Merging into a New Reality

Diabetes Drugs Moving into Obesity

A decided shift has happened in the interaction between the development of therapies for diabetes and therapies for obesity. Ten years ago, diabetes drugs that actually caused weight gain — like Avandia and Actos — were ascending blockbusters while treatments for obesity were falling flat. Drug development for obesity was drying up.

Today, the situation could hardly be more different. Avandia and Actos were pulled from the European market in 2010 and 2011. They are hardly used anymore in the U.S. market and elsewhere in the world. Metformin, which has been around for more than 50 years, remains the first line of treatment for type 2 diabetes. Coincidentally, it does not cause weight gain. Two newer classes of drugs, GLP-1 agonists and SGLT2 inhibitors, can actually lead to weight loss and their use is growing robustly.

And now these newer diabetes drugs are moving into the obesity space. The leading GLP-1 agonist, liraglutide, is on the verge of being approved by FDA for the treatment of obesity. An expert advisory committee recommended its approval in September. The dose for obesity is higher than it is for diabetes and it will be marketed under a separate brand name (Saxenda).

Both of the two new SGLT2 inhibitors are being marketed on TV with zippy ads that conspicuously say “although it’s not a weight loss drug, it may help you lose weight.” The ad for Farxiga (above) is so absurdly happy that you might think type 2 diabetes is a riotous, joyful picnic. (It’s not.)

One of the SLGT2 inhibitors, canagliflozin, is presently being studied in combination with phentermine for obesity treatment. Results of this initial study are expected in mid 2015.

So treatment of obesity is becoming ever more tightly linked with type 2 diabetes. Maybe better treatment of diabetes will help with obesity. Maybe better treatment of obesity will help with diabetes.

Let’s see who wins.

Click here to read more from Seeking Alpha and here for more on the study of canagliflozin for obesity from

Merging into a New Reality, photograph by Iezalel Williams / flickr

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December 10, 2014