GLP-1 Pills Are On The Way. Here's What To Know

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What are GLP-1 drugs and why are they popular?

Emily Kwong 0:00
You're listening to Shortwave from NPR. Hey, Shortwavers. I am here with NPR Pharmaceuticals correspondent Sydney Lupkin today to talk about something that has really changed the game when it comes to weight loss, which is injections. When did this all start?
Sydney Lupkin 0:18
I mean, it all started with celebrity weight loss.
Emily Kwong 0:21
One hot topic everyone in Hollywood still seems to be talking about is Ozempic.
Sydney Lupkin 0:25
You're on Ozempic or one of those things.
Emily Kwong 0:28
Or Wegovy or whatever.
Sydney Lupkin 0:29
Yeah, or you got work done. Like, just stop. Then it wasn't a secret anymore.
Emily Kwong 0:34
Yeah, I remember even Serena Williams came forward as like a spokesperson for the telehealth company Rose GLP-1 injections.
Unknown 0:43
I knew my body was missing something it needed. For me, the answer was GLP-1s.
Sydney Lupkin 0:50
Now, these weight loss injections, called GLP-1s, are kind of everywhere.

How do GLP-1 injections work for weight loss?

Sydney Lupkin 0:56
Examples include Ozempic, which is kind of the Kleenex of GLP-1 drugs, but is actually officially for type 2 diabetes, and Wegovi. These are drugs you inject under the skin once a week. And these injectable drugs have become a valuable tool for millions of people trying to get to a healthier weight. We're talking people who've never been able to lose weight and keep it off finally finding something that works for them.
Emily Kwong 1:23
These are clearly life-changing medications and also drugs. It seems a big commitment. I mean, not everyone is going to want to inject something weekly for weight loss.
Sydney Lupkin 1:31
For sure. And, you know, they're not for everyone or for every wallet. Injectables do have a sticker price of over $1,000 a month. And insurance coverage has been tricky to navigate for a lot of people. So there is a lot of excitement around a new pill form of the drug. We're going to talk about two types of these pills. The first is a Wagobe pill that's expected to win FDA approval by the end of the year. And then there's another kind of obesity pill that could be right behind it.

What challenges do patients face with GLP-1 injections?

Emily Kwong 2:02
Today on the show, a new era of weight loss medications. We talk about the science behind the experimental pills.
Sydney Lupkin 2:08
And what FDA approval would mean for affordability and access.
Emily Kwong 2:12
You're listening to Shortwave, the science podcast from NPR.
Emily Kwong 2:26
Okay, Sydney, I want to talk about GLP-1s. Am I saying that right?
Sydney Lupkin 2:31
GLP-1s.
Emily Kwong 2:32
GLP-1s. How do they work?
Sydney Lupkin 2:34
So, yeah, I talked about this with Andrea Trena. Her background is in clinical pharmacy, and now she's an obesity director at Novo Nordisk. That's the company that makes Ozempic and Wegovy. And Emily, at my request, she went full frizzle during our interview.
Emily Kwong 2:51
So, like… The magic school bus, Ms. Frizzle. That is correct. Our generation's science teacher.
Sydney Lupkin 2:56
100%. Here is her primer on GLP-1s. And GLP-1, by the way, is a hormone your body naturally makes. It stands for glucagon-like peptide 1.
Andrea Trena 3:07
As soon as you ingest food, your body is going to start secreting GLP-1 because it immediately triggers that, oh, you've ingested some food. And so it's going to tell your brain you're eating. And so it's going to make sure it triggers that effect so that you start to feel full. but it's a very short acting and only lasts a couple of minutes.
Emily Kwong 3:26
Oh, okay. So in our bodies, the GLP-1 hormone does a good job of making you feel satisfied, but only for a short time. How does GLP-1 medication work differently?
Sydney Lupkin 3:37
It lasts much longer.

What is the significance of the new GLP-1 pill form?

Sydney Lupkin 3:39
When Novo Nordisk made its medication version of GLP-1, the company tweaked it. The active ingredient in both blockbuster drugs, Ozempic and Magovi, is called semaglutide. Andrea explained how they made it.
Andrea Trena 3:51
We took out a couple of amino acids and exchanged them for other ones so that the molecule can't immediately be degraded by the enzyme that our body naturally makes to break it down. And then the second thing we did is we added a big fatty acid chain to the end of it so that it binds to protein and hangs out in the body for longer. So semaglutide actually has a half-life of a week instead of just two minutes.
Emily Kwong 4:18
Oh, OK. So this is why the retooling of the GLP-1 hormone is why Ozempic and similar injectables are taken weekly, because the chemical at the core of it all, smaglutide, has a half-life of a week.

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