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 substantial amount of weight—without needing to use the same approach as existing popular medications like Ozempic.
Earlier this month in The Lancet, Eli Lilly researchers and others published the latest phase II trial results of eloralintide. Over a 48-week span, people taking eloralintide lost up to 20% of their baseline body weight, well above the average weight loss experienced by those on placebo. Eloralintide’s early success so far is all the more notable because it isn’t a GLP-1 drug.
A different mechanism
Eloralintide mimics the hormone amylin. Our pancreas naturally releases amylin alongside insulin into the bloodstream in response to eating food. Once released, amylin helps tell our body that it’s full, tamps down our appetite, and slows the passage of food through our digestive system.
The most effective weight loss drugs today, such as semaglutide (the active ingredient in Ozempic and Wegovy), are long-acting mimics of the hormone GLP-1. Like GLP-1, amylin plays a part in regulating our hunger and blood sugar control. The two hormones even share some overlap in how they affect the body to carry out these functions. But they also have some key distinctions, and that’s made amylin a promising new target for obesity treatment.
There is an existing 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, like eloralintide, that have really excited scientists. These experimental drugs are designed to last much longer in the body than natural amylin, ideally boosting the hormone’s effects to help people lose weight and control their blood sugar. Much like semaglutide, eloralintide is intended to be taken once a week via subcutaneous injection.
Early promise
Eli Lilly’s phase II trial involved 263 participants without type 2 diabetes who had obesity (a body mass index over 30) or who were overweight (a BMI over 27) with weight-related health conditions. They were randomly assigned to either receive a placebo or varying doses of eloralintide. Some were given the same dosage of the drug throughout the study, while others were given gradually escalating dosages.
People on eloralintide, no matter the dosing strategy, saw greater improvements in weight loss over 48 weeks on average compared to the placebo group, the study showed. People taking the highest weekly dose, nine milligrams, saw the best results, an average 20% weight loss during the study, as did people who steadily increased their dose from six to nine milligrams.
It also appeared to be safe and generally well-tolerated. The adverse events typically associated with the drug were gastrointestinal, similar to the known side effects of GLP-1 therapy. The most common adverse event was nausea, with about a third of people on the highest dose reporting the symptom.
“Eloralintide produced clinically meaningful, dose-dependent reductions in bodyweight over 48 weeks and was generally well tolerated, supporting eloralintide’s potential use for obesity treatment,” the study researchers wrote.
What does this mean for the future of weight loss?
GLP-1s have greatly changed the field of obesity medicine in recent years. And though these drugs aren’t risk-free and can be highly expensive, they’ve already started to turn back the clock on obesity. For the first time in years, America’s obesity rate has noticeably declined as the use of these drugs has steadily climbed.
There are now plenty of obesity drugs in development, many of which are iterations of GLP-1. Other drugs are combining GLP-1 with other hunger-related hormones, including amylin. Eloralintide’s results are especially tantalizing, though, since the drug is only relying on amylin. That’s important because it may mean that eloralintide can eventually become an appealing alternative for people who haven’t responded to GLP-1 therapy.
It’s far too early to be sure, especially without a study directly comparing these medications in a trial. But it’s worth noting that semaglutide only helped people lose about 15% of their body weight on average in clinical trials. Eli Lilly’s existing obesity drug tirzepatide, which pairs GLP-1 and the hormone GIP, has shown weight loss rates hovering around 20%.
These early findings will have to be verified by data from larger trials, of course. But if this research continues to show promise, eloralintide could open up a whole new area of obesity treatment.
