GLP-1 Receptor Agonists Shift from Diabetes to Obesity Treatment: Implications and Trends

Los Angeles, California United States of America
Approximately one million new GLP-1 RA users identified in the US between 2011 and 2023.
Decrease in proportion of new GLP-1 RA users with type 2 diabetes from approximately 57% to around 43%.
FDA approval of GLP-1 RAs for weight management indications and high prevalence of obesity in the US are factors driving this shift.
Increase in proportion of new GLP-1 RA users without type 2 diabetes but with obesity or overweight and obesity-related comorbid condition from nearly 47% to over 66%.
Semaglutide was the most prescribed GLP-1 RA in 2023, accounting for over 88% of new prescriptions.
Shift towards using GLP-1 RAs for obesity raises concerns about potential drug shortages and disparities in access to these medications.
GLP-1 Receptor Agonists Shift from Diabetes to Obesity Treatment: Implications and Trends

In recent years, there has been a significant shift in the use of GLP-1 receptor agonists (GLP-1 RAs) from treating type 2 diabetes to obesity. According to several studies, this trend began around 2020 and has continued since then. In this article, we will explore the reasons behind this shift and its implications.

Firstly, let's examine the data. Between 2011 and 2023, approximately one million new GLP-1 RA users were identified in the United States (Yee Hui Yeo et al., Annals of Internal Medicine). During this period, there was a decrease in the proportion of new GLP-1 RA users with type 2 diabetes and an increase in those without it but with a body mass index (BMI) indicative of obesity or overweight and an obesity-related comorbid condition. For instance, between 2019 and 2023, the proportion of new GLP-1 RA users with type 2 diabetes dropped from approximately 57% to around 43%, while those without it but with a BMI of equal to or greater than 30 kg/m² rose from nearly 47% to over 66% (Rezaie et al., Annals of Internal Medicine).

Furthermore, semaglutide, the active ingredient in Novo Nordisk's diabetes drug Ozempic and their anti-obesity drug Wegovy, was the most prescribed GLP-1 RA in 2023. It accounted for over 88% of new prescriptions (Yee Hui Yeo et al., Annals of Internal Medicine).

The reasons behind this shift are multifaceted. One factor is the FDA's approval of GLP-1 RAs for weight management indications, such as obesity and weight loss in combination with diet and exercise. For instance, semaglutide was approved for chronic weight management in 2021 (Food and Drug Administration).

Another factor is the high prevalence of obesity in the United States. According to the Centers for Disease Control and Prevention, approximately 42.4% of adults in the United States had obesity in 2017-2018 (Centers for Disease Control and Prevention).

However, this shift towards using GLP-1 RAs for obesity has implications. For instance, it may contribute to drug shortages due to the high demand for these medications. Additionally, it may exacerbate racial and ethnic disparities in access to these drugs since they are disproportionately prescribed to non-Hispanic white females with a BMI of equal to or greater than 30 kg/m² (Yee Hui Yeo et al., Annals of Internal Medicine).

In conclusion, the shift towards using GLP-1 RAs for obesity instead of type 2 diabetes has been significant in recent years. This trend is driven by FDA approvals and the high prevalence of obesity in the United States. However, it also raises concerns about potential drug shortages and disparities in access to these medications.


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Confidence

95%

Doubts
  • Are there any studies that suggest a decrease in the effectiveness of GLP-1 RAs for diabetes treatment as they are increasingly used for obesity?
  • Is there enough data to determine if this shift towards using GLP-1 RAs for obesity is sustainable or just a temporary trend?

Sources

95%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

How GLP-1 drugs are used

Axios News Site: https://www.axios.com/2024/01-30/prior-authorization-gap-insurer-drug-decisions Tina Reed Tuesday, 23 July 2024 09:50
  • Unique Points
    • A study in the Annals of Internal Medicine found that between 2011 and 2014, approximately 65% of new GLP-1 users had Type 2 diabetes. This figure dropped to 57% between 2019 and 2023.
    • Between the same time periods, the percentage of new GLP-1 users with a BMI of 30 or higher rose from nearly 47% to over 66%.
    • There was a twofold increase in use of GLP-1s by non-diabetics with either a BMI of 30 or higher or an obesity-related co-morbidity between 2011 and 2023.
    • The study identified one million new GLP-1 users, who were disproportionately non-Hispanic white, female and had a BMI of 30 or greater.
    • Semaglutide was the most prescribed GLP-1 drug in 2023. It is the active ingredient in Novo Nordisk’s diabetes drug Ozempic and their anti-obesity drug Wegovy.
  • Accuracy
    • Approximately 65% of new GLP-1 users had Type 2 diabetes between 2011 and 2014.
    • vs.
    • GLP-1 drugs use for obesity treatment took off quickly after approval in 2021. The greatest increase was recorded between 2019 and 2023 with over 600,00 new prescriptions due to expanded approval for chronic weight management.
    • The proportion of new users with type 2 diabetes decreased while those with obesity or related conditions without type 2 diabetes doubled since 2019.
    • More than half (59.5%) of first-time GLP-1 RA users had T2D and a greater proportion (61.3%) had hypertension.
  • Deception (100%)
    None Found At Time Of Publication
  • Fallacies (85%)
    The article contains a few informal fallacies and an example of inflammatory rhetoric. It also uses data from a specific study without fully understanding or explaining the implications of that data. The author makes an appeal to authority, but does not commit any formal logical fallacies.
    • . . . it's the latest evidence of how large numbers of Americans are embracing drugs developed for the treatment of diabetes for weight loss and raising cost and equity concerns.
    • Perelman School of Medicine at the University of Pennsylvania and Cedars-Sinai studied data from TriNetX, a health research network with records for 45 million individuals in the United States. . . The proportion of patients taking GLP-1s off-label, without an FDA-approved indication, also increased during the study period.
    • Semaglutide, the active ingredient in Novo Nordisk's diabetes drug Ozempic, and the company's anti-obesity drug Wegovy, were the most prescribed GLP-1s by far in 2023.
  • Bias (100%)
    None Found At Time Of Publication
  • Site Conflicts Of Interest (100%)
    None Found At Time Of Publication
  • Author Conflicts Of Interest (100%)
    None Found At Time Of Publication

87%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

Study Finds Big Shift in Who's Using GLP-1 Meds Like Ozempic

HealthDay Dennis Thompson Tuesday, 23 July 2024 20:43
  • Unique Points
    • Since 2011, about 1 million people have become new users of GLP-1 drugs in the US.
    • New prescriptions for GLP-1 drugs have doubled among people with obesity but not diabetes.
    • Semaglutide is being prescribed disproportionately to females, whites, and those with a BMI of 30 or more.
  • Accuracy
    • Approximately 1 million new GLP-1 users were identified between 2011 and 2023.
    • The demand for GLP-1RAs has led to a nationwide drug shortage and issues with accessibility.
  • Deception (50%)
    The article is deceptive in its omission of the fact that GLP-1 drugs have side effects and may not be suitable for everyone. It also implies that the increase in GLP-1 drug use for obesity is solely due to their effectiveness without considering potential financial incentives for healthcare providers and pharmaceutical companies.
    • The article fails to mention any potential side effects of GLP-1 drugs, such as nausea, vomiting, diarrhea, and kidney problems.
  • Fallacies (95%)
    The article contains some instances of inflammatory rhetoric and an appeal to authority, but no formal or dichotomous fallacies are present. The author uses the phrase 'boom' to describe the increase in GLP-1 drug use for obesity treatment, which could be seen as inflammatory. Additionally, the authors quote Dr. Ali Rezaie and Dr. Yee Hui Yeo as experts in their field and refer to their research findings as evidence of a trend towards using these drugs for obesity treatment instead of diabetes management.
    • ][The boom] in using GLP-1 drugs like Ozempic to treat obesity has resulted in a bust regarding the drugs' original purpose, which was to treat type 2 diabetes, a new study finds.[/](Inflammatory Rhetoric), [
  • Bias (100%)
    None Found At Time Of Publication
  • Site Conflicts Of Interest (100%)
    None Found At Time Of Publication
  • Author Conflicts Of Interest (100%)
    None Found At Time Of Publication

96%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

Study indicates surge in GLP-1RA prescriptions to treat obesity and prevent its complications

MedicalXpress Science X Tuesday, 23 July 2024 20:44
  • Unique Points
    • The demand for GLP-1RAs has led to a nationwide drug shortage and issues with accessibility.
    • Between 2011 and 2023, approximately 1 million new GLP-1RA users were identified.
  • Accuracy
    • Approximately 1 million new GLP-1RA users were identified between 2011 and 2023.
    • The proportion of new users with type 2 diabetes decreased while those with obesity or related conditions without type 2 diabetes doubled since 2020.
  • Deception (100%)
    None Found At Time Of Publication
  • Fallacies (95%)
    The article contains an appeal to authority fallacy when the authors quote Dr. Ali Rezaie and Dr. Yee Hui Yeo stating that 'this data suggests that more health care providers are seeing the benefits of these medications for treating obesity' and 'We hope our findings will inform health care policies and promote equitable access to these essential treatments.' This statement implies that their findings are definitive evidence of the benefits of GLP-1RAs for treating obesity, but it does not provide any evidence or data to support this claim beyond their own observations. However, no other fallacies were found.
    • 'This data suggests that more health care providers are seeing the benefits of these medications for treating obesity,'
    • 'We hope our findings will inform health care policies and promote equitable access to these essential treatments.'
  • Bias (100%)
    None Found At Time Of Publication
  • Site Conflicts Of Interest (100%)
    None Found At Time Of Publication
  • Author Conflicts Of Interest (100%)
    None Found At Time Of Publication

99%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

GLP-1 Prescribing Shifts From Type 2 Diabetes to Obesity

Medscape Miriam Tucker Tuesday, 23 July 2024 20:45
  • Unique Points
    • Since 2020, the use of GLP-1 RAs for obesity without diabetes has risen while their use for type 2 diabetes has declined.
    • There were a total of 871,854 new GLP-1 RA users during the study period.
    • In 2019, semaglutide and liraglutide accounted for over 66% of all new GLP-1 RA prescriptions. By 2023, semaglutide accounted for almost 90% of new prescriptions.
    • The rising trend of new GLP-1 RA prescriptions for obesity may contribute to drug shortages and exacerbate racial and ethnic disparities in access.
    • Recent FDA approvals will broaden the indications of GLP-1 RAs, affecting access.
  • Accuracy
    • Between 2011 and 2014, approximately 65% of new GLP-1 users had Type 2 diabetes. This figure dropped to 57% between 2019 and 2023.
    • The proportion of new GLP-1 users with a BMI of 30 or higher rose from nearly 47% to over 66%.
  • Deception (100%)
    None Found At Time Of Publication
  • Fallacies (100%)
    None Found At Time Of Publication
  • Bias (100%)
    None Found At Time Of Publication
  • Site Conflicts Of Interest (100%)
    None Found At Time Of Publication
  • Author Conflicts Of Interest (100%)
    None Found At Time Of Publication

94%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

Semaglutide Behind Huge Increase in GLP-RA Prescriptions with Fewer Written for Type 2 Diabetes

Patient Care Online Grace Halsey Tuesday, 23 July 2024 20:46
  • Unique Points
    • Between 2011 and 2023, there was a significant increase in new GLP-1 RA prescriptions with over 679,000 new prescriptions from 2019 to 2023.
    • Semaglutide accounted for over 88% of new GLP-1 RA prescriptions in 2023, an increase from 31.4% in 2019.
    • First-time GLP-1 RA users skewed disproportionately female, non-Hispanic White and had a BMI of equal to/greater than 30 kg/m2 with an average age of 54.6 years.
    • Overall annual prescribing of new GLP-1 RA rose from 0.5% in 2019 to more than 3% in 2023.
    • Approximately 1 in 5 (17.9%) had ischemic heart disease, and just fewer than 1 in 10 (9.3%) had cerebrovascular disease.
  • Accuracy
    • The greatest increase, more than 600,000, was recorded between 2019 and 2023 due to expanded approval for chronic weight management.
  • Deception (100%)
    None Found At Time Of Publication
  • Fallacies (85%)
    The article contains a few instances of inflammatory rhetoric and appeals to authority. It also uses data without providing the full context for the reader. However, it does not contain any formal logical fallacies or dichotomous depictions.
    • The findings, published in a Brief Research Report in the Annals of Internal Medicine, were reported by researchers from Cedars Sinai Medical Center in Los Angeles.
    • The surge during that time reflected the expanded approval of the medications by the US FDA in 2021 for chronic weight management, following original approvals for the class to reduce hyperglycemia in individuals with T2D.
    • Indeed, the surge in demand for GLP-1 RA medications has led to significant shortages, making it even more crucial to build data on trends in how and for whom they are being prescribed.
  • Bias (100%)
    None Found At Time Of Publication
  • Site Conflicts Of Interest (100%)
    None Found At Time Of Publication
  • Author Conflicts Of Interest (100%)
    None Found At Time Of Publication