In one of the recent studies, researchers tested a new kind of drug that is as good as bariatric surgery. The proof is in the metabolic changes it causes. This new drug may change how obesity and metabolic disorders are treated.
There are tens of drugs for weight loss and diabetes. None of them can match bariatric surgery. Bariatric surgery is for people with a BMI above 40. It also has metabolic effects that science has struggled to explain.
For example, bariatric surgery often brings complete type 2 diabetes remission. Studies show this is not just from weight loss. The surgery appears to set off changes in the body, including hormone changes. Those changes bring big benefits.
Over the years, researchers have learned how much certain gut peptides matter for metabolic health. Drugs like semaglutide (Ozempic) and tirzepatide copy a gut hormone called GLP-1. They also act on other receptors like GIP. These drugs are now among the strongest tools for diabetes and weight loss.
Knowing how bariatric surgery and gut hormones work helps researchers understand obesity and metabolic disorders. So they are now hunting for molecules that copy the surgery more closely.
In one new study, researchers think they have finally found such a molecule. This drug can help manage diabetes and cut body weight. It also brings broader changes: a faster metabolic rate, changes in fat tissue, and other hormone changes.
So, what is this molecule? It is called G49, an oxyntomodulin (OXM). It is a dual glucagon/glucagon-like peptide-1 receptor (GCGR/GLP-1R) agonist. That means it switches on two hormone receptors at once. In early experimental studies, it significantly increased crosstalk between the pancreas, liver, gut, and fat tissue.
Early studies show this drug boosts the release of free fatty acids from the liver. It could even change fat tissue itself, helping turn harmful white adipose tissue (WAT) into brown adipose tissue (BAT). BAT is easier to burn. It raises the metabolic rate, burns more energy, and helps weight loss.
Researchers also compared OXM with bariatric surgery patients. The drug caused metabolic changes quite close to the surgery. If it proves safe and effective in human studies, it may make bariatric surgery obsolete.
There is more good news. These results do not rest only on lab or animal studies. Researchers have already started testing this drug in people. Those early studies found it causes metabolic changes usually seen only after bariatric surgery.
This new class of drugs may be significantly better than semaglutide and tirzepatide, and it may arrive soon for metabolic disorders. It would be strong for reversing diabetes, weight loss, and more. It may also help fatty liver disease, PCOS, and other metabolic disorders.
Medication is only one part of a weight plan. How it fits with food, activity and follow-up is laid out in our medical weight loss program.
Frequently asked questions
Is there a drug that works like bariatric surgery?
Researchers think they have found one: a test drug called G49. They compared it with bariatric surgery patients. It caused metabolic changes quite close to the surgery. Early testing in people has already begun. It found the same kind of changes usually seen only after bariatric surgery. If it proves safe and effective in human studies, it may make bariatric surgery obsolete.
What is G49, or oxyntomodulin?
G49 is an oxyntomodulin (OXM), a dual glucagon and GLP-1 receptor agonist. That means it acts on two hormone receptors at once. In early experimental studies it significantly increased crosstalk between the pancreas, liver, gut and fat tissue. It can help manage diabetes and cut body weight. It also brings broader changes, such as a faster metabolic rate, changes in fat tissue and other hormone changes.
Why does bariatric surgery work better than weight-loss drugs?
There are dozens of drugs for weight loss and diabetes. None compares with bariatric surgery, which is for people with a BMI above 40. The surgery often brings complete type 2 diabetes remission. Weight loss alone does not explain that. The surgery sets off hormone and other body changes. That is why researchers are hunting for molecules that copy them.
Can a drug turn white fat into brown fat?
In early studies, G49 helped turn harmful white fat tissue into brown fat tissue. Brown fat is easier to burn. It raises the metabolic rate, burns more energy and helps weight loss. The drug also boosted the release of free fatty acids from the liver. Researchers tie this to the broader metabolic rewiring behind its surgery-like effects.
Source:
Valdecantos, M. P., Ruiz, L., Folgueira, C., Rada, P., Gomez-Santos, B., Solas, M., Hitos, A. B., Field, J., Francisco, V., Escalona-Garrido, C., Zagmutt, S., Calderon-Dominguez, M., Mera, P., Garcia-Martinez, I., Maymó-Masip, E., Grajales, D., Alen, R., Mora, A., Sáinz, N., … Valverde, Á. M. (2024). The dual GLP-1/glucagon receptor agonist G49 mimics bariatric surgery effects by inducing metabolic rewiring and inter-organ crosstalk. Nature Communications, 15(1), 10342. https://doi.org/10.1038/s41467-024-54080-w
Dr. Gurpreet Singh Padda, MD, MBA, MHP
