Pharmaceutical company Eli Lilly reports that its weight-loss drug, tirzepatide, helps individuals suffering from obesity avoid developing diabetes, even after they stop taking the medication.

Carrying excess weight can heighten the risk of diabetes, and weight reduction can lower that risk. However, achieving and maintaining significant weight loss has proven difficult for many. New medications known as GLP-1s are providing effective solutions for many individuals, including tirzepatide, which Eli Lilly markets as Zepbound for weight loss purposes.

In a three-year study called SURMOUNT-1, participants with pre-diabetes who received the highest dosage (a weekly 15 mg injection) lost an average of nearly 23% of their body weight. Their risk of developing diabetes decreased by 94% compared to a group that received a placebo and only lost about 2% of their body weight, according to a press release from the company.

According to Dr. William Dietz, director of the Sumner M. Redstone Global Center for Prevention and Wellness at The George Washington University, it’s not entirely unexpected for a drug that promotes weight loss and treats diabetes to also prevent the disease. However, corroboration is valuable.

“The outcomes observed are quite remarkable and can be attributed to the rapid and significant weight loss,” he explained.

Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute, called the findings “positive news,” but noted that the data released by the company was too vague to fully grasp its implications.

A 94% reduction seems impressive, he pointed out, yet the company did not disclose the actual figures, making it unclear whether the drug helped 200 individuals avoid diabetes or merely two. “They didn’t provide any data on how many participants developed diabetes during the study,” Topol remarked. “It feels as though they are withholding information.”

Eli Lilly also markets tirzepatide as Mounjaro for diabetes treatment; however, those patients typically experience less weight loss than those without the condition. The retail price of both Mounjaro and Zepbound is approximately $1,000, though promotional offers and discounts may help lower the expense.

Other GLP-1 medications, such as semaglutide (available from Novo Nordisk as Ozempic for diabetes and Wegovy for weight loss), may be even more expensive.

Many insurance providers do not cover the costs associated with weight-loss drugs. Medicare does not cover medications strictly for weight loss, and in some regions, Medicaid does offer coverage for these drugs.

Topol commended GLP-1s for their effectiveness in promoting weight loss and potentially reducing inflammation. “They’re drugs for weight loss, but they likely have broader benefits,” he noted, referencing approvals for heart disease and diabetes treatment, as well as ongoing studies related to neurodegenerative diseases like Alzheimer’s and Parkinson’s.

However, he criticized the “price-gouging” strategies of companies involved. “It’s unfortunate that these necessary medications are not affordable,” Topol observed, emphasizing that those in greatest need often belong to low-income groups facing multiple health challenges and inadequate insurance coverage.

Moreover, the availability of these medications is currently limited, with manufacturers struggling to meet demand.

Research indicates that individuals with private health insurance are most likely to obtain GLP-1 medications.

According to Dietz, priority should be given to patients in dire need of these drugs. Additionally, it is crucial to explore new strategies for maintaining weight loss. While the producers of GLP-1 medications claim lifelong usage is necessary for ongoing weight management, Dietz argued that this isn’t feasible at current prices, and alternative treatments or lifestyle adjustments may provide viable options.

In the SURMOUNT-1 trial, Eli Lilly studied nearly 2,000 volunteers with pre-diabetes and obesity or being overweight, administering either one of three dosages or a placebo, coupled with lifestyle recommendations, over a span of 193 weeks, including 17 weeks after they stopped taking the drug.

Interim results were published in the New England Journal of Medicine in 2022, after 72 weeks of treatment, which included a 20-week gradual increase to the final dosage. At that point, 85% of participants on the medication lost over 5% of their weight, and 15% of those receiving the two higher doses lost 20% or more.

After ceasing the drug, and while still being monitored, participants started regaining weight, and some showed increased progression towards Type 2 diabetes. Nonetheless, they demonstrated an overall 88% reduction in diabetes risk compared to those in the placebo group.

Those using GLP-1 medications often experience a range of side effects, primarily affecting the gastrointestinal system, including symptoms like diarrhea, nausea, constipation, and vomiting.

Both semaglutide and tirzepatide function by controlling appetite and limiting caloric intake, effectively “quieting the food noise,” as many patients describe it.

Tirzepatide has an additional method of action that could enhance its weight loss efficacy compared to semaglutide.