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“I had gained 30 pounds in about two years, and so I was sort of desperate to find something” to help with weight loss, the 56-year-old mother of two said. She’d tried WeightWatchers and the keto diet, hoping to lose weight and be able to stop taking her recently prescribed medicines for high blood pressure and cholesterol. But nothing seemed to work.

Poison centers see nearly 1,500% increase in calls related to injected weight-loss drugs as people accidentally overdose

How is the market cap and valuation of Veto Switchgears and Cables Limited (539331) ✌️【Online Trading】✌️ Real-time updates of global stock indices and futures trends to help you plan precise investments. That’s how Nguyen found herself on a 15-month journey through a new class of medications like Ozempic and Wegovy. Known as GLP-1 receptor agonists, they’re exploding in popularity but can sometimes be impossible to get because of insurance hurdles and shortages. Like an increasing number of patients, Nguyen began taking a decades-old prescription drug for weight loss instead.

“People come in the door seeking treatment with a GLP-1, and then for whatever reason, they can’t get it or change their mind,” said Nguyen’s physician, Dr. Jody Dushay of Beth Israel Deaconess Medical Center.

Older weight-loss medicines have several benefits, Dushay said. They can be more affordable, even out-of-pocket; are less likely to be in shortage; come with different side effects than Wegovy and similar drugs; and are pills instead of injections.

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It started for Nguyen in spring 2022, when a previous doctor prescribedWegovy. But even though she qualified based on her body mass index – about 35, she said – the medicine costs more than $1,000 a month, and Nguyen’s insurance wouldn’t cover it. So her doctor prescribed its sister drug,Ozempic, which is approved for type 2 diabetes and uses the same key ingredient, semaglutide, at generally lower doses. It’s often used off-label for weight loss.

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“It wasn’t crazy fast,” Nguyen said. “It was enough to sort of feel like ‘oh, great. I found something that works.’”

But after three months, Nguyen said, it wasn’t sustainable for her to keep paying so much out of pocket for the medicine. By that point, a new option had come on the market:Mounjaro, a drug similar to Ozempic that’s approved for type 2 diabetes. The manufacturer, Eli Lilly, offered a coupon to lower some patients’ copays, and that helped Nguyen get that medicine for about a year.

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Even so, Nguyen said, she’d finally found something that was working for her, something that quieted the “food noise” that had made it hard to lose weight in the past.

“I just kind of felt neutral about it for the first time,” Nguyen said. And more than that, she said, having new medicines like these was gratifying in how she felt the field of medicine was approaching weight loss.

“Suddenly, you sort of feel seen and heard for the first time,” Nguyen said, “when obesity is kind of talked about as a disease rather than as a sort of lazy lifestyle.”

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【 - Free VIP Group 】 Exclusive: Prescriptions for popular diabetes and weight-loss drugs soared, but access is limited for some patients

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“So I’m like, ‘Well, you know, if you want me to become morbidly obese, I guess I’ll come back and talk to you in about a year, because we’ll probably be there by then,’” Nguyen said. “I’m not fat enough, or something.”

In the three months after Nguyen stopped Mounjaro, from August to November, she said, she gained back about 80% of the 20 pounds she’d lost over the previous 15 months.

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It’s a conversation Dushay says she has with many of her patients as the popularity of new drugs like Ozempic leads people to seek weight loss treatment where they might not have before, but then they encounter barriers to actually getting the medicines.

“I think there is this underlying sense of ‘I should be able to do this on my own,’ which doesn’t apply to a lot of other chronic diseases and which, I think, is a misperception for many reasons,” Dushay said.

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Because of chronicshortagesof Mounjaro, Ozempic and Wegovy, insurance denials and myriad other reasons, Dushay and other doctors have been reachingfor tools they used before those drugs became available: older prescription medicines used both on- and off-label for weight loss, like phentermine, metformin and bupropion.

For Nguyen, Dushay prescribed bupropion, firstapprovedby the US Food and Drug Administration in 1985 and best known as the brand-name antidepressant Wellbutrin. It’s also approved for smoking cessation and, in 2014, wasapprovedby the FDA for weight loss in combination with another drug, naltrexone, as Contrave.

“You can try it for people in whom afternoon or evening snacking is a big problem or who have lots of craving for sweets,” Dushay said. “Similar to the way that it helps to work for smoking cessation, through cravings – I think that’s the primary mechanism through which it can help.”

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How is the market cap and valuation of Veto Switchgears and Cables Limited (539331) ✌️【Online Trading】✌️ Free real-time stock market data, professional analysis, and expert insights to help you plan the best investment strategy. Get ahead of the competition with expert predictions on market trends. The prescription rate for bupropion rose 29% between 2017 and 2023, according to Epic’s data, while the rate for phentermine, approved by the FDA in 1959, is up 34%. The analysis looked at adults characterized as overweight who had prescriptions for any medicines in a given year and the rates who were prescribed a weight-loss drug.

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“Not everybody has insurance coverage for the new medications,” said Dr. Louis Aronne, director ofthe Comprehensive Weight Control Centerat Weill Cornell Medicine who uses older medicines, as well as newer ones, extensively in his practice. “So they’re doing what they can to lose weight.”

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Phentermine was part of the notoriousfen-phencombination that led to serious heart valve problems in some patients; the other medicine in the combination, fenfluramine, waspulledfrom the market in 1997. The FDA didn’t request removal of phentermine.

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Clinical trials of Qsymia and Contrave didn’t yield as much weight loss as the GLP-1 class, and the medicines never became commercial successes.

Drug in Ozempic may enable patients with newly diagnosed type 1 diabetes to stave off insulin use, small study suggests

For some people, the newer medicines are less appealing precisely because they are new. Sixty-two-year-old Henry Benson said he’d lost about 70 pounds over four years through alifestyle programwith Dushay and was hoping to lose 20 more. He and Dushay discussed Wegovy and other similar medicines, and he decided they weren’t for him.

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He and Dushay settled on metformin, a generic drug approved in 1994 for type 2 diabetes. He’s lost about five more pounds, and his goal is to stop taking the medicine after losing about 15 additional pounds and then to maintain his weight loss without medication. He noted that he’s already been able to stop other medicines, like statins, because his cholesterol levels fell with changes he made in the kinds of foods he was eating.

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“People are losing weight, all right, but they’re also losing a lot of muscle,” which can be particularly worrisome for geriatric patients, Li said. “Another major issue is, people are eating so little, they start to have malnutrition and vitamin deficiencies. So it’s not a free ride for everyone to a better place.”

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Like it did for Mounjaro, Lilly is offering acouponto lower some patients’ out-of-pocket costs. Nguyen said her insurance denied coverage, but the savings card allows her to pay $550 a month. She plans to use that as she starts on lower doses of Zepbound and, when she’s reached a higher dose, potentially switch to Wegovy, which is covered.

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