effective as a weight-loss drug? Tirzepatide appears to be the most effective. Liraglutide, approved for weight loss since 2014 and never caused much
appears to be for weigh of a s we e
one thing, it doesn’t directly assess body fat (even though BMI and accurate measures of
of a stir, has shown the lowest impact on weight loss. All three drugs produce side effects, the most common being nausea, vomiting and constipation. Some, like thyroid tumors and bowel obstructions, are life-threatening. Although the incidence of the worst effects is low, broader use leads directly to more actual events. There’s also the cost of these brand-name drugs. A package of four weekly doses of Wegovy b ev Th
body fat are highly correlated). And the historical population statistics used to assess that correlation are based largely on white men—so for women and people of color, it’s probably less accurate. Its big advantage is that it’s cheap and easy to measure—all you need is your height and weight. Google “BMI calculator” if you want to check your own, just be aware that it’s just one way of assessing a healthy weight. Enter Ozempic. In 2011, I spoke to a computer science class o e way l
drugs. A costs $1,350. Th
costs $1,350. That’s $337.50 a pen, or $17,550 a year. Zepbound, at $1,060 for four pens, is less expensive (as Lilly Z b d $ f
at Sonoma State and predicted that the next Bill Gates would be the person who solved the obesity problem. It appears, however, that it won’t be a single person, but pharmaceutical companies. Ozempic, a medicine developed by Novo Nordisk used to treat diabetes and approved for use by the FDA in 2018, was discovered to also cause significant weight loss. Some doctors began prescribing the drug “off-label” (i.e. not for its intended use) to their patients, and it snowballed from there, aided by rumors that many celebrities were using it. Jimmy Kimmel opened the 2023 Academy Awards last March with: “When I look around at this room I can’t help but wonder, ‘Is Ozempic right for me?’” Ozempic’s real name is semaglutide. Novo Nordisk won FDA-approval for the use of semaglutide for weight loss in June of 2021 (eliminating the need for off-label prescriptions), under the brand name Wegovy. Both drugs are typically given as a once-a-week injection. Semaglutide is what is called a “glucogen-like- peptide agonist” (GLP agonist), because it mimics glucogen, which stimulates insulin production and lowers blood sugar. Lower blood sugar levels are clearly good for diabetics (who have high levels). But lowering blood sugar also appears to increase feeling “satisfied” and reduce craving, leading to weight loss. Diabetic drugs which are similar to semaglutide, liraglutide (Saxenda, also
Michael E. Duffy is a senior software engineer for Atlanta-based mobile gaming company Global Worldwide ( globalworldwide.com ), who lives in Sonoma County. He has been writing about technology and business for NorthBay biz since 2001. In the long term, these drugs will improve and become generic, hopefully solving our national problem with obesity. But for now, my spouse and I are counting our calories with myFitnessPal, logging our weight on our Withings internet-connected scale, and trying to be more active. tries to break into the market dominated by Novo), but still $13,780 on an annual basis. And these drugs won’t likely be available as generics for 20 years. Whether health plans will cover the cost of these drugs, and on what basis, remains to be seen. But there are probably plenty of people who are overweight, have money to spend, and are willing to risk the side effects. Elon Musk, Chelsea Handler and Oprah Winfrey have all gone on the record as Ozempic users (google “what celebrities have used ozempic” for a longer list). And that encourages others to do the same.
February 2024
NorthBaybiz 27
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