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“The Year of Ozempic” proclaimed the December 2023 edition of The New Yorker.
That same month, the journal Science declared glucagon-like peptide-1 (GLP-1) weight loss drugs its “Breakthrough of the Year,” beating out commendable contenders such as new malaria and Alzheimer’s treatments, innovative climate change research on natural carbon pumps and artificial intelligence (AI) in improving weather forecasting. Apparently, Science viewed treating obesity as a bigger story than dementia and global warming.
With all the success of human obesity medications, could pet weight loss drugs be far behind?
Following the global attention on weight loss drugs like Ozempic and Wegovy, rumours of pilot clinical trials and safety studies involving dogs and cats began to circulate. In June 2024, Bloomberg highlighted Okava Pharmaceuticals' efforts to develop an implantable device for administering GLP-1 drugs in cats. This development not only aims to help cats with obesity lose weight but also offers the potential to improve the management of feline diabetes.
Okava was using the first FDA-approved GLP-1, exenatide, which was authorised for treating human type 2 diabetes in 2005. If you’re unfamiliar with that drug, marketed as Bydureon (exenatide) Pen by AstraZeneca, that’s because it was discontinued in 2021 “due to business reasons.” Could it also have something to do with the next generation of GLP-1s being even better?
In February 2024, Better Choice Company (BTTR) acquired Aimia Pet Healthco to develop GLP-1 drugs in the form of “treats and toppers to safely combat pet obesity.” While we don’t have details of what they’re working on, they’re one of several companies bringing these types of weight loss medications to the veterinary market.
The primary obstacle for drug makers entering the pet market is price. On average, the highly efficacious second-generation GLP-1 drugs cost between $900 and $1,350 per month, not counting insurance or rebates. That’s prohibitively expensive in the veterinary market, where drugs costing even a couple hundred dollars a month are out of reach for many pet owners.
However, GLP-1 prices are expected to decrease over time, as these things do, as Sir Stephen O’Rahilly outlined during his presentation at the 2022 Royal Society conference on causes of obesity. Pretty soon, O’Rahilly believes these drugs will be “cheap as chips.”
He reminded physicians that a similar dilemma was once faced in treating hypertension.
“When I was a junior doctor in London and Dublin, our wards were full of people suffering the end-stage consequences of uncontrolled hypertension – intracranial hemorrhages, heart failure, renal failure. That problem has pretty much disappeared. We did it slowly and gradually over 40 years. It was a combination of public health measures and smart, safe pharmacotherapy.
“Back in the 1920s and 1930s, we didn’t have any antihypertensive drugs. The first drugs that came in (like guanethidine) had horrible, terrible side effects. And people said, ‘We can never treat blood pressure because these drugs are awful.’
“How did we make better drugs? Well, we started to understand the system. We understood the physiology of renin-angiotensin, we understood the importance of the kidney in the control of blood pressure.
“Now we have at least five classes of antihypertensive agents, all of which are cheap as chips because they’re all off-patent. And there’s pretty much nobody whose blood pressure we can’t control.”
And before you write off generic GLP-1 drugs as something for the future, you’re too late. We already have generic liraglutide. On June 24, 2024, Teva launched their off-patent version of Novo Nordisk’s Victoza to treat diabetes. And, yes, it has also been shown to aid in weight loss like the other compounds in its class.
When can we expect weight loss drugs to arrive for veterinary prescription?
It’s hard to know, but based on the amount of interest and resources being deployed, and with recent changes at the FDA and mounting public pressure to offer more treatment alternatives, I’d anticipate within the next five years. The veterinary profession must prepare for this shift in diagnosis and treatment. The Association for Pet Obesity Prevention (APOP) and the World Pet Obesity Association (WPOA) are working to create universal definitions, develop diagnostic algorithms, and encourage advancements in treating clinical obesity in animals.
We must also continue closely working with our partners in therapeutic nutrition. As we’re learning from long-term studies in humans, GLP-1s aren’t a panacea for sustaining healthy body composition. Lifestyle modifications, physical activity, and diet will continue to play essential roles in improving the health and longevity of dogs, cats, horses, rabbits, and other animals with obesity.
Currently, we have several evidence-based therapeutic dietary solutions to use until FDA-approved veterinary weight-loss drugs arrive to assist our efforts. Veterinary professionals must continue emphasizing the significant health risks of veterinary clinical obesity and the importance of proper nutrition in both treating obesity and improving well-being.
In addition, an “obesity first” strategy should be implemented for animals suffering from chronic conditions such as osteoarthritis, insulin resistance, cardiovascular and respiratory conditions, hypertension, and more. In simplest terms, “obesity first” means we treat obesity as a priority when confronting these obesity-associated disorders. By losing excess body fat and increasing lean muscle mass, nearly all of these chronic diseases improve, and some may even experience remission.
Pet weight loss drugs are inevitable and will likely enter our formularies by the time the next wave of veterinary students graduate. We have the unique advantage of learning from the successes and challenges encountered in human healthcare to guide and inform our next steps.
If you or your organisation are interested in helping us create the guidelines for the future of veterinary obesity care, get in touch here. Together, we can solve the challenges of pet obesity.
References:
Printable Body Condition and Weight Management Charts for Feline and Canine
About the Association for Pet Obesity Prevention
The Association for Pet Obesity Prevention is a charitable non-profit organisation. Through the collective efforts of mission-aligned veterinarians, veterinary technicians, academicians, nutritionists, and other groups and organizations, the Association for Pet Obesity provides clinical resources and tools, promotes evidence-based obesity and weight loss interventions, and drives important research to understand the health impacts and complex causes of weight and obesity-related disorders in animals.
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