Aiming to do the same, an injection named Victoza was launched in India a few years ago. The weight loss potential of injection Victoza, which was originally used for the management of Diabetes mellitus, was recognized early in the course of drug usage. Subsequently US FDA accepted it as a weight loss therapy in non-diabetics too. And people wanting to lose weight obviously got lured - after all who wouldn't want to opt for an anti-obesity injection over spending hours at the gym. But it isn't as simple as it sounds. Dr Ashish Ahuja, Senior Consultant Laproscopic Bariatric Surgeon and Associate Professor in Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, warns, "Victoza is primarily an anti-diabetes injection and is not meant to treat obesity. It may cause weight loss but poses high risk of thyroid and pancreatic cancer. Moreover, Victoza-led weight loss is temporary, unlike weight loss surgeries that keep away lost weight for a longer time. Also, if the injection is self administered, it can even lead to hypo or hyperglycemia."
Diabetes and obesity, though considered to be two different diseases, are closely linked with each other. Dr Sanjay Kalra, Consultant Endocrinologist, Bharti Hospital Karnal & Vice President, South Asian Federation of Endocrine Societies elaborates, "Both diabetes and obesity share so many causes, clinical features and complications that the term 'diabesity' is often used to describe them in combination. Liraglutide is an effective medication, which is used to manage both diabetes and obesity. A once daily injection, it is used in differing doses (up to 1.8 mg daily for diabetes, and 3.0 mg for obesity)."
A large multinational trial, the LEADER trial, conducted in over 10000 participants, demonstrated not only safety, but benefits of liraglutide or victoza. "This drug reduces the risk of death, the risk of death due to cardiovascular cause, and the risk of worsening of kidney disease. This represents a major advance in diabetes care, as we can prevent progression of diabetes and postpone its complications with liraglutide," Dr Kalra adds.
So how exactly does Victoza function? Dr Ambrish Mithal, Chairman-Endocrinology & Diabetes, Medanta elaborates, "The dose of this daily injection recommended for weight loss is 1.5 to 2 times higher than what is used for diabetes. It functions by controlling our intake. The dose alerts our brain centers to reduce appetite, simultaneously slowing down emptying of our stomach to produce a sensation of fullness."
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Having said that, it doesn't work for everyone. Dr Manoj Chadha, Consultant Endocrinologist, P D Hinduja Hospital & MRC, Mumbai says, "Patients may lose between 5-10 per cent of their body weight within 3-4 months. However, a small but significant proportion of patients are categorized as non-responders as these patients do not lose weight." Dr. S.K. Wangnoo, Endocrinologist, Indraprastha Apollo Hospitals adds, "The possible side effects of Victoza are pancreatitis and thyroid tumors, both of which can be fatal. The Institute for Safe Medication Practices (ISMP) reported that the FDA's clinical safety reviewer originally voted against approving the drug because of its link to thyroid tumors, insufficient study to rule out increased heart attack and stroke risk, as well as an increased risk for pancreatitis. FDA published a warning that doctors weren't fully aware of thyroid risks associated with Victoza. That notice also mentioned that clinical trials suggested an increased risk of pancreatitis in Victoza patients."
Comparing it to weight loss surgeries, Dr Chadha adds, "Bariatric surgery works through multiple mechanisms to reduce weight. Patients end up losing up to 30-40 per cent of their original body weight. However, the earliest weight loss noticed in patients after surgery is through an increase in a hormone called GLP1. Injection Victoza stays in blood circulation for nearly 24 hours. The weight loss following Victoza is a modest 5-10 per cent. However, it could be used pre-operatively to prepare the patient for surgery and judge the possible response of the patient to surgery."
Dr Anup Dhir, MD cosmetic surgery A +Mediart warns against the ill effects of the injection, "I would any day recommend bariatric weight loss over Victoza injection as these injections are mainly meant for Type -2 diabetics. It can cause cancer, thyroid and pancreatic diseases and are also second line medicine. On the other hand, bariatric surgeries aid weight loss by restricting the amount of food the stomach can hold."
With a huge number of people struggling to shed weight, a fat-fighting injection surely seems irresistible. But remember the popular adage - 'all that glitters is not gold'. While more studies will be conducted over a period of time to prove its efficacy and safety, it's always advisable to try the natural way - Eat well and burn calories.
Pharm.D @ SRIPMS-CBE-TN