Not only do they cost a lot, but anti -obesity drugs based on traffic lights and tirzepatids have side effects ranging from nausea to intestinal occlusions, up to the “block” of the stomach. For this reason they must use those who really are overweight
They put the wallet to the test, of course, but to the body they cost even more: side effects such as nausea, vomiting, pancreatitis and even intestinal occlusions or “block” of the stomach. We are talking about the super-backmakers based on traffic lights and tirzepatide, the famous medicines that allow you to lose up to 20 percent of your body weight in one year or a little more. A study published in Annals of Internal Medicine has verified that in the years between 2022 and 2023 almost 25,000 patients have gone to the American emergency room following these products.
At the same time, a report released on Jama notes that those who assume Mounjaro, Wegovy, Ozempic, Zepbound (these are the most famous commercial names, all to be administered through an injection in the belly once a week) is four times more subject to developing gastroparese than those who do not take them, and that almost 5 percent can face serious adverse effects.
Taking a step back, it should be remembered that these medicines, called the Glp-1 agonists (because they bind to the homonymous hormone receptors reproducing their benefits), born to treat diabetes, have powerful effects on many pathologies: their use in those suffering from cardiovascular diseases reduces by 20 percent the mortality from a heart attack and stroke (so the cardiologists have started In a massive way), while an investigation that has been held on the New England Journal of Medicine has established that the injecting of trafficlutide lowers the risk by 25 percent, for those suffering from chronic renal disease, of incurring complications.
Today these drugs, prescribed above all by endocrinologists for obesity, are in experimentation on many other pathologies, from Alzheimer to Parkinson’s up to addictions to alcohol and substances. The problem is that they have become so fashionable that they are also taken by those who are only overweight, to lose weight without effort. It is estimated that one in eight American has already appealed, although the treatment exceeds the cost of $ 1,000 per month.
The latest celebrity to praise it was the former tennis player Serena Williams, who thanks to Zepbound (based on Tirzepatide) has lost 14 kilos and now declares to feel more beautiful than ever: it has also become a testimonial of a company that markets slimming programs based on these drugs.
So far the positive side of history, and attention: nobody wants to question the usefulness of these molecules, which are changing the history of medicine. But as always happens, the real scope of both positive and negative effects is not seen so much in the trials conducted by pharmaceutical companies, as in the “real world”, that is, when people in Massa begin to use medicines. And although their diffusion is still, in Italy, much lower than in the United States – with us a cycle of injections costs between 300 and 400 euros per month depending on dose and type of drug – also in our country the doctors begin to see the consequences of their use in lane. “The most frequent adverse effects are their own gastritis, diarrhea or constipation, nausea, vomiting and abdominal pain”, explains Professor Silvio Danese, director of the unit of gastroenterology and digestive endoscopy to Panorama of the IRCCS Hospital of San Raffaele in Milan. «We also find several cases of reflux and halitosis. However, as evidenced by the US studies, even much more serious problems can occur: since trafficlutide and tirzepatide induce a delay in emptying the stomach – mechanism that is the basis of the sense of satiety and therefore their effect on weight loss – can cause the formation of the so -called Bezoari, that is, accumulations of food that are not disposed of and that could lead to a real “bloc” gastric. In addition, cases of pancreatitis have also occurred ».
Moreover, it is the reverse of the medal: the side effects of the medicines (all) are inherent in their power and effectiveness. The fundamental thing is to take them only if really necessary. “In diabetic patients, as well as in obese and super obese, the risk-benefit relationship is clear and in favor of their intake”, says Paolo Sbraccia, ordinary of internal medicine of the University of Rome Tor Vergata and member of the Council of European Society Obesity. «The problem arises when the GLP-1s are taken for aesthetic rather than clinical motivations, therefore without criteria and without medical follow-up. I don’t want to be stigmatizing, but the social thrust to thinness can bring to inappropriate prescriptions, and that’s where the risks become concrete. Moreover, we are still witnessing a phase of “settlement”, which is quite predictable for a revolutionary drug, and the pharmaceutical companies are working to mitigate the problems ». Soon they will arrive, adds Sbraccia, oral pills such as Orforglipron, which should have fewer side effects than injective traffic light: but with a slightly lower effectiveness.
And while some cases of sudden loss of sight also occurred in the United States, in Italy at the moment the situation does not worry much. “In the vast majority of cases I have observed exclusively manageable and transitory effects,” Sbraccia points out. «Problems to be solved with simple antacid or antiestic bench, and only a serious case: a diabetic and obese patient who has developed an intestinal sub -occlusion due to a stubborn constipation. However, great attention is needed, both by specialists and basic doctors and emergency rooms ». Emergency clinics and departments where, at the moment, the cases of patients who arrive in emergency for adverse effects from GLP-1 are counted in the order of tens: even if there are no structured data and therefore we are based, for now, only on informal “polls” carried out by the primary of the most important cities. However, great regional differences emerge: in the south and in the islands these drugs are still almost unknown to users.
The Milanese situation is a little different. “We begin to see the first patients who present themselves for side effects, almost always individuals who would not have clinical indication to take these drugs,” says Alessandra Iorfida, the emergency room of IRCCS Humanitas and national representative of Simeu (Italian emergency medicine and urgency) representative). «I remember a 27 -year -old boy, a little overweight, who arrived from us after three days of uninterrupted vomiting. It was dehydrated, with renal failure and metabolic alkalosis. He took the drug without being followed by a doctor, moreover to a wrong dosage. Then a lady who just wanted to lose 5 kilos: she manifested severe abdominal pain, and had acute pancreatitis ».
The real trap is, as always, improper use. Favored by doctors or pharmacists who prescribe them or sell them without getting too scruples. A colleague echoes the doctor of Humanitas. “The cases that we have observed are almost all linked to patients who use them to lose weight rather than for diabetes,” says Alice della Torre, Medical Director of the emergency room of the IRCCS Maggiore Polyclinic Hospital in via Sforza. “Usually the side effects occur at the beginning of the treatment, or when the dose is increased. There is also the difficulty of managing weekly release molecules, because the peak of adverse effects can come after two or three days from the injection, and then the symptoms can recur. So far, however, nothing serious: more than other nausea, vomiting, diarrhea and abdominal pain ».
At this point, in a world where a billion individuals is obese and almost 20 million people every year die for cardiovascular diseases, it is appropriate to resort to super drugs only when the risk-benefit relationship is clearly in favor of the latter. For those who have to lose a few pounds, the advice is always that: a balanced diet and then a race in the park.
