Study details

For the study, researchers performed two trials with overweight or obese patients who had moderate-to-severe obstructive sleep apnea, with moderate being defined as a person who stopped breathing at least 15 times an hour during sleep.

In one of the trials, which involved around 200 people with obesity who couldn't or weren't willing to use a CPAP machine, half were assigned Zepbound as a weekly injection, while the other half received a placebo.

The group that received Zepbound saw an average of 27.4 fewer apnea events per hour, compared to an average reduction of 4.8 events per hour for those in the placebo group, the researchers found.

In the second trial, around 200 people with obesity used a CPAP machine were encouraged to continue using it during the trial. Those who were assigned Zepbound saw an average of 30.4 fewer apnea events per hour after a year of taking the drug, compared to an average reduction of six events per hour for those in the placebo group.

In both trials, those who took Zepbound lost around 20% of their weight. Daniel Skovronsky, Eli Lilly's chief scientific officer, said he attributed the sleep apnea results to the loss of fat deposits in the tongue and airway.

The study has yet to be peer-reviewed and Eli Lilly only provided a summary of its results. Skovronsky said the drugmaker is still analyzing its data and would provide detailed results at the American Diabetes Association's 84th Scientific Sessions in June.

Skovronsky added that Eli Lilly intends to submit an application to FDA and other drug regulatory agencies worldwide requesting that Zepbound be approved for the reduction of sleep apnea in patients classified as overweight or obese.

Reaction

Some experts were impressed with the results of Eli Lilly's trial.

Marishka Brown, director of the National Center on Sleep Disorders Research, said it's been difficult to know just how impactful weight loss can be for people with sleep apnea.

"Sometimes the sleep apnea goes away, but not always," Brown said.

As a result, "the research community has been a bit cautious about saying yes or no" to whether weight loss is an effective treatment for sleep apnea, Brown said.

However, with these study results, that group's hesitancy may change, experts said.

Eric Landsness, a sleep medicine researcher at Washington University in St. Louis, said the results of the study were "phenomenal" and suggest that Zepbound "is a great alternative for people who are obese and can't use CPAP or are on CPAP and want to improve the effect."

Landsness added that, unlike current sleep apnea treatments that only address its symptoms, Zepbound attacks the underlying cause — blockages in the airway that make a person unable to breathe.

According to Jeff Emmick, Eli Lilly's SVP of product development, some medications are available to help treat the drowsiness that often comes with sleep apnea, but Zepbound has "the potential to be the first pharmaceutical treatment for underlying disease."

Advisory Board's weight-related resources

According to CDC data, more than 70% of U.S. adults ages 20 and older are either overweight or obese. Obesity is also prevalent among children, with rates growing between 17.7% and 21.5% over the last decade.

As obesity rates continue to rise, so will healthcare costs. Currently, obesity costs the U.S. healthcare system $173 billion every year.  

To help address the growing weight-related issues in healthcare, Advisory Board offers several resources on different topics, including:

GLP-1 drugs

Interest in new weight-loss drugs, including Novo Nordisk's Wegovy and Eli Lilly's recently approved Zepbound, has surged this year. This has led to record sales, and, as a result, supply shortages as manufacturers struggle to keep up with demand.

Advisory Board's Chloe Bakst and Rachael Peroutky have also shared their insights on how GLP-1 shortages might impact healthcare and what leaders can do in the meantime.

Radio Advisory's Rachel Woods has also covered GLP-1 drugs on the podcast, discussing the  potential future of these drugs  and how they could help — or hurt —  health systems' finances.

Other useful resources include the expert insights "5 catalysts that will impact the future of weight management drugs," and "What the headlines get wrong about weight management medications."

Bariatric surgery

In 2022, the American Society for Metabolic and Bariatric Surgery and the International Federation for the Surgery of Obesity and Metabolic Disorders updated guidelines for weight-loss surgery, expanding eligibility for more people.

Under the new guidelines, anyone with a BMI over 35, regardless of their health status, is eligible for weight-loss surgery. People with a BMI over 30, the official marker of obesity, are also eligible if they haven't been able to achieve substantial or long-term weight loss.

This expert insight outlines three barriers to bariatric surgery and how to overcome them. For patients considering bariatric surgery, this resource offers three factors they should keep in mind while they decide.

Meanwhile, this decision guide offers resources to help you build a successful weight management program that effectively attracts new patients struggling with obesity. It also guides patients through their care journey and keeps them engaged in the long term.

Healthcare's approach to obesity

Recently, healthcare organizations have made an effort to move away from using BMI to determine obesity and assess health. In June, the American Medical Association voted to adopt a new policy that moves away from using BMI alone when assessing whether a patient is at a healthy weight.

Some physicians are also looking beyond BMI and weight as they assess their patients' health and recommend treatments. Instead of focusing on weight loss to treat health issues, some providers are now taking a "weight-neutral" approach that avoids intentional weight loss.

In a recent Radio Advisory episode, Rachel Woods and Advisory Board experts Darby Sullivan and Chloe Bakst discussed healthcare's current approach to obesity and whether it's helping or harming patients.

Similarly, this expert insight covers three missteps in our current approach to obesity, outlining five potential ways providers can address these issues. (Kolata, New York Times, 4/17; Muller, Bloomberg/TIME, 4/17)