Is Victoza Auditioning to Be the New Thing in Weight Loss?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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“Everyone in Canada is talking about Victoza for weight loss” was what I heard from a visitor last week. It’s true, the potential is there to use this new class of diabetes medications for weight loss, given that in studies folks lose weight and their appetite diminishes. So, what’s the scoop on Victoza?

Get to know GLP-1. You will hear more from this class of medications. Victoza (liraglutide) is a long-acting GLP-1 analog available for use in the United States for the treatment of type 2 diabetes. Byetta is a similar drug also available. Victoza is given daily as a shot under the skin. In diabetes trials, Victoza was associated with a significant reduction in weight (5 to 7 pounds) when compared with placebo. The role of GLP-1 as a weight loss agent in folks without diabetes is under investigation.

It gets better. Weight loss has also been reported in patients without diabetes who received Victoza (liraglutide). As an example, in a 20-week randomized trial comparing Victoza to Xenical (orlistat) the average weight loss was 10 to 15 lbs!

How does it work? GLP-1 is produced from cells of the small intestine and is secreted in response to nutrients (so when you eat, GLP-1 is secreted). GLP-1 levels are decreased in type 2 diabetes. GLP-1 exerts its main effect by stimulating insulin release from the pancreas but it also slows gastric emptying and reduces food intake. The other cool thing being investigated is that Victoza may hold promise for halting the progression of beta cell failure that often occurs in type 2 diabetes.

The downsides. With a higher dose of Victoza there’s more weight loss, but also more nausea (wonder if that’s why folks lose weight). The weight loss may be due, in part, to gastrointestinal side effects. As with most weight loss medications, people gained most of their weight back when they stopped the Victoza. Hmmm, worth it?

Dr O.

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