“Weight loss injection” is the “Science” breakthrough of the year

Ozempic

Ozempic, Wegovy and other “weight loss injections” based on GLP-1 analogues are the scientific breakthrough of 2023. © Imyskin/iStock

Every year, shortly before Christmas, the journal “Science” selects the scientific milestones of the year and chooses the greatest breakthrough. This year the choice fell on “weight loss injections” based on so-called GLP-1 analogues. These preparations, known under the names Ozempic and Wegovy, are the first medicinal ingredients that enable severely overweight people to lose significant weight and also improve their health. Despite many unanswered questions, these and similar drugs could usher in a new era in the fight against obesity, according to the “Science” editors. Other highlights of the year include the oldest human footprints in North America, antibody drugs against Alzheimer's, AI weather forecasts and the gravitational wave background of the cosmos.

What were the outstanding scientific findings and discoveries this year? Which development has particular future potential? And where were there devastating setbacks? Every year, shortly before Christmas, the editors and publishers of the specialist magazine “Science” choose their top ten: the research results and discoveries that they consider to be the most important. They choose one of the ten as their breakthrough of the year. In 2022, the highlight of the year was the James Webb Space Telescope, in 2021 it was the decoding of the protein code by artificial intelligence, and in 2020 it was the vaccines against the coronavirus.

New weapons in the fight against obesity

This year, a medical breakthrough is at the top of the list of fame for 2023: weight loss injections based on so-called “glucagon-like peptide-1” mimetics (GLP-1). These active ingredients, which were originally brought onto the market several years ago as diabetes medications, have proven in several studies to be effective weight loss aids, especially for very overweight and obese people. The GLP-1 analogues mimic a natural intestinal hormone that affects our metabolism and appetite in several ways. On the one hand, it regulates insulin release in the pancreas and can therefore help diabetics against excessive blood sugar levels. On the other hand, the GLP-1 analogues also have an effect on the satiety center in our brain. There they activate signaling chains that inhibit appetite and also stimulate digestion. “These new therapies are changing not only treatment, but also our understanding of obesity: It is a chronic disease with roots in biology, not just a weak will,” writes “Science” author Jennifer Couzin-Frankel.

Last year, several clinical studies based on the GLP-1 active ingredient semaglutide demonstrated how effective the GLP-1 analogues are against obesity. Unlike previous variants, it no longer needs to be injected daily, but only once a week, which makes it much easier to use. In the studies, participants lost between 15 and 20 percent of their body weight within around one and a half years - previously this amount could only be achieved through surgical stomach reduction. Further clinical studies this year also showed that the risk of heart attacks, strokes and other health consequences associated with obesity can be reduced by 20 percent or more. “For these reasons, Science names the GLP-1 active ingredients as the breakthrough of the year,” writes Couzin-Frankel. However, the hype on social media about “weight loss injections” also has some downsides. Because more and more non-obese people are now using these preparations as a lifestyle product, the rapid demand has caused massive supply bottlenecks, which are particularly causing problems for diabetics. In addition, these active ingredients are expensive and, based on current knowledge, may have to be taken for life.

Alzheimer's drugs, gravitational waves and exascale computers

In addition to the breakthrough of the year, the science editors also present other scientific highlights. In the medical field, this includes a new vaccine against malaria and the new antibody therapies Lecanemab and Donanemab against Alzheimer's. Both preparations target the misfolded amyloid proteins in patients' brains and dissolve the plaques they create. In clinical trials, these antibodies slowed the progression of dementia by 27 to 35 percent, but in rare cases can cause serious side effects in the form of cerebral hemorrhage. However, the antibody active ingredients raise the hope of finding further, optimized therapies against Alzheimer's.

In astronomy, the detection of the gravitational wave background has been selected as an important breakthrough. This “background noise” of long-wave, weak oscillations in space-time arises from the interaction of orbiting supermassive black holes. This “humming” was only proven through long-term observation of pulsars and the subtle fluctuations of their regular radio pulses. Two further highlights come from the area of ​​computer technology and artificial intelligence. One is the beginning of the exascale era in supercomputers: With the “Frontier” supercomputer at the Oak Ridge National Laboratory in the USA, a computer managed to carry out more than a trillion floating point calculations per second for the first time. Additional exascale supercomputers are already being built. This also opens up new opportunities for science, writes “Science”. In the area of ​​AI, the journal rated an AI system developed by Google-DeepMind as a milestone that can create precise ten-day weather forecasts faster than common numerical weather models.

more on the subject

Ancient human traces, deep currents and the superconductor debacle

In archaeology, a new dating of ancient human footprints in White Sands National Park in the USA has shed new light on the settlement of North America. These footprints were created 21,000 to 23,000 years ago and are therefore significantly older than other relics of human presence on this continent. The prints provide clear evidence for the first time that there were people in North America at the height of the last Ice Age. There were also significant new findings in the geosciences in 2023: new geological explorations suggest that there could still be undiscovered hydrogen reservoirs in the earth's crust. These could store more than a trillion tons of this fuel - enough to supply humanity with this climate-friendly fuel for centuries. However, the results of new research into one of the central engines of global ocean circulation are not very positive. In March 2023, researchers found that the flow of Antarctic deep water has slowed and weakened by up to 20 percent since the 1970s. This suggests that climate change and warming oceans are already affecting this current, which is important for climate and marine ecology.

The “Science” editors see the developments in the area of ​​superconductor research as one of the “breakdowns” – the setbacks of the year. This year, several research groups reported on alleged room temperature superconductors, but none of them stood up to scrutiny. Among them is the “miracle material” LK-99 presented by South Korean physicists, but also an experiment with lutetium hydride published by the controversial US physicist Ranga Diaz in the journal “Nature”. This publication was withdrawn from the journal in November 2023.

Source: Science, American Association for the Advancement of Science (AAAS)

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