Weight loss drugs: Everyone wants them, but are they even safe?

Over the past few years, everyone has been talking about weight loss drugs. Although these injections aren't for everyone, it seems every other person who thinks about dieting also wants an easier solution and ends up switching over to these treatments.

It's been repeatedly discussed why these injections aren't exactly a panacea and why they aren't suitable for everyone. However, a recent study has found they might have a surprising and disturbing side effect.

The study in question, published in the peer-reviewed academic journal Diabetes Care, discovered a link between the long-term use of these treatments and one's risk of developing thyroid cancer. The study notes that people who used the drugs for one to three years were 58% more likely to develop thyroid cancer.

Thyroid cancers are considered relatively mild. It develops very slowly and sometimes doesn't cause any symptoms at all and only gets diagnosed randomly as part of neck imaging tests.

Common symptoms are hoarseness for no apparent reason that doesn't go away after a few weeks, as well as difficulty breathing or swallowing.

Is this a reason to stop using weight loss drugs?

The current weight loss drugs on the market are sold as a treatment for obesity and have been used for years to treat diabetes. Researchers at the University of Montpellier in Vermont examined type 2 diabetes patients who were treated with these drugs between 2006-2018. 

They found that yes, there was indeed a higher likelihood of developing thyroid cancer.

However, this is just one study. What's most likely ot happen is that it will add an additional routine test for people who take these drugs need to undergo.

Currently, weight loss drug treatment patients need to get their liver, diabetes levels, kidneys, cholesterol and electrolytes examined every three-four months. Currently, though, that doesn't include testing the thyroid.

Regardless, experts cautioned that these drugs should only be used when the benefits outweigh the risk, and even then the patient should see their doctor regularly.

However, it should also be noted that aside from a higher likelihood of developing thyroid cancer, these drugs have other side effects.

The most common ones that nearly all patients get are nausea, abdominal pain, diarrhea or constipation. However, these are mild and may even improve or disappear over time. Not only that, but they are dependent on the dosage, so the slower and more gradually your dosage increases, the less likely these will become severe.

There are other rare side effects that aren't dose-dependent, though. These include pancreatitis, which is an acute inflammation of the pancreas, and gallstone complications like cholecystitis, which is an acute inflammation of the gallbladder.

How do these weight loss injections work?

In Israel, there are two types of these drugs that are available for use. The first and older one is called Liraglutide, also known as Victoza or Saxenda. The second and newer one is called Semaglutide, also known as Ozempic.

These injections contain a synthetic hormone similar to a hormone our digestive system secretes after meals. This hormone, called GLP-1, links to specific receptors in the digestive system and brain, and has several effects.

Regarding the brain, it causes a decrease in appetite and a mental fixation on food. In the digestive system, it manages to stop the stomach from emptying as fast, which means the food stays in longer and you stay more satisfied from your food. 

It also impacts the pancreas, which is responsible for secreting insulin for increased sugar levels, and the liver, which helps balance blood sugar levels.

Who should get weight loss injections?

Dr. Relly Reicher, a senior physician at the obesity and endoscopic bariatric unit at Sourasky Medical Center (Ichilov) in Tel Aviv, told Walla that medical treatment for obesity, including these drugs, can be prescribed to patients with a BMI of over 30 or over 27 if there are other obesity-related comorbidities.

"This isn't a technical matter. These have been the criteria to be included in clinical studies on obesity drug treatments for years," he said. "As part of these studies, thousands of patients were treated and monitored, which taught us about the drugs' effectiveness as well as the possible side effects and complications. There's no reliable and controlled information about the effect these drugs have on people with normal body weight and without underlying obesity-related conditions. Like any drug treatment, when the patient has no need for it, they are only left with the potential risks and side effects without any benefits."