Unexpected Uses of Medications
Sometimes, medications developed for one condition become more popular for another. Viagra and thalidomide are classic examples. Similarly, Ozempic was initially created for type 2 diabetes but is now known for weight loss.
Original Purpose
Ozempic treats type 2 diabetes by managing high blood sugar due to ineffective insulin use. However, 1980s diabetes medications often led to weight gain, worsening the condition.
Academic Trust
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Journey of Discovery
In the 19th century, Claude Barnard explored glucose tolerance. Later, Frederick Banting and Charles Best discovered insulin, but the difference between oral and intravenous glucose tolerance remained unexplained.
Incretin Discovery
In 1932, Jean La Barre identified “incretin,” a hormone stimulating insulin secretion. The 1960s revealed the incretin effect accounted for two-thirds of insulin response, involving hormones like GIP and GLP-1.
GLP-1 and GIP
GLP-1, cloned in the 1980s, proved crucial for insulin secretion but metabolized too quickly for medical use.
Lizard Venom Breakthrough
In the 1980s, John Pisano and Jean-Pierre Raufman studied Gila monster venom, discovering exendin-4, a molecule stimulating insulin like GLP-1 but with slower metabolism. Despite initial skepticism, exendin-4 led to the FDA approval of exenatide (Byetta) in 2005, showing significant weight loss.
Transition to Ozempic
Novo Nordisk developed liraglutide (Victoza) and semaglutide (Ozempic), advancing GLP-1 therapy. Ozempic, approved in 2017, and a higher dose, Wegovy, approved in 2021, became effective weight-loss treatments.
Mechanism of Action
GLP-1 drugs slow gastric emptying, increase insulin, and reduce appetite by targeting GLP-1 receptors in the brain and gastrointestinal tract.
Mounjaro and New Developments
Tirzepatide (Mounjaro) targets GLP-1 and GIP receptors, showing superior weight loss. Approved for type 2 diabetes in 2022 and obesity in 2023, it stimulates metabolism and fat use.
Oral Administration Challenges
Current GLP-1 drugs are peptides, requiring injections. Novo Nordisk’s Rybelsus, an oral semaglutide, offers limited absorption. Small-molecule drugs like Pfizer’s Danuglipron and Eli Lilly’s Orforglipron show promise but face challenges.
Failures and Successes in Weight-Loss Drugs
Many anti-obesity drugs have failed due to side effects, but Ozempic’s safety and efficacy have revolutionized the field. However, potential side effects and weight rebound post-discontinuation remain concerns.
