Injectable weight-loss medicines reduce appetite but raise questions of long-term safety and affordability
The people who seek out endocrinologist Domenica Rubino have tried again and again to lose weight. Diets of all kinds. Exercise regimens. Health-tracking apps. Some have turned to gastric bypass surgery, lost scores of pounds but then regained them. Many patients have medical problems related to severe obesity, including diabetes, fatty liver disease, hypertension, polycystic ovary syndrome, sleep apnea and painful arthritic joints.
Kushner emphasizes the drug is not just for weight loss but to reduce the associated risk of chronic illnesses. “We want to be sure our patients are getting healthier, not just thinner,” he says. The hitch is that these drugs must be used throughout life, much like diabetes medications, or else the benefits are lost. In fact, a 2021 study led by Rubino found that people on semaglutide regain weight when the drug is stopped. The premise of such treatments is that serious obesity is not a transitory condition related mainly to behavior and environmental factors, as many people see it.
Cost is also an issue for the weight-loss drug and will likely be a problem for similar medications. The price is $1,349 a month. Insurance coverage is spotty, and Medicare does not pay for it. Yet demand is so strong the drugmaker, Novo Nordisk, can’t keep up. “We’ve been asked to hold off starting new patients,” Kushner says.
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