inspiring canadians to live better.

healthing leaf

inspiring canadians to live better.

healthing leaf
get healthing in your inbox with the morning checkup and weekender newsletter!

signs point to glp-1 drug innovation beyond wegovy and ozempic

with the explosive demand for breakthrough drugs like wegovy and ozempic for weight loss, pharmaceutical companies are racing to improve these medications and target additional conditions.

by karen hawthorne
published sep 06, 2024
read time 6 minute read
join the conversation
read time 6 minute read
join the conversation
according to a national survey from dalhousie university’s agri-food analytics lab, between 900,000 and 1.4 million canadians are currently using a glp-1 drug to manage weight loss and diabetes. getty images
with the explosive demand for breakthrough drugs like wegovy and ozempic for weight loss, pharmaceutical companies are racing to improve these medications and target additional conditions. these drugs are classed as glucagon-like peptide 1 receptor agonists, or glp-1 ras, the satiety hormone first developed to treat type 2 diabetes more than 20 years ago. it has a pronounced satiety effect, slowed down gastric emptying and delaying carbohydrate absorption. people eat less and are satisfied with smaller portions.
now, between 900,000 and 1.4 million canadians are currently using a glp-1 drug to manage weight loss and diabetes, according to a december 2023 national survey from dalhousie university’s agri-food analytics lab in halifax. the success of the drugs could also disrupt the food industry because cravings, especially among millennials taking the drug for weight loss, are reduced for impulse-buy snack foods like cookies and chips, ctv news reports.
both diabetes and obesity are flagged as growing public health crises in canada and around the world that also increase the risk of heart disease, stroke and cancer, and pose a burden on healthcare services. in canada, almost two-in-three adults and one-in-three children and youth are overweight or living with obesity with even higher rates in marginalized populations, says the public health agency of canada. and an estimated one in 10 canadians aged 20 years and older has been diagnosed with diabetes; nine in every 10 of those diagnosed have type 2 diabetes, where adopting healthy lifestyle habits can improve management and reduce the damage.

related stories

next-level health: obesity – the hidden pandemic and new answers
while new drugs like ozempic and wegovy are effective, obesity requires a comprehensive approach to treatment, tailored to meet each patient’s needs.
for people with obesity, their weight is likely the largest predictor of negative outcomes to their overall wellbeing.

study highlights wegovy's expanding benefits from obesity to heart disease
the obesity drug wegovy shows promise in treating heart disease as well as obesity, diabetes, and renal disease.
dr. subodh verma was also part of other studies looking into using semaglutide in the treatment of heart disease driven by obesity, and the results of those trials were just as promising.
story continues below
dr. sean wharton, a leading obesity physician and internal medicine specialist in toronto, says the glp-1 drugs offer the scalable pharmacological intervention that has been missing for obese patients and an alternative to bariatric surgery that has its own risks. the first generation delivered between eight to 10 per cent weight loss, and now refined formulations are showing up to 25 to 30 per cent weight loss, which is well into the surgical levels achieved by a bariatric procedure, he told healthing.ca.

new treatments on the horizon

all that said, the next generation of glp-1 drugs could be game-changers. healthnews reports the following three patent applications have been filed for approval:

tri-receptor agonists for enhanced overall health benefits

eli lilly and company has developed a tri-receptor agonist, a drug that is powered by three receptors: glp-1, gastric inhibitory polypeptide, or gip, and glucagon. glp-1, as mentioned, curbs hunger and slows the movement of food from your stomach into your small intestine. gip is released in the small intestine in response to food to promote insulin production and improve your body’s sensitivity and use of insulin, while glucagon is a hormone that your pancreas makes to help regulate blood sugar levels. the formulation modifies the activation of the receptors to avoid the side effects of too much activity of each receptor.
powered by
obesity canada
story continues below
another advantage, the drug could be administered orally and also by injection. frequency would range from once a day to once a week. the three-pronged hormone-receptor formulation could be used for other conditions than those targeted by glp-1ras alone, including osteoarthritis, metabolic syndrome, non-2022年世界杯预选赛阿根廷 liver disease and polycystic ovary syndrome.
the tri-receptor agonist retatrutide for obesity has been tested in a phase 2 trial, funded by eli lilly and published in the new england journal of medicine in june 2023. on average, adults with obesity and overweight lost up to 17.5 per cent within 24 weeks of the treatment. the additional metabolic health measures, such as blood pressure, cholesterol and insulin also improved. the authors note that in a prior phase 1b trial with participants living with type 2 diabetes, retatrutide treatment resulted in a mean weight reduction of about 10 per cent in the highest-dose group after 12 weeks.
as research has shown, the most important factor in achieving remission for people with type 2 diabetes is weight loss. the diabetes remission clinical trial known as direct, conducted in primary care practices in the uk, examined type 2 diabetes remission rates in participants who lost weight and sustained the weight loss over time. direct found high rates of type 2 diabetes remission among people who lost a significant amount of weight – about 22 pounds – and sustained the weight loss over 12 to 24 months.
powered by
obesity matters
story continues below

implantable devices for more convenience

celanese corporation is developing an implantable device that delivers one or more glp-1 receptor agonists so that continuous dosage can be easily managed. glp-1 treatments can last months and years, and otherwise require frequent injections or daily pills. intarcia therapeutics, however, designed a miniaturized glp-1 implant to slowly release the type 2 diabetes medication exenatide over the course of six months that was turned down in 2023 by the u.s. food and drug administration’s committee of outside advisers. another competitor, vivani medical, has announced it will begin human trials of its six-month glp-1 implant for chronic weight management in obese or overweight patients with a related comorbidity like type 2 diabetes.

double receptor agonists to manage side effects

and novo nordisk, producer of wegovy, has filed a patent application for a new drug therapy that combines glp-1 and amylin receptor agonists. amylin is a hormone that is co-secreted with insulin from your pancreas. its job is to regulate energy metabolism. it also leads to weight loss by inhibiting food intake, delaying gastric emptying and decreasing blood glucose levels. the aim is to balance the activity of both systems to reduce unwanted side effects. it also offers more convenience as the drug can be taken orally every 12 to 60 hours. the new drug therapy has applications beyond diabetes and obesity. it could be used for weight maintenance after weight loss, prevention or treatment of cardiovascular disease and treatment of eating disorders.
story continues below
novo nordisk’s cagrisema, a combination therapy with 2.4mg semaglutide and 2.4mg cagrilintide, an amylin analog, is currently in the phase 3 clinical trial. the novel therapy has been shown in the american college of cardiology journal in 2023 to promote substantial weight loss with fewer side effects compared to semaglutide and cagrilintide alone.
while filing a patent application doesn’t mean these drugs will get to market, there is growing demand.

cost, access, side effects and the future of glp-1 treatments

glp-1 obesity therapies have already generated billions in sales. globaldata has estimated that glp-1 receptor agonist sales for the type 2 diabetes and obesity markets will reach more than us$125 billion in 2033.
and although these drugs are promising and effective tools for physicians, there are concerns over cost, access, frequency of injections, and side effects like the nausea, stomach pain and heartburn that can happen with wegovy, for example. medicines in the same class as wegovy and ozempic, with the active ingredient semaglutide, may increase the risk of pancreatitis, intestinal blockage and stomach paralysis compared to an older obesity drug with the active ingredient liraglutide, a study published in the jama medical journal in october 2023 found. so, news of r&d in the pharmacy industry is notable, and the coming wave of lower-cost generic alternatives to the current meds on the market could offer flexibility of treatment, like higher doses to be used in the acute phase to help patients shed pounds, followed by lower maintenance doses on a less frequent schedule.
story continues below
what’s becoming clearer to researchers and healthcare providers is that these drugs don’t work for everyone and patients usually relapse if they stop treatment. they aren’t a magic pill that solves everything in weight management. muscle mass loss, for example, occurs with weight loss, so resistance training and protein consumption are equally important strategies to protect muscle. experts also recommend cognitive behavioral therapy to support mental health and develop healthy lifestyle routines.
as wharton says, there’s much more work to be done in obesity medicine to promote understanding of the condition and advance therapies. “we don’t always have the biological and the scientific answer. i don’t really know all the scientific aspects of obesity or the visceral adiposity (body fat deep in the abdomen) or the brain neurochemistry. because we’re not there yet.”
karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

read more about the author

comments

postmedia is committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. comments may take up to an hour for moderation before appearing on the site. we ask you to keep your comments relevant and respectful. we have enabled email notifications—you will now receive an email if you receive a reply to your comment, there is an update to a comment thread you follow or if a user you follow comments. visit our community guidelines for more information and details on how to adjust your email settings.

you may also like
ozempic insulin injection pen for diabetics and weight loss.
wegovy approved for lowered risk of heart attack: what it means for people living with obesity and heart disease
obesity matters has developed a series of 12 wellness workshops starting this fall to bring wellness resources and experts free of charge to all people through informative and actionable virtual gatherings.
obesity matters wellness workshop: embracing wellness beyond the scale
the obesity matters leadership team, pictured, has worked tirelessly to develop resources to bring unprecedented support to people living with obesity in quebec through the organization's new french division, parlons obésité.
obesity matters launches french division to support and advocate for people in quebec  
a group of cheerful small school kids in canteen, eating lunch and talking.
understanding the childhood obesity epidemic: environment, genetics and education
neda nasseri, product director of benefits at desjardins insurance and advisory board member with obesity matters; rachel atkins, board vice-chair, director of strategy, and patient advocate with obesity matters; and dr. david attalla, internal medicine and obesity medicine physician. (left to right)
the toll of obesity: long-term impact, access to care and insurance support
you may also like
ozempic insulin injection pen for diabetics and weight loss.
wegovy approved for lowered risk of heart attack: what it means for people living with obesity and heart disease
obesity matters has developed a series of 12 wellness workshops starting this fall to bring wellness resources and experts free of charge to all people through informative and actionable virtual gatherings.
obesity matters wellness workshop: embracing wellness beyond the scale
the obesity matters leadership team, pictured, has worked tirelessly to develop resources to bring unprecedented support to people living with obesity in quebec through the organization's new french division, parlons obésité.
obesity matters launches french division to support and advocate for people in quebec  
a group of cheerful small school kids in canteen, eating lunch and talking.
understanding the childhood obesity epidemic: environment, genetics and education
you may also like
ozempic insulin injection pen for diabetics and weight loss.
wegovy approved for lowered risk of heart attack: what it means for people living with obesity and heart disease
obesity matters has developed a series of 12 wellness workshops starting this fall to bring wellness resources and experts free of charge to all people through informative and actionable virtual gatherings.
obesity matters wellness workshop: embracing wellness beyond the scale