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No more needles? A daily pill may work as well as Wegovy shots to treat obesity
What if treating obesity could be as easy as popping an effective pill?
That’s a notion that has long fueled hope for many of the more than 40% of Americans who are considered obese — and fueled criticism by those who advocate for wider weight acceptance. Soon, it may be a reality.
High-dose oral versions of the medication in the weight-loss drug Wegovy may work as well as the popular injections when it comes to paring pounds and improving health, according to final results of two studies released Sunday night. The potent tablets also appear to work for people with diabetes, who notoriously struggle to lose weight.
Drugmaker Novo Nordisk plans to ask the U.S. Food and Drug Administration to approve the pills later this year.
“If you ask people a random question, ‘Would you rather take a pill or an injection?’ People overwhelmingly prefer a pill,” said Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats patients with obesity but was not involved in the new research.
That’s assuming, Bessesen said, that both ways to take the medications are equally effective, available and affordable. “Those are the most important factors for people,” he said.
There have been other weight-loss pills on the market, but none that achieve the substantial reductions seen with injected drugs like Wegovy. People with obesity will be “thrilled” to have an oral option that’s as effective, said Dr. Katherine Saunders, clinical professor of medicine at Weill Cornell Health and co-founder of Intellihealth, a weight-loss center.
Novo Nordisk already sells Rybelsus, which is approved to treat diabetes and is an oral version of semaglutide, the same medication used in the diabetes drug Ozempic and Wegovy. It comes in doses up to 14 milligrams.
But results of two gold-standard trials released at the American Diabetes Association’s annual meeting looked at how doses of oral semaglutide as high as 25 milligrams and 50 milligrams worked to reduce weight and improve blood sugar and other health markers.
A 16-month study of about 1,600 people who were overweight or obese and already being treated for Type 2 diabetes found the high-dose daily pills lowered blood sugar significantly better than the standard dose of Rybelsus. From a baseline weight of 212 pounds, the higher doses also resulted in weight loss of between 15 and 20 pounds, compared to about 10 pounds on the lower dose.
Another 16-month study of more than 660 adults who had obesity or were overweight with at least one related disease — but not diabetes — found the 50-milligram daily pill helped people lose an average of about 15% of their body weight, or about 35 pounds, versus about 6 pounds with a dummy pill, or placebo.
That’s “notably consistent” with the weight loss spurred by weekly shots of the highest dose of Wegovy, the study authors said.
But there were side effects. About 80% of participants receiving any size dose of oral semaglutide experienced things like mild to moderate intestinal problems, such as nausea, constipation and diarrhea.
In the 50-milligram obesity trial, there was evidence of higher rates of benign tumors in people who took the drug versus a placebo. In addition, about 13% of those who took the drug had “altered skin sensation” such as tingling or extra sensitivity.
Medical experts predict the pills will be popular, especially among people who want to lose weight but are fearful of needles. Plus, tablets would be more portable than injection pens and they don’t have to be stored in the refrigerator.
But the pills aren’t necessarily a better option for the hundreds of thousands of people already taking injectable versions such as Ozempic or Wegovy, said Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital.
“I don’t find significant hesitancy surrounding receiving an injection,” she said. “A lot of people like the ease of taking a medication once a week.”
In addition, she said, some patients may actually prefer shots to the new pills, which have to be taken 30 minutes before eating or drinking in the morning.
Paul Morer, 56, who works for a New Jersey hospital system, lost 85 pounds using Wegovy and hopes to lose 30 more. He said he would probably stick with the weekly injections, even if pills were available.
“I do it on Saturday morning. It’s part of my routine,” he said. “I don’t even feel the needle. It’s a non-issue.”
Some critics also worry that a pill will also put pressure on people who are obese to use it, fueling social stigma against people who can’t — or don’t want to — lose weight, said Tigress Osborn, chair of the National Association to Advance Fat Acceptance.
“There is no escape from the narrative that your body is wrong and it should change,” Osborn said.
Still, Novo Nordisk is banking on the popularity of a higher-dose pill to treat both diabetes and obesity. Sales of Rybelsus reached about $1.63 billion last year, more than double the 2021 figure.
Other companies are working on oral versions of drugs that work as well as Eli Lilly and Co.’s Mounjaro — an injectable diabetes drug expected to be approved for weight-loss soon. Lilly researchers reported promising mid-stage trial results for an oral pill called orforglipron to treat patients who are obese or overweight with and without diabetes.
Pfizer, too, has released mid-stage results for dangulgipron, an oral drug for diabetes taken twice daily with food.
Novo Nordisk officials said it’s too early to say what the cost of the firm’s high-dose oral pills would be or how the company plans to guarantee adequate manufacturing capacity to meet to demand. Despite surging popularity, injectable doses of Wegovy will be in short supply until at least September, company officials said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
World
Putin mulls striking Kyiv with new hypersonic missile that can reportedly reach US West Coast
Following an overnight missile and drone attack by Russia targeting Ukraine’s key energy infrastructure, Russian President Vladimir Putin now says that government buildings in Kyiv could be targeted next using a new hypersonic missile that could also potentially reach the U.S.
Russian attacks have not so far struck “decision-making centers” in the Ukrainian capital as Kyiv is heavily protected by air defenses. But Putin says Russia’s Oreshnik hypersonic missile, which it fired for the first time at a Ukrainian city last week, is incapable of being intercepted.
Russia fired the Oreshnik at the Ukrainian city of Dnipro on Nov. 21, striking a weapons production plant. This was in retaliation against Ukrainian strikes on a Russian military facility in Bryansk two days earlier with U.S. made long-range missiles called ATACMS, after President Biden had given Ukrainian President Volodymyr Zelenskyy permission to do so.
RUSSIA LAUNCHES ANOTHER LARGE MISSILE, DRONE ATTACK ON UKRAINE’S ENERGY INFRASTRUCTURE
Russia says Ukraine fired more ATACMS at its Kursk region on Nov. 23 and Nov. 25.
“Of course, we will respond to the ongoing strikes on Russian territory with long-range Western-made missiles, as has already been said, including by possibly continuing to test the Oreshnik in combat conditions, as was done on November 21,” Putin told a meeting of a security alliance of ex-Soviet countries in Kazakhstan.
“At present, the Ministry of Defense and the General Staff are selecting targets to hit on Ukrainian territory. These could be military facilities, defense and industrial enterprises, or decision-making centers in Kyiv,” he said.
The instrumentations of the Oreshnik missile – its sensors, electronics, data acquisition capabilities – are those of the Rubezh, a Russian solid-fueled intermediate-range ballistic missile (IRBM). With its flight capability of between 310 miles and 3,100 miles – just 310 miles below the standard low limit of an ICBM – the Oreshnik can target most of Europe and the West Coast of the United States. After a launch, such a missile could probably hit Britain in 20 minutes and Poland in 12 minutes.
The Oreshnik can be outfitted with a non-nuclear or nuclear warhead. And it is nearly impossible to intercept by existing missile defense systems because it is designed to fly at hypersonic speeds, reaching Mach 11.
Putin said Russia’s production of advanced missile systems exceeds that of the NATO military alliance by 10 times, and that Moscow planned to ramp up production further.
His plans to increase production and ongoing strikes mean the conflict – which has already passed 1,000 days – shows no signs of abating.
Russia unleashed a massive aerial drone and missile attack on Ukraine on Thursday targeting the country’s key energy infrastructure, leaving more than a million households without power in the west, south and center of the country, Ukrainian officials said.
RUSSIA LAUNCHES RECORD NUMBER OF DRONES IN NEW ATTACK
The attack consisted of firing nearly 200 missiles and drones with explosions being reported in Kyiv, Kharkiv, Rivne, Khmelnytskyi, Lutsk and many other cities in central and western Ukraine.
The operation was Russia’s second major aerial attack on Ukraine’s power grid in less than two weeks, with President Vladimir Putin saying on Thursday that the attack was a response to Kyiv’s attacks on Russian regions using longer-range American missiles.
The attack has raised fears in Ukraine that Russia is looking to cripple its energy infrastructure before the winter cold starts to bite and dampen Ukrainian spirits about the outcome of the war.
Zelenskyy said that the attack was a “vile escalation” and that Kalibr cruise missiles with cluster munitions were used to deliberately target civilian infrastructure.
“The use of these cluster elements significantly complicates the work of our rescuers and power engineers in mitigating the damage, marking yet another vile escalation in Russia’s terrorist tactics,” Zelenskyy wrote on X.
He urged Western countries to deliver on promised air defense weaponry. Ukrainian officials in the past have grumbled that military aid is slow to arrive.
The attack came just hours after President-elect Trump nominated Lt. Gen. Keith Kellogg for a potential new post focused on ending the Russia-Ukraine war. Trump has created the position of special envoy for the Ukraine conflict,
Three sources familiar told Reuters that Kellogg presented Trump with a plan to end the conflict, and in April co-authored a research document that presented the idea of using weapons supplied to Ukraine as leverage for armistice negotiations with Russia.
Rebekah Koffler, The Associated Press and Reuters contributed to this report.
World
At least 13 killed, many more feared dead as landslides bury Uganda homes
Dozens of houses in six villages of Bulambuli district in eastern Uganda submerged in landsides triggered by heavy rainfall.
More than 10 people have been killed and many others are feared dead after heavy rains caused landslides in eastern Uganda.
The Uganda Red Cross Society said on Thursday at least 13 bodies had been recovered after landslides “completely buried” 40 homes in six villages of the mountainous district of Bulambuli the previous night.
Images on local media showed huge swaths of fallen earth covering the land in the village of Masugu, about a five-hour drive from the capital, Kampala. Videos and photographs shared on social media purported to show people digging for survivors in the village of Kimono.
The Uganda Red Cross Society said the rescue effort was continuing but the death toll was likely to rise.
“We lost about 30 people,” district commissioner Faheera Mpalanyi told the AFP news agency, adding that six bodies, including that of a baby, had been recovered so far.
“Given the devastation and the size of the area affected and from what the affected families are telling us, several people are missing and probably buried in the debris,” she said.
The heavy rains in recent days caused flooding in the northwest after a tributary of the Nile River burst its banks, prompting the prime minister’s office to issue a disaster alert on Wednesday, saying that main roads across the country had been cut off.
Emergency teams were sent to rescue stranded motorists.
A road connecting the country with South Sudan was impassable late on Wednesday, with emergency boat crews deployed near the town of Pakwach.
“Unfortunately, one of the boats capsized, resulting in the death of one engineer,” Uganda’s defence forces said on X.
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