With the growing popularity of new weight loss drugs, doctors are stressing the potential risks

When researchers discovered that a class of drugs initially used to treat type 2 diabetes could also cause weight loss, the drugs Victoza and Ozempic gained popularity as a treatment option for obesity.

Given as daily or weekly injections, these drugs, called GLP-1 RAs, help people make insulin and lower the amount of sugar in the blood. First approved for use in type 2 diabetes patients in 2005 by the U.S. Food and Drug Administration, the drugs were soon noticed to promote weight loss.

The FDA later approved a GLP-1 RA for chronic weight management in 2014. Additional in-class medications have since been approved for weight loss.

According to the Journal of the American Medical Association, it is estimated that more than one in 10 Americans of the nearly 35 million Americans with type 2 diabetes used these drugs in 2019.

“I prescribe these drugs 10 times a day,” Dr. Amanda Velazquez, director of obesity medicine at Cedars-Sinai Medical Center, told ABC News.

“Obesity is a chronic relapsing disease,” Velazquez added, saying the weight-loss effects of the drugs disappear after discontinuation of the drug.

PHOTO: The diabetes drug Ozempic in a pharmacy in the Netherlands, on Nov. 10.  2022.

The diabetes drug Ozempic in a pharmacy in the Netherlands, on Nov. 2022.

Dutch Height/Shutterstock

Novo Nordisk, the pharmaceutical company that makes Ozempic, Victoza and another drug called Wegovy – which is specifically for weight loss – said last December: “While we recognize that some healthcare providers are prescribing Ozempic to patients whose goal is to lose weight, It is up to the clinical discretion of each healthcare provider to choose the best treatment method for their patients.”

In the fall there were occasional shortages of different doses of Ozempic and Wegovy.

“There is generally high demand, increased awareness of the drugs for their efficacy and supply chain gaps in making the drug from manufacturers,” Velazquez said.

Off-label use of the drugs may contribute to this deficiency.

“It’s very frustrating for everyone,” Dr. Heather Sateia, an assistant professor of medicine at Johns Hopkins Hospital, told ABC News. “Pharmacies are so understaffed that they don’t let people know when it’s back in stock, so it’s like a scavenger hunt — time-consuming and terrifying for patients.”

A recent study from the University of Montpellier, published in Diabetes Care, looked at type 2 diabetes patients treated with GLP-1 RAs from 2006-2018 and identified an association between the long-term use of these drugs and a greater likelihood of thyroid disease. cancer. Specifically, the study found that people who took the drugs for one to three years were 58% more likely to develop thyroid cancer. Medullary thyroid cancer, a rare form of the disease, carried an even higher risk, according to the study.

“The newer findings provide interesting additional data for this clinical discussion, but are not independent enough to establish a new standard for screening,” Dr. Erik K. Alexander, chief of the Thyroid Division of the Department of Endocrinology, Diabetes and Hypertension at Brigham and Women’s Hospital, told ABC News. “[These drugs] should only be used if the benefit of treatment outweighs the known or suspected risk, and this assessment should be regularly reconsidered by each patient with their physician.

45,000 Americans are diagnosed with thyroid cancer, but according to the American Cancer Society, this is by no means a death sentence. With surgery and therapy, the 5-year survival rate is 98%, but this largely depends on the type of thyroid cancer and the stage of the disease. According to the American Cancer Society, medullary thyroid cancer has a relatively poor prognosis compared to the other types.

In a statement, Novo Nordisk says extensive data from randomized trials, long-term studies, and real-world evidence “have not shown a causal relationship between GLP-1 receptor agonist use and risk of thyroid tumors.”

The company “remains confident in the benefit-risk profile of its products and remains committed to ensuring patient safety,” the statement said.

The drugs can sometimes cause nausea, pain at the injection site, and inflammation of the pancreas. Some patients taking concomitant diabetes medications may also experience low blood sugar.

Patients are currently monitored every 3-4 months with liver, diabetes, kidney, cholesterol and electrolyte tests. Thyroid tests are not currently recommended.

“The thyroid cancer data definitely gives me pause,” Sateia said. “There is currently no recommendation for thyroid ultrasound or serum calcitonin monitoring, but we’re monitoring changes in those recommendations. I suspect we’ll see a shift in this soon.”

“This probably wouldn’t change the way people prescribe, but it’s something to be aware of,” Dr. Yufei Chen, assistant professor of general surgery at Cedars-Sinai Medical Center, told ABC News.

Natalie S. Rosen, MD, is a physician in hematology & Oncology Department at New York-Presbyterian Columbia and a former member of the ABC News Medical Unit.

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