A drug shows good results against obesity and can be taken orally.

An international trial has demonstrated the effectiveness of a new drug in reducing weight in cases of obesity. This drug also has the advantage of being administered orally, making treatment easier.

The results of this international phase 3 clinical trial, in which the Vall d'Hebron Hospital in Barcelona participated, have been published in The New England Journal of Medicine and presented at the Annual Congress of the European Association for the Study of Diabetes (EASD), held in Vienna.

The drug, orforglipron, acts on the GLP-1 receptor (which regulates appetite) and researchers have found it reduces body weight by an average of 11% , while also improving cardiovascular risk factors, according to Vall d'Hebron Hospital.

Orforglipron is expected to enter the regulatory process necessary for approval in the coming months, potentially opening a new era in obesity treatment.

Andreea Ciudin, coordinator of the Vall d'Hebron Comprehensive Obesity Treatment Unit and principal investigator of the Diabetes and Metabolism group at the Vall d'Hebron Research Institute (VHIR), explained to EFE that the key to addressing obesity is to accurately calculate the fat lost, not so much the weight itself.

"And this study showed that three-quarters of what is lost in the treatment is fat, while the rest is fat-free mass (muscle and other tissues)," he explained.

Specifically, the study followed 3,100 obese individuals without diabetes from nine different countries for 72 weeks , with body mass indexes greater than 30 kg/m2 and with some associated complication (such as hypertension, cardiovascular disease, or sleep apnea).

Participants were randomly assigned to different doses of orforglipron (6 mg, 12 mg, or 36 mg) or placebo, always in the form of one capsule daily, combined with recommendations for a healthy diet and physical activity.

The results show that treatment with the highest dose of orforglipron achieved an average reduction of 11.2% in body weight.

More than half of the patients lost at least 10% of their weight, and approximately 18% lost more than 20%.

In addition, significant improvements were recorded in blood pressure, waist circumference, triglyceride and cholesterol levels, all of which are risk factors for cardiovascular disease.

The advantages of the oral route

Like other already approved obesity drugs, orforglipron acts on the GLP-1 receptor, present in various cells involved in regulating appetite and metabolism in the brain and digestive tract, but with the advantage that it can be taken orally.

Most of the products that act on GLP-1 and are already on the market are injectable , because they contain a peptide molecule (a protein) that, if taken orally and reaches the stomach, breaks down and loses its effectiveness.

There is a peptide medication that can be taken orally, semaglutide, because it encapsulates the molecule within a special pill so it doesn't break down. However, this requires a series of requirements when administering it, such as always taking it on an empty stomach or waiting half an hour before eating.

Orforglipron, on the other hand, has a different chemical structure, as it is not a peptide molecule, so it does not lose its effectiveness in the stomach.

"It's a drug that has the same effect as existing ones, because it stimulates the GLP1 receptor, but it's not a peptide, it's not a protein, so it can be administered orally without the need for special measures," explained Ciudin, the sole European author of the publication.

GLP-1, the most sought-after target

The GLP-1 hormone has been the focus of research in recent years in the field of obesity and diabetes, as the benefits of controlling its function through drugs that mimic its function (known as GLP-1 analogues) have been demonstrated.

GLP-1 is one of the peptide hormones that appear when food touches the intestinal mucosa ; among other functions, it induces satiety and acts on various organs of the digestive system to ensure proper metabolism.

While GLP-1 analogues are showing very good results in weight loss, the Vall d'Hebron researcher emphasized that medication alone is not enough to treat obesity; it must be complemented with lifestyle guidelines or, in some cases, psychological support.

In this regard, he emphasized that obesity is not a temporary condition, but rather a chronic disease caused by an alteration in biological mechanisms that requires lifelong treatment, supervised by a specialist.

"Short treatment sessions just for bikini surgery or to fit a cousin's wedding dress is bad practice," he warned.