Recently, the "star drug" semaglutide oral version was approved by the US Food and Drug Administration for weight loss. Its injection version was previously approved as the world's first GLP-1 weight loss drug and received widespread attention. Last year, China approved semaglutide injection for adult weight control. The approval of its oral tablets in the United States has once again sparked the public's eager anticipation for "convenient slimming and beauty". Why can GLP-1 drugs help adults control their weight? Will the oral version improve medication convenience and lead to drug abuse? With these questions in mind, a reporter from Science and Technology Daily interviewed relevant experts on December 25th. First question: What happens in the body after taking or injecting semaglutide? Many people have come to know a difficult molecular biology term GLP-1 because of the "star drug". GLP-1, also known as glucagon like peptide-1 in Chinese, can precisely regulate insulin and glucagon secretion based on blood glucose levels, and semaglutide is its analog. There are many 'locks' on cells that match these peptides, called receptors, and only by binding to them can the intracellular response be' activated '. ”Associate Professor Li Kefeng from the Artificial Intelligence Drug Discovery Center at Macau Polytechnic University told reporters that it's like the "key" in the body is not enough. A similar "key" was synthesized from outside the body and introduced into the body, which can also open the "locks" on pancreatic beta cells, gastrointestinal tract, central nervous system and other cell membranes, promote insulin secretion, inhibit glucagon, delay gastric emptying, and suppress appetite through central pathways. From the mechanism, it can be seen that the weight loss core of semaglutide is not 'fat burning'. ”Li Kefeng said that it activates satiety related neural circuits such as the hypothalamus and brainstem to reduce hunger, decrease food cravings, and delay gastric emptying, making users feel more "top" after meals and hungry later. The core ingredients and principles of the oral and injection versions are the same, only the dosage form and administration method are different. ”Li Nan, the director and chief pharmacist of Handan People's Hospital in Hebei Province, stated that for patients, oral administration is more convenient than subcutaneous injection. Due to the fact that oral administration requires absorption through the gastrointestinal tract and has lower bioavailability, the required dosage is usually higher than that of injectable form. Therefore, it is necessary to follow medical advice when using it. The oral absorption rate is low and greatly affected by food and water intake, so it is necessary to strictly follow the medication method and not simply swallow it. ”Li Kefeng said that it is usually required to have an empty stomach in the morning, only a small amount of water, swallow the whole tablet, and wait for at least 30 minutes before eating, drinking water, or taking other oral medications. Question 2: What are the other weight loss drugs and who needs to use them? The currently available weight loss prescription drugs in China are mainly GLP-1 class drugs. ”Li Nan stated that BMI (Body Mass Index) is an important evaluation criterion, and individuals with a BMI greater than or equal to 28 or greater than or equal to 24 and at least one obesity related complication can be evaluated by doctors and treated with medication. Orlistat is the only over-the-counter option. ”Li Nan said that it can inhibit the breakdown of triglycerides, thereby preventing fat absorption, but it has poor tolerance and more side effects. The new generation of dual target and triple target weight loss drugs is constantly being promoted. Li Kefeng introduced that, for example, Liriopide adds the GIP (glucose dependent insulinotropic polypeptide) pathway on top of GLP-1 to enhance weight and metabolic benefits, while Xindamashidu peptide introduces the glucagon receptor pathway, emphasizing the contribution of energy consumption and fat oxidation. But all drugs require continuous attention to long-term safety and tolerability, and the public should also self monitor and balance their blood sugar, heart rate, and other aspects when using approved drugs. The new target weight loss drugs have received very high attention due to their significant weight loss effects, but the public should strictly follow the indications when using them to avoid blind medication for non indications. ”Li Nan reminds that as an innovative drug, its long-term safety and efficacy are still under monitoring. Question 3: What harm can oral medication bring if abused? Oral administration, which is more convenient, may indeed bring hidden concerns about drug abuse. ”Li Kefeng admitted that some "weight loss" behaviors that do not meet the indications are prone to problems of "low benefits and high risks". For example, normal people who want to lose weight quickly through medication may experience a decrease in muscle mass, malnutrition, and even an increased risk of developing gallstones, cholecystitis, thyroid cell tumors, negative emotions, mental stress, and other problems. Drug development is moving towards more convenient and effective directions, but lifestyle interventions will always be the primary and irreplaceable cornerstone for weight loss. ”Li Nan stated that the general public should not blindly pursue rapid weight loss when managing their weight, as there is a risk of rebound after discontinuing medication for weight loss. Interventions in lifestyle such as balanced diet, regular exercise, and adequate sleep can not only effectively manage weight in the long term, but also benefit health. Don't treat prescription drugs as' beauty drugs'. ”Li Kefeng said that many people only focus on fat or weight loss when losing weight, but overlook the importance of maintaining muscle mass. Protein, resistance training, and sleep are the core of long-term weight management. If medication is necessary, attention must be paid to important issues such as gastrointestinal reactions and contraindications, and "maintenance strategies" including exercise and diet must be designed in advance to carry out weight regain management after discontinuation of medication. (New Society)