Weight loss drugs ‘do not increase quality of life’, study shows

Weight loss drugs ‘do not increase quality of life’, study shows Weight loss injections and pills cause ‘no meaningful improvement’ in quality of life as the more pounds people shed the higher risk of side effects and muscle wastage Weight loss drugs do not meaningfully increase quality of life, a scientific review has concluded. The findings in the British Medical Journal included 262 trials of the appetite-suppressing injections and pills, involving 100,000 participants with an average age of 49. Questionnaires were used to establish quality of life scores and people on the drugs showed “no meaningful improvement” on average one year later. The more weight people lost the higher the chance of side-effects such as stomach problems and muscle wastage. Side-effects also increased the risk people would have to stop taking the drugs. It is the biggest study to date looking at the broader balance of benefits and harms of the powerful drugs which have become a global phenomenon. The review looked at 19 currently available and emerging obesity drugs, with people on them followed up for 12 to 172 weeks. Compared with lifestyle changes alone, the largest weight loss after one year was with Mounjaro at 14.9% and new jab CagriSema at 14.8%. This was followed by Wegovy pills at 10.9% - which started being sold in the UK from this week - orforglipron pills at 9.9% and injectable Wegovy at 9.8%. Few drugs appeared to improve heart health in the period studied and none convincingly reduced kidney failure risk. Lead researcher Sheyu Li, of Sichuan University in China, said: “Larger benefits are generally accompanied by greater harms, treatment burden, and discontinuation. [Weight loss] improvements are not sustained after treatment cessation [stops]. “Treatment decisions for obesity should be individualised, balancing expected benefits, harms, treatment burden, costs, availability, and patient preferences.” GLP-1 drugs slow digestion and reduce appetite by mimicking a hormone called glucagon-like peptide 1 (GLP-1) which regulates hunger and feelings of fullness. They can cause side effects such as vomiting and require personalised support from specialists so that weight loss is maintained. The NHS prescribes the GLP-1 injections Mounjaro and Wegovy for weight loss but Ozempic only for diabetes. Researchers stressed people taking the drugs must increase exercise levels substantially to prevent muscle wastage. Previous studies have shown a large proportion of weight lost is muscle and bone density. Experts say weight bearing exercise programmes are essential to minimise this. Stopping taking GLP-1 drugs usually sees fat return but not muscle or bone mass. Mounjaro caused the highest fat loss by 25.7% but also the biggest loss of lean body mass such as muscle at 8.3%. Experts also found that Wegovy injections were the only drug linked to a lower risk of death from any cause, with users being 19% less likely to die during the study period. They were also 28% less likely to have a heart attack and 57% less likely to develop heart failure. Mounjaro reduced the heart failure risk by 51%. Emerging drugs such as retatrutide, ecnoglutide and mazdutide showed large effects on weight loss but were supported by low or very low certainty evidence. The researchers from China, Norway and Canada said that as the trials had relatively short follow-up periods there may be some benefits that the review did not pick up. Dr Hamlet Gasoyan, of the Cleveland Clinic in the US, wrote in an accompanying editorial: “The growing number of new obesity drugs is welcome news for clinicians and over a billion people worldwide living with obesity or overweight as they expand the options for treatment. “As the number of new drugs increases, physicians must now choose the right obesity treatment for each patient, individualising the balance of benefits and adverse effects.”