People receiving weight-loss drug Wegovy sustained weight loss for up to four years, shedding an average of 10% of their body weight in that time, as per a new study. Wegrovy is a brand that markets semaglutide injections, that have gained widespread attention for their weight-loss effects. The study also found that Semaglutide injections boost an individual's heart health, even when weight loss doesn't take place.

The study, called SELECT, was published in journal Nature Medicine. "At four years, we see ongoing benefits of semaglutide," said Cheng-Han Chen, MD, interventional cardiologist from Cardiologist, who was not involved in the research. Besides the weight loss, it also lead to a loss in cardiovascular outcomes.

The research was conducted on 17000 adults, who had obesity but did not have diabetes. Overall, people who received once-weekly injections of semaglutide lost on average 10.2% of their body weight over the course of four years. All of the study participants continued to lose weight for about 65 weeks, a year and three months, and then their weight remained at a stable level.

Were There Any Side Effects?

What Did The Results Say?

Of the people on the highest dose of Wegovy, 68% lost at least 5% of their body weight. This compared to 21% of people on the placebo. Additionally, of the total people on Wegovy about 23% lost at least 15% of their body weight. For those in the placebo group, only 1.7% lost that much body weight.

Semaglutide Shows Heart Benefits Beyond Weight Loss

Researchers found that even individuals who did not experience significant weight reduction while on the drug saw a reduced risk of major heart events. Recent analysis of the SELECT trial data revealed that semaglutide significantly lowers the risk of heart attack, stroke, and cardiovascular-related deaths in adults with obesity or those who are overweight. Notably, the results of this study lead the US FDA to approve Novo Nordisk's Wegovy for reducing heart-related risks in this group.

What Is Semaglutide?

Are Their Any Side Effects Of Semaglutide?

Semaglutide, marketed under the brand name Wegovy, is primarily an antidiabetic medication used to treat Type 2 diabetes. It is also an anti-obesity drug used for long-term weight management. While it can be taken as a subcutaneous injection or orally, it has significant side effects. It primarily impacts your gastrointestinal tract and its side effects include constipation, nausea, abdominal pain, diarrhoea, and fatigue amongst others.

A team of Indian scientists has uncovered a rare mutation in the USP18 gene that appears to drive repeated neurological deterioration in children. This unusual mutation offers important clues about a disorder previously seen in only 11 cases worldwide, now identified for the first time in India.

The work was carried out by specialists at the Indira Gandhi Institute of Child Health in Bangalore, along with researchers from Ramjas College, University of Delhi, and Redcliffe Labs. But what does this neurological condition involve?

The study, featured in the journal Clinical Dysmorphology, describes a never-before reported variant, c.358C>T (p.Pro120Ser), adding to what is known about Pseudo-TORCH syndrome type 2.

What Is Pseudo-TORCH Syndrome Type 2?

Pseudo-TORCH syndrome type 2 is an extremely uncommon inherited disorder that affects how a child’s brain forms and functions. The symptoms often resemble those caused by congenital infections, though no actual infection is present.

According to the researchers, it is marked by serious brain abnormalities such as intracranial calcifications, a smaller-than-usual head size, and white matter injury. These problems can lead to seizures, stiffness of the limbs, and often early death. The condition results from recessive mutations in genes like USP18.

What Is The USP18 Gene?

The USP18 gene provides instructions for making the Ubiquitin-Specific Peptidase 18 protein, which helps regulate the body’s type I interferon response. It performs two major tasks. It works as an enzyme that removes ISG15 tags from certain proteins, and it also dampens interferon signaling by attaching to the IFNAR2 receptor. Disturbances in this gene are linked to interferon-related disorders and some cancers, according to the National Institutes of Health.

In a healthy state, USP18 keeps the immune response balanced so the body does not produce unnecessary inflammation. When the gene is altered, this control weakens and the immune system reacts in an exaggerated way, which can damage the developing brain.

“The finding shows how clinical experience combined with advanced genetic tools can change outcomes. For years, we treated symptoms without a clear explanation, but identifying this new USP18 mutation has changed both the diagnosis and the child’s path forward,” said Dr. Vykuntaraju K. Gowda from the Department of Pediatric Neurology, IGICH, speaking to IANS.

What Doctors Found?

The investigation began with an 11-year-old girl who had shown symptoms since infancy, including repeated episodes of febrile encephalopathy, meaning fever-associated unconsciousness, along with seizures, developmental delays, and microcephaly. Her brain scans over time showed growing calcium deposits in several regions.

To trace the cause of her recurring neurological episodes, the doctors advised detailed genetic analysis. Using exome sequencing combined with mitochondrial genome testing, the team uncovered a previously unknown alteration in the USP18 gene, finally providing an explanation after years of uncertainty.

This new mutation changes the USP18 protein’s shape, reducing its ability to keep inflammation under control. The overly active immune response offers a clear reason for the child’s repeated fever-linked neurological decline. Recognising this link is important because it helps clinicians spot early signs, avoid unnecessary infection-related treatments, and pay closer attention to conditions caused by immune overactivity instead.

“This is also the first reported instance of a USP18-related disorder showing up as recurrent febrile encephalopathy,” said Dr. Himani Pandey, part of the research team.

The study underscores the value of early genetic testing in children with unexplained neurological issues and suggests new possibilities for more focused care in the years ahead.

In a breakthrough investigation published in Nature Medicine found that GLP-1 medicines are not just weight loss drugs, but actually brain reprogramming drugs. The study highlighted how deeply GLP-1 medications influence our brain's reward circuits, cravings, and the electrical rhythm.

Case Study

The study took a 60-year-old woman who had a lifelong "food noise", and underwent deep-brain stimulation that targeted the nucleus accumbens, which is brain's craving centre. The woman was also to start tirzepatide, an antidiabetic medication used to treat type 2 diabetes and for weight loss, which is an active ingredient in Mounjaro. As she reached her full dose, her compulsive food thoughts went silent, however, five to seven months later, the neutral signal returned before her cravings did, while she was still on the medication.

How Was The Study Conducted?

Scientists from the University of Pennsylvania, monitored brain activity directly from the nucleus accumbens in people using tirzepatide.

The research followed three patients with severe food preoccupation and uncontrolled eating. Two underwent deep-brain stimulation, while the third received tirzepatide and also had electrodes implanted around the same time. When cravings or intense food thoughts occurred, researchers observed strong delta-theta waves in the nucleus accumbens. These slow brain signals are linked to reward, motivation, and compulsive eating.

Once the patient on Mounjaro reached the full therapeutic dose, the changes were dramatic: for nearly four months, they reported almost no episodes of “severe food preoccupation.” Their delta-theta activity also fell to very low levels, even during moments when cravings typically occurred. However, while initially there was a suppression in the brain activity that triggered cravings, the cravings returned over time.

Why Does This Matter?

This is the first time scientists have been able to directly record craving-related brain activity in real time and compare it before and after using a medication like Mounjaro. Although the study involved only three people, the findings help explain why medications in this class appear to influence more than just appetite. They may also reshape how the brain processes reward and desire around food.

The researchers say larger studies are needed, but early signs point to a clearer understanding of how obesity drugs change both behavior and brain biology.

What To Keep In Mind?

Dr Simon Cork, senior lecturer in Physiology, Angila Ruskin University said that there must be some caution that should be applied while looking at the findings of the study.

Dr Cork says, "This study specifically looked at a marker of brain activity associated with periods of “binge eating” in patients with obesity associated with food preoccupation. This is important because this is a specific (and rare) condition associated with obesity. They found that in three patients, periods of intense preoccupation with food was associated with a characteristic change in brain activity in a region of the brain associated with reward...While this study is methodologically very interesting, it has to be clear that this is only one patient with a very specific condition that is associated with obesity and so shouldn’t necessarily be generalised to the entire population.”

The Supreme Court of India has directed a Noida hospital to form a medical board to assess whether life-sustaining treatment can be legally withdrawn for a 31-year-old man who has been in a vegetative state for more than a decade.

This has come from the bench of Justices JB Pardiwala and KV Vishwanathan who noted the young man's condition that deteriorated over the years, despite care. The medical evaluation is now also required to be presented before the court to decide the plea. The hospital has also been told to submit its report within two weeks.

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The bench said, "We want the primary board to give us a report that life-sustaining treatment can be withheld. Once it is before us, we shall proceed to pass further orders."

What Made The Court Consider Passive Euthanasia?

This is the case of Harish Rana, whose life changed in 2013 when he suffered severe head injuries after he fell from the fourth floor from his PG accommodation while he was studying at Panjab University. He had been bedridden ever since, and survived on feeding tube. His father filed a petition seeking passive euthanasia under the guidelines Supreme Court had laid down in 2018 under Common Cause judgment. This is the second time the parents have approached the apex court.

Last year, the court also suggested that Rana could receive home-based care with support from the Uttar Pradesh government. The home-based care includes periodic visits by doctors and physiotherapists. The court suggested that in case home care was not feasible, he could be moved to Noida's district hospital. However, his parents have noted that his condition continued to worsen. Family advocate Rashmi Nandakumar also informed the bench that "nothing seems to be working out".

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"He is falling ill quite often and is repeatedly admitted to hospital," she said. The advocate further added that the family only sought passive euthanasia, which is withdrawal of treatment, and not any active intervention.

Justice Pardiwala also read medical reports and observed, "Just look at the condition of the boy. It's pathetic."

What Is The Common Cause Ruling?

The Common Cause ruling refers to a landmark Indian Supreme Court judgment that involves the NGO Common Cause. This is a 2018 case that recognized 'right to die with dignity' and legalized passive euthanasia and living will.

Under the ruling, a request for passive euthanasia must be evaluated by a primary medical board and if the board concludes that treatment could be withdrawn, a secondary board will be constituted to verify the decision before taking a final call.

The registry has been instructed to send Thursday’s order to the Noida hospital and to the office of Additional Solicitor General Aishwarya Bhati.

A Legal Journey To Die With Dignity

Rana’s parents have been navigating an incredibly tough journey, caught between differing medical opinions and strict legal requirements. In July 2023, the Delhi High Court declined their request for a medical board, saying Rana did not fall under the criteria for passive euthanasia because he was not on mechanical life support.

The Supreme Court later agreed that he wasn’t being kept alive by machines since he could breathe on his own and was being fed through a tube. But the judges also recognized the overwhelming strain on his elderly parents, who have even sold their home to keep his care going.

By November 2023, the court again suggested that he could be cared for at home, but still did not allow treatment to be withdrawn.

Now, as Rana’s condition worsens and his parents struggle to manage, the court has taken a more urgent stance. It has ordered a thorough medical evaluation to understand whether continuing treatment is simply prolonging his suffering rather than helping him recover.

What Does India Say About Passive Euthanasia?

India permits passive euthanasia under strict guidelines, and legalizes only the withdrawal of life support for terminally ill patients. One of the key cases also includes the Aruna Shanbaug Case (2011).

Shanbaug was an Indian nurse who was attacked and strangled in 1973. This attack left her in a persistent vegetative condition for 42 years until her death in 2015. She was admitted in the same hospital she worked as a nurse, at KEM Hospital in Mumbai. The case was brought by her friend, who petitioned the Supreme Court of India to end her life through passive euthanasia. The court, in a landmark judgment, allowed passive euthanasia, and also set new guidelines for the legality of euthanasia in India.