With problems with being overweight since childhood, Maria da Silva (fictitious name) says she’s tried everything in the fight against the scale.
“I’ve been on so many fad diets in my life that sometimes I even miss out: protein regimen, blood type, Beyoncé, even intermittent fasting,” reveals the nursing assistant, 38.
After many attempts and numerous remedies, in 2017 he decided to resort to bariatric surgery. A year and a half after the surgery she had managed to lose 35 kg.
“I was very happy, but my joy was short-lived. I thought I was going to be skinny for the rest of my life and went back to eating everything. Since then, I’ve earned almost half of what I have left. It was disappointing,” she laments.
Despite the setback, Maria remains stubborn in finding a solution that will help her achieve her ideal weight.
“I can’t give up because it’s a health issue, right? I’m super excited about this new injection that’s popular on TikTok right now. If it really works, I will pay any amount for it. I also have debts,” he says.
Maria refers to Wegovy, the trade name of semaglutide 2.4 mg, the first weekly injectable drug for the treatment of obesity which was approved by the National Health Surveillance Agency (Anvisa) on 2 January.
Produced by Novo Nordisk and marketed in the United States since 2021, the drug has been identified by many specialists as an important ally in the fight against excess body weight.
But beyond all its fame, what is the real effectiveness of this drug?
“Semaglutide has shown in clinical trials an average weight loss of approximately 17%, and up to a third of patients in the program achieved approximately 20% weight loss. Other drugs tested are between 5 and 10%. So far it is the approved drug with the highest percentage of weight loss,” explains Flávia Coimbra Pontes Maia, president of the Brazilian Society of Endocrinology and Metabolism – Regional Minas Gerais (SBEMMG).
Initially, semaglutide was introduced to the market to treat type 2 diabetes, but it ended up surprising and proved to be effective for weight loss purposes as well.
“It acts like a hormone produced in the gut, called GLP1, which works to increase the production of insulin by the pancreas and is therefore used in the treatment of diabetes. In addition, it delays stomach emptying and acts on the central nervous system, giving a feeling of satiety,” Flávia points out.
The results were so optimistic that the drug could become a viable option for gastric bypass surgery in the future, the researchers say.
“Bariatric surgery has more than one technique available and can achieve 25 to 30 percent weight loss between the first and second postoperative year,” points out Ana Paula Borges Santos, an endocrinologist with a master’s degree from UFMG.
He mentions, however, that there is already a new group of drugs available, such as semaglutide and tertipatide – which are not yet sold here – that show better results in studies: a loss of 25% or more in weight in about 36% of the participants tested. .
“Thus, these drugs may one day be an alternative for some patients instead of surgery,” he says.
Usage and side effects
It is important to note, however, that Wegovy should only be used with a prescription and medical supervision.
“It should be taken as directed by a specialist physician. Indiscriminate use can alter intestinal transit: intense nausea, diarrhoea, vomiting and risk of pancreatitis, especially in patients who use certain types of drugs and consume alcohol”, warns sports and behavioral nutritionist Ruth Egg.
Semaglutide is indicated for people with a body mass index (BMI) greater than 27 or 30 and who suffer from diseases related to being overweight, such as heart disease and diabetes.
“Its main benefit is sustained weight loss. It is worth emphasizing that a decrease of around 10% is already very important to reduce the damage caused by obesity”, underlines Flávia Coimbra Pontes Maia.
However, the doctor cautions that when used indiscriminately, the drug can increase the risk of adverse health events as well as give a false impression that treating obesity can be something simple.
“It is a drug indicated for the treatment of a chronic disease. It should not be used to lose a few extra pounds that we have gained at the end of the year”, he warns.
Light on the body, heavy on the pocket
A darling of celebrities in the US – with staunch fans like billionaire Elon Musk – Wegovy has yet to set his price at Anvisa. The expectation, however, is that it will reach Brazilian shelves with a value as steep as that of North America, where the treatment costs no less than R$6,000 a month.
Here in Brazil, Saxenda (liraglutide), which is another drug already approved in the same category and has a similar action, although it is applied daily, costs around R$ 600 per package with three doses.
“These drugs tend to be more expensive to curb some indiscriminate use,” notes Ruth Egg.
Ana Paula Borges Santos agrees and adds. “The cost must be considered by us doctors for individual prescriptions, but the possibility of using new drugs with a good therapeutic response, even if expensive, immediately improves the treatment of a group of patients”, informs the doctor.
Although the effects of semaglutide are considered to be significant, it is imperative that you make significant lifestyle changes to shed the extra pounds for good.
“These factors are key strategies. Medications can help, but what will keep the weight off is healthy eating and exercise. There’s no way,” advises Ruth.
And these habits must be done correctly and maintained for life.
“The use of drugs never replaces lifestyle changes that include good nutrition, as well as regular physical activity, especially to maintain weight loss achieved with the help of effective drugs appropriately prescribed by doctors”, points to Ana Paula Borges Santos.
Medicine doesn’t work miracles
Although the appearance of drugs that promise positive effects in the fight against limescale is common, all the doctors interviewed agree that none of them have miraculous powers.
“There is no miracle or magic. We must take seriously the treatment of a chronic disease such as obesity, which can cause very serious health problems such as high blood pressure, heart disease and even some types of cancer”, underlines Flávia Coimbra Pontes Maia.
Also remember that this fight against weight involves not only medications, but medical monitoring and a lot of discipline.
“Only in this way can we reduce the stigma of obesity treatment and help people suffering from this disease seek help without fear of prejudice from family, friends and even the healthcare team themselves. We also need government agencies to provide the conditions for increased access of the entire population to effective treatments. Who knows, maybe one day we will be able to eradicate this deadly epidemic?”, she concludes.
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