Fortune | FORTUNE 2024年10月11日
GLP-1 drugs like Wegovy are all the rage—but people are quitting them too fast to achieve meaningful weight loss, finds 170,000-patient study
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GLP - 1药物可助糖尿病与肥胖症患者降糖减重,现广为人知。但其使用存在问题,一项研究显示患者用药不当,多数未完成12周最低疗程,年轻人更易提前停药。胃肠副作用或为原因之一,擅自停药危险。医生专业度、就诊次数、支持措施及健康公平性等影响治疗效果。

💊GLP - 1药物能助糖尿病和肥胖症患者降血糖并促进减重,本应受到重视,但实际使用中存在诸多问题。

😔多数患者未按规定完成至少12周的疗程,难以达到临床有意义的减重效果,尤其是年轻患者更易提前中断治疗。

🤢药物的胃肠副作用如恶心、呕吐和腹泻,可能是人们无法完成治疗的原因之一,擅自停药存在风险。

👨‍⚕️医生的专业度对患者能否坚持治疗影响很大,经过内分泌学和肥胖管理专业培训且获得认证的医生,能提高患者的治疗依从性。

💪增加就诊次数,不论医生专业,都能提高患者达到有意义减重目标的几率,同时支持饮食、营养、行为健康和副作用管理也很重要。

As recently as the onset of COVID-19 four years ago, you probably didn’t know what a glucagon-like peptide 1 agonist, or GLP-1 drug, was. But this class of medications, which help people with Type 2 diabetes and obesity lower their blood sugar and promote weight loss, is now a household name.“It’s everywhere,” Dr. Razia Hashmi, Blue Cross Blue Shield Association (BCBSA) vice president of clinical affairs, said Tuesday during a town hall at Fortune’s Brainstorm Health conference in Dana Point, Calif. “It’s part of our conversation. It’s on social media, your family’s talking about it, we’re talking about it in the boardroom, we’re talking about it in the break room. There is, obviously, a lot of excitement about it—the adoption’s been exponential—but there is so much more to learn.”Not all of it is positive, as revealed by a new study conducted by Blue Health Intelligence that examined nearly 170,000 GLP-1 users who were prescribed the medication for weight loss. Released Tuesday, it’s “the largest-ever study done, real-world evidence study” of the medication, Hashmi said.The study shows patients aren’t taking the medication properly, despite its skyrocketing popularity: Net sales of antiobesity drugs such as semaglutide, or Wegovy, hit $1.1 billion in the second quarter of 2023, per the Congressional Budget Office.Most patients taking GLP-1 drugs for weight management didn’t stay on their prescribed treatment for the minimum 12 weeks, meaning they were unlikely to attain clinically meaningful weight loss. Young adults (aged 18–34) were more likely to drop out of treatment sooner, and more than 30% of all patients dropped out after just four weeks, before reaching the targeted dose.The gastrointestinal side effects of GLP-1s, including nausea, vomiting, and diarrhea, may be a reason people don’t complete treatment, the study notes. But because the medication is intended to treat obesity and Type 2 diabetes—both serious, chronic conditions—quitting cold turkey without a doctor’s guidance may be dangerous.“One has to ask, why?” Hashmi said. One clue, she said, comes from the doctor prescribing the medication: “Your provider matters. If your provider is trained in endocrinology, if they are trained and board-certified in obesity management, the likelihood that you will stay on the treatment is much, much higher.“The other thing that we found was that each additional visit to your doctor, regardless of specialty, increased your chances of reaching that meaningful weight-loss goal by 60%.”Another finding Hashmi highlighted was that support for diet, nutrition, behavioral health, and side effect management matters. The same goes for health equity; the study revealed people who lived in underserved health regions were less likely to complete 12 weeks of treatment.Andrew Nusca, editorial director of Fortune’s Brainstorm conference series, moderated the town hall, which also featured Dr. Rami Bailony, cofounder and CEO of Enara Health. While acknowledging that such research on GLP-1 usage and outcomes is needed, Bailony stressed the drugs should be just one component of obesity management.“[GLP-1s] will change the way we do care, but ultimately, what matters is the framework in which those are delivered,” he said. “Our mission is to deliver personalized, data-driven treatment, and we do that by integrating directly into primary care and cardiology care, and [it] will be the data layer that personalizes that treatment that’s going to make a difference in the end.”For more on weight management:Subscribe to Well Adjusted, our newsletter full of simple strategies to work smarter and live better, from the Fortune Well team. Sign up for free today.

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GLP - 1药物 用药不当 治疗效果 医生专业度 健康公平性
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