The new generation of obesity treatments, which have become extremely popular in just a few years, are not “miracle drugs” and “should never be taken for aesthetic reasons”, warns Svetlana Mojsov, one of the scientists who helped develop them.
Along with two other researchers, Joël Habener and Lotte Bjerre Knudsen, she was awarded the prestigious Lasker Prize on Thursday, often considered a precursor to a possible Nobel Prize.
All three have helped revolutionize the management of obesity, a chronic disease and a real public health scourge, by contributing to the discovery and development of drugs that enable significant weight loss.
Ozempic, Wegovy, Mounjaro, Zepbound… Indicated against obesity or type 2 diabetes (hyperglycemia often linked to being overweight), these treatments have caused such a craze that they are sometimes diverted to lose a few kilos deemed superfluous.
“The big success is being able to treat obesity and that’s what we should stick to,” insisted Svetlana Mojsov, 76, recalling the side effects — particularly gastrointestinal — of these drugs.
Treatment of obesity
In interviews with AFP, this chemist and her co-winner Joël Habener recounted the decades of research necessary for their development.
“It’s a dream, when you’re a researcher, to discover something that will help people,” he said. He also welcomed the fact that these advances are helping to make people realize “that obesity is a metabolic disease, not a problem of willpower.”
AFP
The effectiveness of these new drugs is due to a discovery: they mimic a hormone secreted by the intestines, called GLP-1.
Joel Habener, an endocrinologist at Massachusetts General Hospital, was the first to detect its existence, first in fish, in 1982.
Svetlana Mojsov identified the active sequence of GLP-1, demonstrated its presence in the intestine and synthesized a pure form.
She then showed, in collaboration with others, that GLP-1 stimulates the secretion of insulin by the pancreas, allowing the level of glucose in the blood to be lowered.
Immediately, she was “sure that this would be a good treatment for diabetes,” she recalls.
But at that time, no one suspected its usefulness against obesity.
“We didn’t really have weight loss in mind,” because obesity wasn’t such a big problem back then, says Joel Habener, 87.
Moreover, in the 1980s, “there was no scientific evidence that hormones regulate weight,” adds Svetlana Mojsov, a Yugoslavian-born associate professor at Rockefeller University.
It was only by chance, while conducting large clinical trials, that scientists realized that patients were losing weight.
GLP-1
It is gradually being understood that GLP-1 slows down the emptying of the stomach, but also acts in the brain, influencing the feeling of satiety. A decisive discovery.
Pharmaceutical companies are quickly catching on. At Novo Nordisk, researcher Lotte Bjerre Knudsen is overcoming a major challenge: in the body, GLP-1 disappears within minutes.
She is developing techniques to make it last longer in the body — first for a day, then for a week.
The Danish group’s first drug containing a GLP-1 analogue was first approved in the United States in 2010 for type 2 diabetes, then in 2014 for obesity (under the name Saxenda).
The others follow and turn out to be golden gooses for pharmaceutical companies.
Ozempic “paved the way”
The American laboratory Eli Lilly has for its part developed a molecule associating GLP-1 with another gastrointestinal hormone, which could according to Svetlana Mojsov reduce the side effects.
“We may be getting to a new generation” combining different hormones, she believes. “Ozempic is not necessarily the final solution,” but “has paved the way.”
Even more promising for the future: the possible effects of GLP-1 on a host of other diseases. One of the molecules is already authorized against cardiovascular accidents.
But researchers are exploring many other avenues and studies are pouring in: sleep apnea, addiction, kidney, liver or even neurodegenerative diseases (Parkinson’s, Alzheimer’s)…
“It’s extraordinary,” confides Joël Habener, pointing in particular to the action of GLP-1 in the brain to explain these multiple potential benefits.
For Svetlana Mojsov, GLP-1 opens the way to the idea that a drug is not reserved for a single disease.
“Until now, we’ve said one drug per disease,” she says. “Now we’re seeing that GLP-1 has a much broader range of health benefits.”
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