Understanding Weight Loss and Cancer
- Research has shown that although popular weight-loss drugs like Ozempic (generic name: semaglutide) work to shed excess pounds, the weight loss is not maintained when the medications are stopped.
- Ozempic, the brand name of Novo Nordisk’s semaglutide. It’s also known by the brand names Rybelsu and Wegovy. It is an FDA-approved prescription medication for adults with type 2 diabetes.
- Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
- The Centers for Disease Control and Prevention (CDC) says, “Being overweight or having obesity are linked with a higher risk of getting 13 types of cancer.” Some of these cancers include breast, colon, ovarian, and stomach (gastric).
- If you’re considering taking a weight loss drug, talk with your care team about whether that’s a good option for you. And make sure you consider good diet and exercise practices as a part of your treatment plan.
Various clinical trials—the STEP 1 trial extension, STEP 4 trial, and the SURMOUNT-4 Trial—have found discontinuing GLP-1 drugs leads to weight gain. And as per a recent report from MedPage Today, in part with the “Ozempic: Weighing the Risks and Benefits” series created through the NIHCM Foundation, experts, referring to clinical trial data, experts say it’s clear patients who lost weight on blockbuster weight loss drugs [GLP-1 agonists] will regain some weight back after stopping them.
Read MoreHowever, the experts noted that there is a lack of evidence on how to prevent weight gain after stopping the drugs, with some suggesting that gradually stopping a GLP-1 agonist may help, but more research needs to be done.
Additionally, Sarah Armstrong, MD, of Duke University School of Medicine, pointed out a challenge associated with long-term use of GLP-1 agnosist, telling MedPage Today, “The potential challenges are ‘really the same challenges of being told you have to take a medication long-term for any disease
“The only way that we know to convince the body that it’s not good to carry this excess weight are by these drugs that work in the brain to kind of turn off that protection mechanism and to … let the pounds fall away without the body going into crisis mode and thinking that it’s starving.”
She added, “What we don’t have” are data on “strategies to mitigate weight regain. We don’t know, when an ideal BMI is achieved, what the next steps really should be.”
Additionally, Robert Kushner, MD, of Northwestern University Feinberg School of Medicine, who worked as an Investigator in STEP 1, said, “What I can tell my clinician colleagues is we have good evidence that suddenly stopping the medication is not ideal, because in both the extension trial, and these STEP 4 and SURMOUNT-4 trials, the medication was stopped suddenly.
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“There was no weaning of the medication. There was no dose de-escalation of the medication.”
How Does Semaglutide Work?
Semaglutide works by impacting the glucagon-like peptide-1 (GLP) GLP-1 hormone.
Integral to blood sugar control, GLP-1 is a hormone released by the gut in response to food. It causes the pancreas to release insulin. A rising blood insulin level causes all the body tissues to start absorbing glucose (blood sugar) from the bloodstream, thereby lowering blood glucose levels. GLP-1 also prevents the release of glucagon, which is a hormone that raises blood sugar levels by stimulating liver cells to release glucose and helps people feel full for longer. These effects can also cause people to lose weight.
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Modern studies on GLP-1 have shown that it has a role beyond glucose control. It modulates the immune system cells, including NK cells, in a way necessary for weight loss.
Semaglutide is a GLP-1 receptor agonist, meaning that it mimics the effects of GLP-1 in the body. Given as weekly subcutaneous injections, it is normally prescribed to manage blood glucose levels in diabetic patients. It also leads to a significant amount of weight loss in these patients.
Although semaglutide has been approved for blood sugar control in people with type II diabetes, under the brand name Ozempic, and for weight loss under the brand name Wegovy, it has not been approved for use as an immune booster and cancer preventative. Thus, it should not be prescribed for that purpose. Those taking it to control their diabetes or weight, however, can expect the additional benefit of improving their immunity. as per a recent study, and lowering their cancer risk, as a link between weight and cancer does exist.
It’s important to note there are a variety of drugs available right now for weight loss, like Nova Nordisk’s semaglutide—which can be purchased under brand names Ozempic, Weygovy, and Rybelsu—and Tirzepatide, sold under the brand names Mounjaro and Zepbound. Others include Phentermine (Adipex-P, Lomaira), a prescription medication which lessens one’s appetite, Contrave (naltrexone/bupropion), and bupropion (the generic form of Wellbutrin).
Cancer Risk and Obesity
Bodyweight can be a sensitive subject for many people on any given day. However, among cancer patients whose treatment and diagnosis may influence their weight, the numbers on the scale fuel an already emotional journey.
The Centers for Disease Control and Prevention (CDC) says, “Being overweight or having obesity are linked with a higher risk of getting 13 types of cancer.”
Research published in the journal “Cancers” says that “Obesity also increases the risk of dying from cancer and may influence the treatment choices. About 4–8% of all cancers are attributed to obesity.”
Some of the cancers associated with being overweight or obese include:
- Colon
- Breast
- Ovarian
- Esophagus
- Pancreatic
- Multiple myeloma
- Endometrial
- Liver
WATCH: Living a healthy lifestyle.
According to the National Cancer Institute (NCI), fat tissue “produces excess amounts of estrogen,” which is associated with an increased risk of certain cancers, including breast, ovarian, and endometrial cancer. The NCI says a person who is severely obese is “7 times” more likely to be diagnosed with endometrial cancer.
Obesity is associated with high levels of insulin, which can lead to colon, kidney, prostate, and endometrial cancer.
Obesity can affect cancer survivors in various ways, including the chance of cancer recurrence and overall quality of life.
To learn more about your ideal healthy weight, determine your body mass index (BMI).
Body weight that exceeds what the body mass index deems appropriate for your weight and height can help determine body fat content. Although your BMI can help you learn if you are at a healthy weight, underweight, overweight, or obese, other factors may contribute to your overall health.
The NCI analyzed several studies to observe physical activity’s impact on overall cancer risk. The NCI says that “higher levels of physical activity are linked to lower risk of several types of cancer.”
Regular exercise, a balanced diet, and managing stress are some ways people can practice leading a healthy life. For cancer survivors, a healthier lifestyle alongside getting regular checks for recurrence may improve your quality of life.
Contributing: SurvivorNet Staff
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