Landmark study presented at European Congress on Obesity showed daily pill made by drugmakers behind Mounjaro helped users maintain weight year after stopping jab
Millions of Brits could be put on weight loss pills for life as landmark research suggests they could be key to staying slim for good.
A study presented at the European Congress on Obesity in Istanbul showed the appetite-suppressing drugs in tablet form could help maintain weight loss in people who stop taking them as injections. The researchers behind the study said the daily pill orforglipron could replace drugs for other related conditions such as high blood pressure and Type 2 diabetes – and could even be given to people earlier to stop them becoming obese.
Study author Dr Louis Aronne, of the Weill Cornell Medicine centre in New York, said: “A daily pill – its treatment for life. For hypertension, its treatments for life, you take a pill every day. Diabetes you hope to take a pill for life and the diabetes doesn’t come back. The beauty of treating obesity is you are treating all of these things.”
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Experts said weight loss drugs could prevent more than 200 diseases linked to obesity – and ultimately be prescribed by GPs to those who were barely overweight.
Currently around 2.5 million people in the UK are taking weight loss injections with the vast majority being accessed via expensive private prescriptions. The NHS intends to roll out treatments like Wegovy and Mounjaro to up to 3.4 million people over the next 12 years.
The powerful appetite-suppressing injections can help people lose up to a fifth of their body weight but can come with side effects such as nausea, constipation and diarrhea – so often people have to stop using them.
Private prescriptions also cost hundreds of pounds so many people stop taking them after losing weight, including muscle mass, before piling fat back on. Eventually, the drugs are expected to be much cheaper in pill form.
The trial of 376 patients in the US who moved onto orforglipron, made by the makers of the jab Mounjaro, maintained 75% of their weight loss after a year. Drugamer Eli Lilly funded the study.
Dr Aronne, who is director of the Comprehensive Weight Control Center at Weill Cornell, said his team are now looking at “the idea that you treat obesity first and not waiting until someone has a severe problem body mass index (BMI) of 35.” He said: “The average patient that we see in our clinics ..the average BMI is 38, the average person is on seven medications and has sleep apnoea..
“What would happen if you started treating people with a BMI of 25 or 27 and they never got to that?” You never get to the point of severe obesity. I think that is very appealing model to me but it has to be proven.”
Regulator the Medicines and Healthcare products Regulatory Agency (MHRA) is currently considering an application from Eli Lilly to have orforglipron approved for sale in the UK.
Kenneth Custer, executive vice president at Lilly Cardiometabolic Health, said: “We’ve been waiting for a scalable solution and that’s what we have here. We’ve made tremendous investments in advance of this launch to be able to supply it at the time of approval in every market where it’s submitted.”
The pill suppresses appetite by mimicking the GLP-1 hormone in the same way as injections but previous research showed pills were less effective at initially shifting weight than weekly injections.
Mounjaro injections have been dubbed the “King Kong of weight loss jabs” and have a list price of £122 for a pack which lasts a month. Orforglipron were approved by the Food and Drug Administration in the US last month and are expected to be much cheaper to mass produce.
Both the injections and pills work by lowering blood sugar levels and slowing the digestion of food to reduce appetite and make people feel full sooner.
The new study, also published in the journal Nature Medicine, showed that among those who had been on Mounjaro jabs before moving to pills, they maintained 74.7% of their weight loss after a year compared with 49.2% taking the placebo. Some 79.3% of former semaglutide users also maintained their weight loss compared to 37.6% in the placebo group.
Jason Murphy, weight loss expert at pharmacy chain Chemist4U, said: “The introduction of next generation weight loss pills to the public will be game-changing. Many people who want to start weight loss medications have said they are uncomfortable injecting themselves, or feel a sense of stigma and shame. Beyond this research showing how effective pills are, they will also massively widen access for those who were previously hesitant.
“This latest research shows that in the near future, we could have millions more people accessing weight loss drugs than ever before, as pills reshape the way we tackle obesity as a nation.”
Lack of NHS capacity to provide essential counselling support from clinicians is the reason millions of those technically eligible for weight loss injections cannot be prescribed them on the NHS. They are currently being prioritised for the most dangerously obese people who have other, linked health conditions.
How are pills different?
Orforglipron is a “non-peptide small molecule” allowing it to survive stomach acid and be absorbed by the gut.
Weight loss injections are generally made up of a “peptide” which is larger and usually broken down by the stomach – and therefore needs to be injected to work.
The drugs in pill form do not need to be kept in the fridge like injections and do not require fasting, strict water limits or a 30-minute wait to eat.
Dr Aronne said: “It’s not a peptide, it’s a small molecule. It’s easier to manufacture and you don’t need to take it with four ounces of water and half an hour before or after a meal. However, it does interact with other medications so, like many treatments, there are benefits to using it and there are other things that need to be adjusted with time.”
