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Dismissed drugs
GLP-1 drugs were thought to be an offshoot of diabetes drugs and expected to be very niche products. Early on, people dismissed them as vanity programs. The safety profile looks excellent, many more drugs are in development, and costs are expected to keep coming down.
Willpower or biology
A Wall Street Journal article by Betsy McKay described how for years the assumption was that people with obesity just lacked willpower. The thinking now is that it is in our genes and biologic for most everybody, so a medicine that helps is about improved health and not only about looking good and feeling better about oneself.
Effects on society
Those medicines could transform a society in which obesity leads to diabetes, metabolic disorders, and cardiovascular disorders, and also affects self-image and mental health.
How much of body weight is genetic?
Twin studies have put the heritability of body mass index somewhere between 40 and 70 percent, a range reported in a 2012 review in Frontiers in Endocrinology. In 2007, researchers reported that common variants in the FTO gene were linked to obesity, the first such variants found through genome-wide scans. Since then, scans of hundreds of thousands of people have found many more genes involved, most with small effects.
How do GLP-1 drugs reduce appetite?
GLP-1 is a gut hormone released after eating. It acts on areas of the brain that regulate appetite, slows the emptying of the stomach, and boosts insulin release when blood sugar is high. The first GLP-1 drug, exenatide, was based on a compound from Gila monster saliva and was approved in 2005 for type 2 diabetes.
Why did leptin change views of obesity?
In 1994, Jeffrey Friedman's lab at Rockefeller University identified the gene for leptin, a hormone made by fat tissue. Mice lacking it grew severely obese. In 1997, Stephen O'Rahilly's group in Cambridge reported children with leptin gene mutations who were severely obese from early life. The American Medical Association recognized obesity as a disease in 2013.