Study shows costly weight loss drug may also cut risks of heart attacks
Study shows costly weight loss drug may also cut risks of heart attacks
The nation’s obesity epidemic is growing. Nearly 42 percent of all American adults are considered obese. Now, new findings about the FDA-approved weight-loss drug Wegovy may lead to even more demand for a medication that can be both life-changing and expensive. William Brangham reports.
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Content
3.488 -> geoff: The nation's obesity
5.357 -> epidemic is growing. Nearly 42%
6.425 -> of all adults are considered
7.86 -> obese.
9.261 -> Now, new findings about an fda
11.23 -> approved weight-loss medication
13.265 -> may lead to even more demand for
15 -> a medication that can be both
16.935 -> life-changing and expensive.
19.471 -> William brangham has the latest.
22.074 -> William: Roughly 100 million
23.876 -> Americans suffer from obesity
25.344 -> and its many associated health
26.879 -> risks. Obesity takes a terrible
28.513 -> economic toll as well, costing
30.482 -> this country an estimated $200
32.117 -> billion a year.
36.488 -> A new weight loss drug called
37.222 -> wegovy has shown, according to
38.056 -> one study, that it not only can
39.892 -> help with obesity, but it might
41.894 -> also cut the risk of heart
43.228 -> attacks, strokes, and other
46.098 -> heart problems by 20%. But there
46.999 -> are real concerns about
47.9 -> potential side effects.
50.102 -> For a closer look, we are joined
51.036 -> by Dr. Michael Blaha.
53.906 -> He's director of clinical
54.506 -> research at the Johns Hopkins
55.908 -> chika Roni center for the
57.175 -> prevention of cardiovascular
58.043 -> disease.
61.079 -> Dr. Blaha, very good to have you
62.014 -> on the news hour.
64.116 -> Before we get to talking about
64.917 -> this drug, could you just remind
65.984 -> us of the connections between
67.252 -> obesity and heart disease?
75.127 -> >> Yeah, sure. As you said, rbc
77.262 -> -- obesity is extremely common,
78.33 -> and it's linked with so many
79.097 -> forms of cardiovascular disease.
79.932 -> Obesity itself is an
80.532 -> inflammatory condition. It
81.934 -> raises your blood pressure, can
84.269 -> cause diabetes and other risk
85.137 -> factors, and it's linked to
86.939 -> atherosclerosis of the arteries,
88.307 -> which puts you at risk for heart
89.041 -> attacks and strokes.
91.343 -> It also raises the risk of heart
93.512 -> failure and atrial fibrillation.
95.247 -> Heart rhythm abnormality, too,
96.081 -> so really, obesity underpins
97.95 -> many of the chronic
99.418 -> cardiovascular conditions that
100.619 -> we treat in a cardiology
101.353 -> practice.
103.956 -> William: According to this
107.259 -> study, only parts have been
107.96 -> released, it indicates this drug
110.429 -> could prevent 1.5 one million
114.132 -> heart attacks, strokes, and
115.067 -> other events over the course of
115.968 -> 10 years, if that's true, with
116.969 -> all the caveats there.
117.469 -> How big a deal is that?
120.272 -> >> This is a really big deal. In
121.406 -> my opinion, we've waited for a
122.507 -> long time to build a treat
125.544 -> obesity and clinical medicine
127.479 -> and actually lower
127.98 -> cardiovascular events. And as a
128.981 -> cardiologist, you know we
131.583 -> haven't paid much attention to
132.351 -> obesity because we couldn't do
134.286 -> anything about it and affect our
136.989 -> outcomes. But now, with the
138.123 -> potential on the horizon about a
138.991 -> treat obesity and lower
139.658 -> cardiovascular disease, you have
143.028 -> the attention of cardiologists
144.262 -> and other specialists who treat
145.03 -> cardiovascular disease. So this
146.398 -> is a really big deal, and I
148 -> think it's finally going to
149.501 -> change the paradigm on the way
151.003 -> we think about obesity, the
154.006 -> way we treat obesity and there's
155.007 -> a lot more to work out. And as
156.008 -> you mentioned, we need to see
156.475 -> the results of the actual study.
160.012 -> William: Walk me through the
162.614 -> ways in which it might be a
163.582 -> paradigm shift for your
164.182 -> profession.
168.253 -> >> Most of our patients don't
169.221 -> lose weight.
169.621 -> In fact, most of our patients
173.025 -> gain weight over time.
173.425 -> Obesity underpins so many of the
174.159 -> chronic diseases that we treat
176.028 -> obstructive sleep apnea is one
176.695 -> that can lead to hypertension
178.063 -> becoming hard to treat.
180.032 -> Cholesterol abnormalities, of
181.5 -> course diabetes. And I mentioned
183.468 -> before, myocardial infarction
187.472 -> and heart attacks and strokes.
188.306 -> But also the heart failure, the
189.041 -> chronic heart failure that's
190.042 -> troubling for many of our
193.612 -> patients.
194.079 -> And atrial fibrillation, which
195.047 -> is becoming an epidemic so
196.681 -> it underpins so much of what we
197.582 -> do. So we treat many of the
198.283 -> complications of obesity in our
199.051 -> practice right now, but we never
200.585 -> get to the root cause and this
204.356 -> is what has been frustrating
205.557 -> over so long.
206.124 -> We are just treating the
206.725 -> manifestations of obesity. It's
207.526 -> a very costly way of doing
208.16 -> things compared to actually
212.23 -> treating the underlying causes
213.065 -> of all the problems.
213.498 -> William: As I mentioned, there
214.232 -> are some concerns about
215.3 -> complications or side effects
216.568 -> with these drugs. What is your
218.07 -> understanding of those? And what
218.67 -> do people need to know about
222.107 -> that part of it?
223.075 -> >> These drugs are really well
224.309 -> known actually, because we've
225.077 -> been using them in the diabetes
226.078 -> space for over a decade. So now
228.08 -> we have approval to use some of
230.615 -> the same medications at higher
234.086 -> doses for weight loss, or at
234.519 -> least one in particular. So
235.62 -> we've learned a lot in the
237.089 -> clinical arena about how to use
238.757 -> these drugs. And absolutely
240.092 -> there are side effects. In fact,
241.626 -> the side effects are closely
243.261 -> associated with their mechanism
246.098 -> of action. And if I could
246.731 -> briefly say that the way these
250.569 -> medications work is, they slow
251.269 -> the emptying of food from the
252.637 -> stomach. They signal hormonal
256.108 -> changes that put us in their fed
256.541 -> states. We feel satiated and not
257.342 -> hungry anymore, and they also
258.31 -> work directly on the brain to
260.312 -> reduce hunger. So some of the
263.115 -> side effects are those very
269.621 -> things.
270.122 -> If they are beyond what a
273.458 -> patient can tolerate, you can
274.159 -> get a full bloating feeling in
275.36 -> , the stomach after a big meal.
276.361 -> You can get nausea, sometimes
277.429 -> vomiting or diarrhea. They are
279.131 -> largely controlled with diet
280.132 -> changes. So it's very important
281.133 -> if a patient were to consider a
282.134 -> medication like this, that this
283.135 -> isn't in lieu of diet and
286.805 -> exercise.
287.172 -> It is with diet changes.
290.308 -> William: And if someone starts
291.476 -> on these drugs, do they take
292.144 -> them for a short period of time?
293.145 -> Are they taking them for the
293.745 -> rest of their life? What is
294.446 -> that?
298.15 -> >> If you stop taking these
300.152 -> medications, patients do regain
301.286 -> weight.
302.154 -> Most of them have regained
305.457 -> weight, maybe not all of it but
307.159 -> much of it.
307.559 -> So it's really shifting the
308.293 -> thinking about obesity towards
309.161 -> that of a chronic disease. You
309.694 -> know, we take blood pressure
310.529 -> medications for hypertension. We
311.263 -> expect that our blood pressure
312.23 -> will go back if we stop them.
314.199 -> And same with our cholesterol
315.167 -> medications. We sort of assume
315.6 -> that if you stop taking them the
317.169 -> cholesterol goes up. But this
318.403 -> hasn't really been worked out so
319.571 -> much in the obesity space. But
321.173 -> as we learn more about the
322.174 -> disease and think of it as a
324.309 -> chronic disease, it sort of
328.18 -> makes sense, then, that the
329.181 -> medications need to be there to
330.782 -> exert their effect. So we hope
331.716 -> we will learn a lot more about
333.185 -> the maintenance phase of
334.352 -> pharmacologic treatment for
336.521 -> obesity over time, but right now
337.355 -> it looks like you do need to
338.657 -> stay on the drug to get the
343.195 -> maximum benefit.
344.663 -> In the meantime, we like our
346.264 -> patients to have a thorough
348.4 -> diet and lifestyle change that
350.402 -> might help them keep the weight
351.203 -> off. So it's really once again
352.204 -> about diet, exercise and drugs.
354.206 -> William: You are not in the
357.209 -> business of health insurance,
359.211 -> per se. But there is a question
359.811 -> as to whether these drugs show
360.512 -> their promise, whether or not
361.213 -> health insurance, and
361.78 -> particularly, whether medicare
362.48 -> ought to cover them.
363.715 -> Is it your opinion that these do
365.217 -> offer enough benefit that that
368.286 -> really ought to be a
370.222 -> consideration?
372.29 -> >> It is my opinion, based on
373.425 -> this trial that's been running,
374.326 -> the size of that trial and how
375.227 -> well it was run, that the
376.695 -> evidence is going to be
377.562 -> sufficient for the fda to
379.331 -> approve these weight loss drugs,
380.665 -> wegovy particularly, for
382.701 -> cardiovascular risk reduction.
384.236 -> And having that fda approval for
386.238 -> cardiovascular risk reduction
387.472 -> will then open up an opportunity
389.241 -> or at least put pressure on
391.243 -> payers like medicare to cover
392.644 -> this medication more broadly,
395.247 -> and we've been waiting for this.
395.78 -> We've anticipated this trial as
401.319 -> a pivotal moment to see, is this
402.32 -> going to be a drug that many
403.288 -> people will benefit from? Or is
404.256 -> this one that you know will keep
407.259 -> as more of a niche product for
408.26 -> maybe severe obesity, and it
409.261 -> looks like we're going to have a
409.794 -> broad based cardiovascular
410.762 -> benefits. So absolutely, we're
411.529 -> going to see much broader
415.5 -> coverage I think.
416.268 -> William: All right, Dr. Michael
416.768 -> Blaha. Johns Hopkins medicine.
417.469 -> Thank you so much for being
418.336 -> here.
418.837 -> >> My pleasure. Thank you.
421.273 -> ♪♪
Source: https://www.youtube.com/watch?v=Or64aCwcGT0