What If Metabolism Didn’t Have to Drop?

Do you remember the birthday after which you looked at the scale and realized that you need to break up with doughnuts? Or carbs? Or [insert your indulgence here]?

Yeah, me too. I was 41 and yes, I dream about bread.  

Something kind of big happened (forgive the pun) last month that might give us all hope, not that we can indulge forever, but that age-related weight gain may not be inevitable.  

A new kind of investigational drug (ATX-304) entered a human trial in Europe. The history of weight loss drugs is dominated by examples of drugs aiming to reduce calories, functioning like a fast or a diet. Even some of the newest drugs, the GLP-1 weight loss drugs, are focused on suppressing appetite to reduce weight. While the FDA has determined some of these to be effective, extreme diets (and the drugs that mimic them) can potentially have side effects like muscle loss and fatigue.  

Our investigational drug, ATX-304, seeks to provide an entirely new approach, aimed at increasing metabolism. It targets activating an enzyme (AMPK) in the human body that is one of the key players involved in increasing the rate at which calories are burned. AMPK gets less responsive as we age. Some diets and some vitamins claim to support AMPK but, unlike those products, this investigational drug is entering the most rigorous of human trials under the direction of expert scientists at Amplifier Therapeutics.

Imagine that we could maintain a healthy metabolism through our 60’s, 70’s, 80’s. There are a million drugs, vitamins, and diets out there aiming to help people lose weight. How much easier would it be if we could maintain a healthy metabolism and keep the weight off in the first place as we age?  

On a policy level, how would a preventive medicine that helps Americans stay healthier and more active into our older years change our families, our communities, and our economy?

Could a drug aimed at maintaining metabolism reduce the tremendous impact of diabetes on our lives? CDC estimates that 1 in 3 Americans will develop diabetes in their lifetime, increasing their average out of pocket costs by more than double. What if we could prevent those costs and more importantly, prevent the devastating complications like blindness and kidney failure that reduce the quality of life for millions of Americans each year?

Stimulating the metabolism might have an even bigger effect on heart health. Could a drug like ATX-304 eliminate the need for some of the 900,000 cardiac surgeries performed every year in America?  

In animal trials, ATX-304 resulted in weight loss in the obese or diabetic animals and inspired longer exercise endurance in old animals. That makes sense, right? Metabolism is all about the rate at which our bodies burn fats and sugars to create energy that powers our bodies. It makes sense that higher metabolism would mean more energy.  

Imagine a drug that can safely restore the energy and vitality of older Americans and prevent the decline of others. What would that mean to the 2.1 million Americans over age 60 who are raising their grandchildren, too often due to the opioid crisis? What would it mean to those children if we could help their grandparents stay healthy and strong?  

It is early, I know. The theory needs to be tested, the very first trial has just begun and more will be required before this drug could possibly show up in a pharmacy. This investigational drug has yet to be approved by the FDA, and even if it works the way we think it will, this drug may never be used for prevention if we can’t fix the market failure.  

But I can’t help being excited and hopeful when I think of all that this kind of preventive medicine could do. Can you?