Diabetes Care Community Learn, connect and care
Two new weight loss treatments for people with severe obesity were recently approved for use in the United States.
Saxenda (liraglutide)
In December 2014, the U.S. Food and Drug Administration approved a drug called Saxenda (its generic name is liraglutide) as a weight loss drug for people who are very obese. The same drug, liraglutide (Victoza®), is available in Canada in a lower dose and is used to treat type 2 diabetes. Saxenda is indicated for two groups of people:
- Those who have a body mass index (BMI) of 30 kg/m2 or greater. (To calculate your BMI, click here.
- Those who have a BMI of 27 kg/m2 or greater, and who also have another weight-related condition (for example, type 2 diabetes, high blood pressure levels, or high cholesterol levels).
Saxenda is intended for use in combination with a calorie-reduced diet and a physical activity regimen for chronic weight management. Rather than taken by mouth, the drug is injected once daily.
The SCALE Obesity and Prediabetes study examined almost 4,000 patients who were treated with either 3 mg of Saxenda once a day or placebo, in combination with diet and exercise. The study lasted 56 weeks, and at the end of the trial the participants who took Saxenda had a loss of 9.2% of their body original weight, compared with only a 3.5% reduction in the placebo group.
Saxenda is a member of a class of drugs called glucagon-like peptide-1 receptor agonists. These types of drugs stimulate insulin production while suppressing the liver’s glucose output.
According to the product monograph, people who begin taking Saxenda should be evaluated after 16 weeks to determine if the treatment is working. If a patient has not lost at least 4% their body weight at that time, then Saxenda should be discontinued.
Minor side effects associated with Saxenda include nausea, diarrhea, constipation and low blood sugar.
Maestro Rechargeable System
In January 2015, a treatment called the Maestro Rechargeable System was approved in the U.S. for weight loss. It is the first device approved for the treatment of obesity, and is indicated for people who have a BMI between 35 to 45 kg/m2, who also have one other obesity-related condition (for example, type 2 diabetes, high blood pressure levels, or high cholesterol levels).
The Maestro system consists of a rechargeable electrical pulse generator, two small leads (wires) and electrodes placed surgically into the abdomen. The system is implanted just under the skin, and is attached to nerves on the stomach.
It works by sending electrical pulses to the abdominal vagus nerve. The vagus nerve is the longest nerve in the body, and is one of the nerves between the brain and the stomach that controls hunger and feelings of fullness.
The Maestro system helps people feel less hungry, and may also help them reduce the amount of food eaten at meals. As well, people who use the Maestro system generally feel full longer, so they don’t have the urge to eat in between meals.
The Maestro system was studied in a clinical trial that included 233 patients with a BMI of 35 kg/m2 or greater; 157 of the study participants used the activated Maestro system; the other 76 patients received a Maestro system whose electrical pulse generator was not activated.
After 12 months, patients who used the activated Maestro system lost an average of 8.5% more weight than the other group. In fact, about one-half (52.5%) of the patients in the experimental group lost at least 20% of their original body weight.
Minor side effects associated with the Maestro system include heartburn, problems swallowing, belching, mild nausea and chest pain.
