Obesity Medications Coming Down the Pipeline: What You Need to Know

by Sindhura Kolli, MD; and Holly F. Lofton, MD

Fall 2020

While there are currently five approved medications for weight loss and a handful of diabetic medications that can cause weight loss indirectly, the pharmaceutical industry continues to perfect new and upcoming weight loss medications, known as “medications in the pipeline.”

Medications in the Pipeline:

Like with all weight loss medications, these new medications work best with a healthy, balanced diet and a regular exercise plan for best results. They work by causing patients to feel full earlier, prevent overeating, or correct the genetic disease that may be causing obesity. Weight loss medications are for those with a Body Mass Index (BMI) of 30 or above, or a BMI of 27 with a weight-related medical condition such as diabetes, high blood pressure or obstructive sleep apnea.

These pipeline medications can treat rare genetic diseases which can cause obesity, help manage diabetes while helping with weight loss, and can also help with weight loss alone.

These new upcoming weight loss medications include:

• Semaglutide
• AM833
• Setmelanotide
• RM-853
• Tirzepatide
• Metreleptin (Myalept)

A Closer Look

Let’s learn more about the weight loss medications mentioned previously, including what they do, who they benefit, and their potential risks.

Semaglutide

For those familiar with weight loss medications, this class is definitely recognizable. Semaglutide slows down the emptying of our stomach so food stays in it longer. This makes us feel full earlier and therefore eat less. It’s a weekly injection that is mainly used to treat diabetes but has the added benefit of causing weight loss. Early data shows that generally, people in research studies lost 17.6% of their weight while taking it. Side effects may include nausea, vomiting and stomach pain. Rarely, this medication may irritate the pancreas or cause low blood sugar. This can make you feel dizzy and confused.

AM833

AM833 is in the very early stages of development. It is also a weekly injection. AM833 works by causing us to eat fewer calories by mimicking a hormone called amylin. Amylin slows the movement of food from the stomach into the intestines and enhances the feeling of fullness. Early data shows that this medication caused people in research studies to lose 10.8% of their weight. Side effects of this medication may include nausea and vomiting.

Setmelanotide

This medication is a daily injection for people affected by rare genetic diseases known as Bardet-Beidl Syndrome or Alstrom Syndrome and a few others. These disorders typically cause early childhood weight gain, diabetes and uncontrollable hunger. The excess weight is difficult to tackle with diet and exercise alone. Setmelanotide is a medication meant to repair these genetic deficiencies. We hope that by repairing them, patients will experience less hunger and weight loss while increasing the amount of calories they burn while performing normal daily activities. Side effects may include darkening of the skin.

RM-853

RM-853 is an oral medication that is meant to block a hormone called Ghrelin. Ghrelin can cause us to feel uncontrollable hunger and overeat. It can also cause diabetes and another genetic disorder known as Prader Willi Syndrome (PWS) that also causes childhood obesity. RM-853 is meant to prevent and fix all of these diseases. It is still in the very early stages of development, so we still don’t know the side effects of this medication.

Tirzepatide

This medication is a weekly injection that causes weight loss by imitating two hormones our body normally produces. It turns the sugar we eat into energy our muscles can use instead of storing it as fat. It also slows down the emptying of our stomach so food stays in it longer and we end up eating much less. Tirzepatide decreases the feeling of hunger that our brain sends to us which causes us to eat. It will also increase the number of calories you burn while doing your normal daily activities. Research studies found that patients lost about 12 lbs. over 12 weeks. Side effects may include nausea, vomiting and diarrhea.

Metreleptin

Metreleptin, also known as Myalept, is a medication in the pipeline that is made to replace leptin. Leptin is a hormone that tells our brain we are full. When it is absent, we overeat and gain weight. This medication is intended for those who have a genetic disease which causes leptin to be absent. Metreleptin will consist of a daily injection that is approved for all ages. Some side effects may include infections, diabetes and a cancer known as lymphoma.

Conclusion

While some of these medications are made to tackle issues like diabetes and rare genetic disorders, they also carry hopes of treating the possible weight gain that can happen as a result.

There is no one perfect drug to treat obesity because there are many different reasons for why it occurs. Creating different medications allows people to have options and to be able to target the cause of their weight gain. It is important that medical and pharmaceutical fields recognize these challenges and continue developing medications that work in a variety of ways to help all different types of people achieve their weight and health goals.

About the Authors:
Sindhura Kolli, MD, is a board-certified internal medicine physician and Clinical Assistant Professor of Medicine at NYU Grossman School of Medicine. She completed a clinical obesity fellowship at NYU and is an advocate for women’s health, obesity and gastroenterology-related issues.

Holly F. Lofton, MD, is a Clinical Associate Professor of Medicine and Surgery at NYU Langone Health where she has served as Director of the Medical Weight Management Program at NYU Langone Health since 2012. In 2016, she became a founding member of the NYU Comprehensive Program on Obesity and leads the Education and Clinical Access divisions of the program. She is also the Program Director of NYU Langone Health’s Clinical Obesity Medicine Fellowship.

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