People who take weight loss medication should be regularly assessed by their doctor, experts have said following another study into the risk associated with the drugs.
The popularity of new weight loss drugs has led medics and researchers in America to say that care should be taken when prescribing them, and that they “should only be used when the benefit of treatment outweighs known or suspected risk”.
Drugs that were first used to treat type 2 diabetes, GLP-1 RAs, were also found to promote weight loss, leading to the drugs Victoza and Ozempic becoming a popular choice in the treatment of obesity.
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Almost 25 million Americans have type 2 diabetes and it was estimated in 2019 that more than one in 10 were taking these drugs.
A link between the long-term use of the drugs and a greater risk of thyroid cancer was identified in a recent study from the University of Montpellier, which looked at people with type 2 diabetes who used GLP-1 RAs from 2006 to 2018.
A key finding was that those who took them for one to three years were 58% more likely to develop thyroid cancer. A rare form of the cancer, medullary thyroid cancer, carried an even higher risk.
Dr Erik K. Alexander, Chief of the Thyroid Section in the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women’s Hospital, said: “The newer findings provide interesting additional data to this clinical discussion, though are not independently enough to set a new standard for screening.
“[These drugs] should only be used when the benefit of treatment outweighs known or suspected risk, and this assessment should be continually reconsidered by each patient with their physician on a regular basis.”
The growing popularity of the drugs has led to supply and demand issues.
Dr. Amanda Velazquez, Director of Obesity Medicine at Cedars-Sinai Medical Center, said: “I prescribe these medications 10 times per day.
“There is high demand overall, more awareness of the medications because of their efficacy, and shortages in the supply chain with making the drug from manufacturers.”
Dr Heather Sateia, Assistant Professor of Medicine at Johns Hopkins Hospital, said: “It is very frustrating for everyone.
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“Pharmacies are so short-staffed that they won’t let people know when it is back in stock so it is like a scavenger hunt- time-consuming and anxiety-provoking for patients.”
Dr Velazquez added that “obesity is a chronic relapsing disease” and that the medication’s weight loss effect wears off once someone stops taking the drug.
Pharmaceutical company Novo Nordisk, which makes Ozempic, Victoza and another drug called Wegovy, said: “While we recognise that some healthcare providers may be prescribing Ozempic for patients whose goal is to lose weight, it is up to the clinical discretion of each healthcare provider to choose the best treatment approach for their patients.”
The company also said that data from trials and studies “have not shown a causal relationship between use of GLP-1 receptor agonists and risk of thyroid tumours”, and that the company “remains confident in the benefit risk profile of its products and remains committed to ensuring patient safety”.
Dr Sateia said: “The data on thyroid cancer certainly gives me pause. There is not currently a recommendation for thyroid ultrasound or serum calcitonin monitoring, but we are keeping an eye out for changes in those recommendations. I suspect we’ll see a shift in this soon.”
