Ozempic’s Latest Weight Loss Competition Is Like Nothing We’ve Seen Before

The race to develop the next generation of weight-loss drugs has taken an interesting new turn. In recent research, Eli Lilly’s experimental treatment Eloralintide helped people lose a significant amount of weight — without having to use the same approach as existing common medications like Ozempic.

Earlier this month in The Lancet, researchers from Eli Lilly and others published the latest results of a phase 2 trial of Eloralintide. Over the course of 48 weeks, people who took ellorintide lost up to 20% of their baseline body weight, which was much higher than the average weight loss experienced by those who took placebo. Eloralintide’s early success to date is all the more notable because it is not a GLP-1 drug.

Different mechanism

Eloralintide mimics the hormone amylin. The pancreas naturally releases amylin along with insulin into the bloodstream in response to food intake. Once amylin is released, it helps tell the body that it is full, reduces our appetite, and slows the passage of food through our digestive system.

Today’s most effective weight-loss drugs, such as semaglutide (the active ingredient in Ozempic and Wegovy), are long-acting mimics of the GLP-1 hormone. Like GLP-1, amylin plays a role in regulating hunger and controlling blood sugar. The two hormones even share some overlap in how they influence the body to perform these functions. But they also have some key differences, which is what makes amylin a promising new target for treating obesity.

There is an amylin-based drug, pramlintide, which was first approved two decades ago as a treatment for diabetes. But it’s the newest amylin analogues in development, such as eluralintide, that have scientists really excited. These experimental drugs are designed to last longer in the body than natural amylin, perfectly enhancing the effects of the hormone to help people lose weight and control blood sugar. As with semaglutide, eloralintide is supposed to be taken once a week by subcutaneous injection.

Early promise

Eli Lilly’s phase 2 trial included 263 participants without type 2 diabetes who were obese (BMI over 30) or overweight (BMI over 27) and had weight-related health conditions. They were randomly assigned to either receive placebo or different doses of elloralintide. Some were given the same dose of medication throughout the study, while others were given gradually escalating doses.

The study showed that people who took elloralintide, regardless of dosing strategy, saw greater improvements in weight loss over an average of 48 weeks than the placebo group. People who took the highest weekly dose, nine milligrams, saw the best results, averaging 20% ​​weight loss during the study, as well as people who steadily increased their dose from six to nine milligrams.

It also appears to be generally safe and well-tolerated. Adverse events commonly associated with the drug were gastrointestinal, similar to known side effects of GLP-1 therapy. The most common adverse event was nausea, with about one-third of people taking the highest dose reporting symptoms.

“Eloralintide produced clinically meaningful dose-dependent reductions in body weight over 48 weeks and was generally well tolerated, supporting the potential use of loralintide for the treatment of obesity,” the researchers wrote in the study.

What does this mean for the future of weight loss?

GLP-1s have brought significant change to the field of obesity medicine in recent years. Although these drugs are not risk-free and can be expensive, they are already starting to turn back the clock on obesity. For the first time in years, the obesity rate in America has dropped significantly as the use of these drugs has steadily increased.

There are now many obesity drugs in development, many of which are duplicates of GLP-1. Other medications combine GLP-1 with other hormones linked to hunger, including amylin. However, the results for Eloralintide are particularly puzzling, given that the drug is based solely on amylin. This is important because it could mean that eloralintide could eventually become an attractive alternative for people who have not responded to GLP-1 treatment.

It’s too early to know for sure, especially without a study directly comparing these drugs in a trial. But it should be noted that semaglutide only helped people lose about 15% of their body weight on average in clinical trials. Eli Lilly’s current obesity drug, which combines GLP-1 with the hormone GIP, has shown weight loss rates hovering around 20%.

Naturally, these early results need to be verified by data from larger trials. But if this research continues to show promising results, elloralintide could open up a whole new field of obesity treatment.