Approved by the National Health Surveillance Agency (Anvisa) this week, the drug Mounjaro, from the pharmaceutical company Eli Lilly, is becoming popular not only for the treatment of type 2 diabetes. With effects such as decreased appetite and increased satiety, the drug began to be used by many people off-label (that is, for a purpose not indicated on the leaflet) for weight loss. Such action, however, can result in side effects, in addition to harm to patients’ health.
In the leaflet, Mounjaro is described as a medicine “indicated for glycemic control in adults with type 2 diabetes mellitus in conjunction with diet and exercise”. Fabio Moura, doctor and director of the Brazilian Society of Endocrinology and Metabology (SBEM), explains that the medicine is a double agonist of two gastrointestinal hormones – GLP1 and GIP -, which stimulate the production of insulin in the pancreas and the anorexigenic pathways (reducing the hunger and increasing the feeling of satiety), as well as energy expenditure.
The combination causes patients to lose weight quickly, with cases of losing up to 12 kilos in a few months. Despite the effect, pharmaceutical company Eli Lilly reinforces that Mounjaro is not recommended for patients who only want early weight loss. In these cases, side effects such as nausea, abdominal pain, vomiting and diarrhea are likely. Serious adverse effects are rare, but in some situations they may include kidney failure, gastrointestinal bleeding and pancreatitis, for example.
Hugo Valente do Couto Pereira, endocrinologist and specialist in clinical medicine, says that the demand for Mounjaro is similar to that for Ozempic, manufactured by the Novo Nordisk laboratory. The drug, already approved in Brazil for the treatment of type 2 diabetes, acts on the hormone GLP1, also inducing satiety and, consequently, reducing appetite. However, as Manjaro’s effect is equivalent to twice that of Ozempic, the search for Novo Nordisk’s drug began to lag behind.
“Ozempic, at the dose that exists in Brazil, up to 1 mg, is not approved for weight loss. So, it is used off-label. The same happens with Mounjaro”, explains Pereira. “Both medications must be very well indicated, with the risks and benefits having to be evaluated, with the monitoring of an endocrinologist, because they are not suitable for everyone. What is different from Wegovy [também recomendado para o tratamento da obesidade tipo 2]which has already been approved for obesity in Brazil”, he adds.
Like Wegovy, recent studies by Eli Lilly have shown that Mounjaro can also help patients with obesity. Since October last year, the pharmaceutical company has been accelerating tests to prove the effectiveness of the drug in cases of overweight. In the United States, for example, there are already expectations for the authorization of the use of the drug for weight control in adults. Authorization may also be close in Brazil.
“It is necessary to distinguish what the treatment of obesity is from the ?social desire to lose weight?. The short-term use of medications for aesthetic purposes (and often without a medical prescription) must be treated very differently than the serious treatment of obesity, which aims to improve health and quality of life. Obesity is a chronic, complex, multi-cause disease that is difficult to treat and its treatment, whether medicinal or not, must always go hand in hand with lifestyle change strategies”, reinforces Moura.
Data from the International Diabetes Federation indicate that Brazil is the sixth country with the most cases of the disease in the world. More than 16.8 million people suffer from uncontrolled blood glucose levels, a number that could increase to 23.2 million by 2045. Obesity, in turn, affects around 20% of the population, a rate that, according to the Ministry of Health, has increased by 72% in the last 13 years. When evaluating the number of Brazilians with obesity and overweight, the percentage reaches 56.8%.
