TODAY’S STARTING POINT
Four years after doctors began prescribing the drug semaglutide to treat obesity in the US, it seems to be everywhere. Better known by the brand names Ozempic and Wegovy, the drug is advertised on TV, joked about at awards shows, and has a catchy jingle that’s become an online meme.
A similar drug — marketed as Zepbound or Mounjaro — soon followed. Millions of Americans, including 140,000 in Massachusetts last year, have been prescribed some form of weight-loss drug. In addition to treating obesity, studies and other evidence suggest that the drugs can improve heart and kidney health, reduce joint pain, and quell cravings for alcohol, cigarettes, and even online shopping. Many doctors have hailed them as a revolution in medicine.
Now that revolution is poised to continue.
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More than 100 other anti-obesity drugs are in the pipeline, according to the science publication Nature. If development and clinical trials go well, several could arrive in pharmacies over the next few years.
Today’s newsletter explains what this coming wave of drugs aims to accomplish, and the questions about them that remain unanswered.
More of less
Wegovy and Zepbound can help patients who take either drug for about 15 months lose between 15 and 20 percent of their body weight. The next generation of weight-loss drugs aim to help patients lose more weight even faster.
CagriSema — developed by Novo Nordisk, the company behind Wegovy — is one example. In a trial last year, patients who stuck to the regimen shed about 23 percent of their body weight after about 15 months (although Novo Nordisk had projected a 25 percent reduction, which sent its stock price tumbling).
Retatrutide, which Eli Lilly is developing as a successor to Zepbound, may be even more powerful. Nicknamed “triple G,” it works by mimicking three hormones related to hunger instead of just one or two. In a trial, the drug reduced patients’ body weight by an average of 24 percent in just 11 months.
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Less nausea, more convenience
Wegovy and Zepbound require weekly injections, and patients often have to contend with side effects that can include nausea, fatigue, vomiting, diarrhea, constipation, and loss of muscle mass. Future weight-loss drugs aim to fix those shortcomings.
Bimagrumab, in development from Eli Lilly, may limit muscle loss. So-called combination therapies, drugs that contain more than one method of treatment, may also help reduce side effects. CagriSema, which mixes semaglutide with a second, experimental treatment, is one such medication.
Making things more convenient for patients is another goal. Amgen is testing a weight-loss drug that can be injected monthly, potentially helping more patients stick to a regimen. Eli Lilly is testing a daily pill, which it hopes to bring to market next year. AstraZeneca also has ongoing trials for a pill it licensed from a Chinese company. And as the Globe reported this week, several Boston-area startups are working on Velcro-like patches to administer weight-loss drugs (good news for patients who shudder at needles).
What’s next?
The weight-loss revolution has had its speed bumps. Some patients are taking or being prescribed existing drugs in the wrong doses, and a tsunami of new options could exacerbate that. One doctor told STAT News, the Globe’s sister site that covers health and science, that he’s seen elderly weight-loss patients become frail to the point of falling and hurting themselves.
Other clinicians worry about overkill. Many patients, they say, don’t need to lose the amounts of weight that some of the more powerful experimental drugs, like retatrutide, can deliver in order to lead healthy lives. And some Americans who don’t need to lose weight at all appear to be misusing the drugs for cosmetic reasons.
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Existing anti-obesity drugs can cost $1,000 a month without insurance, and it’s unclear how affordable future versions will be. That price tag has helped create a black market of illegally shipped or even counterfeit drugs, which could expand if demand grows.
Finally, there’s the question of politics. Robert F. Kennedy Jr., the Trump administration’s new health secretary, has criticized anti-obesity drugs, preferring lifestyle and dietary changes. As head of the agency that oversees the FDA, he could try to fire agency staff or change drug-development standards to slow-walk weight-loss medications from getting regulatory approval, or limit Americans’ access to them.
President Trump has also threatened to place tariffs on other countries — including Denmark, where Novo Nordisk is based — and on foreign pharmaceuticals. That could raise the price of Wegovy and other weight-loss drugs manufactured abroad.
We’ll keep you updated as the progress and politics shake out.
🧩 8 Across: Itsy-bitsy | 🌬️ 30º Warmer days ahead!
POINTS OF INTEREST
Boston and New England
- Sunshine under the Golden Dome: The state Legislature, traditionally shrouded in secrecy, says it will make committee votes public and rely less on opaque omnibus bills to pass major policy.
- Labor dispute: Locked in a contract fight, Stop & Shop is threatening to start closing its Freetown distribution center as union leaders warn of a strike.
- Bird flu strikes again: A 21-year-old harbor seal at New Bedford’s Buttonwood Park Zoo died after contracting the virus.
- Happy family: Big Brothers Big Sisters of Eastern Massachusetts merged with a former rival, the Big Sister Association of Greater Boston.
- ‘Kill the beast’: A visit with Jack Edwards, the former Bruins play-by-play announcer who retired because of a mysterious illness, reveals a guy still passionate about his team.
Trump Administration
- Patel installed: The Senate confirmed Trump loyalist Kash Patel as director of the FBI, an agency he wants to drastically restructure. (NBC News)
- No vaccine advice: The CDC postponed a scheduled meeting of an expert panel that advises the agency on vaccines. Robert F. Kennedy Jr., who now oversees the CDC, has criticized the panel. (AP)
- Sleepless in the Senate: Lawmakers spent all night in a “vote-a-rama” debating hundreds of amendments, most from Democrats, to a proposed $345 billion budget designed to fund Trump’s agenda. (Roll Call)
- Junk mail: Trump plans to fire the board of the Postal Service and place the agency under his commerce secretary’s control. The board plans to fight his effort. (WashPost)
- Back to work: Some federal employees fired last week from the Environmental Protection Agency’s regional office in New England have been reinstated.
- Say it to my face: Senator Elizabeth Warren invited Elon Musk to testify about his efforts to gut the Consumer Financial Protection Bureau, the watchdog agency she helped create.
- Standing up: Doctors and patients at UMass decried the Trump administration’s cuts to funding for scientific research. And the organizers of the 2017 March for Science are planning a similar rally next month in cities across the country.
- Money talks: If Trump’s economic policies shake markets, columnist Larry Edelman writes, Wall Street could be the one thing that reins him in.
- Sign of the times: A Trump flag hung inside police headquarters has sparked a bitter dispute between West Boylston’s police chief and its town administrator.
The Nation and the World
- Sick kids: Measles, a contagious virus that mostly hits children, is spreading in Texas and other states where childhood vaccination rates have declined. (USA Today)
- Kentucky two-step: With former GOP Senate leader Mitch McConnell retiring next year, one would-be successor has already said he’s running. (Politico)
- Unmasked: A prosecutor for Immigration and Customs Enforcement appears to be behind an anonymous white supremacist account on X. (Texas Observer)
- Nowhere safe: Tennis star Emma Raducanu stopped her match in Dubai after spotting a man who had allegedly stalked her sitting in the stands. Police removed him and imposed a restraining order. (Yahoo Sports)
- Not her: Israel accused Hamas of releasing a body that was not an Oct. 7 hostage, calling it a violation of their cease-fire agreement.
BESIDE THE POINT
🧘♀️ Go out: Ten things to do this weekend in Boston range from a drag show tonight to a partner yoga and Thai massage class Sunday.
👩🍳 Make a reservation: Martha Stewart will open a restaurant at the Foxwoods Resort Casino in Connecticut this fall.
❤️ Love Letters: She’s stubbornly independent but still wants to meet someone.
🌮 Boston bites: Taco John’s, known for its spicy tater tots, is one of at least eight restaurants opening downtown soon.
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🌊 Get it in writing: A cautionary tale of a young expectant couple who paid a contractor after their dishwasher flooded their kitchen. (It didn’t go well.)
👶 IVF error: A Georgia woman who gave birth to and raised a baby boy for five months gave up custody of the child because a fertility clinic implanted another couple’s embryo in her. She’s heartbroken — and suing. (USA Today)
🎻 Tune in: The MFA, known for its paintings, is also home to about 1,460 musical instruments. Meet their caretaker.
🦶 Chair, please: Spending all day on your feet at work could be an occupational hazard. (AP)
🪐 Star struck: All seven planets will align in the night sky for the next week, a rare celestial event. Here’s how to see it for yourself. (Museum of Science)
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Ian Prasad Philbrick can be reached at ian.philbrick@globe.com.