Making a difference - drug targeting gut hormones could turn tide on obesity

 

Obesity and its effect on health is a global crisis, but to date there have been no safe, effective weight loss drugs. UCL’s Professor Rachel Batterham has led two decades of research to develop a breakthrough gut hormone-based drug called semaglutide that reduces food intake. Semaglutide is licensed for use in the US and UK and is being reviewed by EU regulators.

World obesity has nearly tripled since 1975: in 2016 there were around 650 million people with obesity. Obesity is linked with increased risk of type 2 diabetes, heart diseases, strokes, liver disease, cancer and earlier death. Lifestyle interventions and drugs currently do not help people with severe obesity to lose enough weight to improve their health. For these patients, the only effective treatment is bariatric surgery that alters how food passes through the digestive system, but this is difficult to access and not suitable for all.

Professor Batterham is the NIHR BRC Obesity Theme lead. The gut hormone-based drugs she has developed have filled this ‘treatment gap’ between lifestyle changes and surgery, revolutionising obesity management. In a series of landmark

studies1,2 she identified that gut hormones act directly on the parts of the brain that control eating and play a critical role in regulating body weight. Her work also revealed that people with obesity have gut hormone abnormalities that predispose them to weight gain: treating them with gut hormones reduces their appetite and food intake.

Batterham helped lead the global final phase clinical trials to test the weight loss effectiveness of a gut hormone mimic, semaglutide, alongside lifestyle interventions. On average, semaglutide-treated people lost 15% of their weight compared to 2% in the placebo group, their blood test scores used to track risk of heart disease and stroke improved, and their quality of life was better 3. This led to semaglutide being described as a ‘game-changer for obesity’ by the Obesity Action Coalition, a 70,000- strong US patient group.

Semaglutide was licensed as a treatment for obesity in the UK and US in 2021 and is being reviewed by the European Medicines Agency (EMA) for use in the EU. Several other gut hormone-based drugs and combination therapies are in development at UCLH BRC, promising new and effective treatments for obesity.

  1. Batterham RL Nature 2002; 2. Batterham RL Nature 2007; 3. Wilding J NEJM 2021