Ozempic, originally developed as a diabetes treatment, has garnered significant attention for its unexpected role in weight loss, drawing interest from celebrities, tech figures, and TikTok influencers who have shared their experiences with rapid weight loss while using it.
Approved by the Food and Drug Administration (FDA) in 2017 for diabetes management, Ozempic contains semaglutide as its active ingredient. In 2021, a higher-dose version of semaglutide, marketed as Wegovy, received FDA approval specifically for treating obesity. Since then, the drug has been making waves across various online platforms. Elon Musk even mentioned taking Wegovy when asked about his impressive physical condition. Andy Cohen discussed the growing popularity of Ozempic, while Variety reported that actors and producers were privately praising the drug on Signal, an encrypted messaging app. On TikTok, the hashtag #Ozempic has amassed over 273 million views, with users sharing stories of their purported weight loss and discussing potential side effects. Soon, thousands of people in Britain will have access to Wegovy as well.
However, Ozempic and Wegovy are not the only medications gaining recognition for their weight loss effects. Mounjaro, a diabetes drug produced by Eli Lilly, is also in demand. The company highlights significant weight loss results in trials using tirzepatide, the active component of Mounjaro, for individuals dealing with obesity and diabetes. Furthermore, similar drugs that employ a mechanism akin to Wegovy and Ozempic are currently under development.
Doctors occasionally prescribe medications for “off-label” purposes, which means using them for something other than their intended use. Dr. Disha Narang, an endocrinologist at Northwestern Medicine Lake Forest Hospital, notes that as interest in Ozempic grows, more individuals may seek to use the drug for weight loss. This could involve either finding a physician willing to prescribe it off-label or attempting to obtain the medication online. Dr. Narang has personally encountered patients who have acquired Ozempic off-label.
However, she expresses concern that as the drug’s popularity surges, people might start perceiving it as a tool for vanity rather than a crucial medication for managing diabetes.
Here’s what we understand about the capabilities and limitations of this medication, as well as who it is suitable for.
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How does Ozempic work?
Ozempic, also known as semaglutide, is a medication used primarily to manage diabetes. It belongs to a class of drugs called GLP-1 receptor agonists, and its primary mechanism of action involves regulating blood sugar levels. Here’s how Ozempic works:
- GLP-1 Mimicry: Ozempic mimics the action of a natural hormone called glucagon-like peptide-1 (GLP-1) that is produced in the intestines in response to food intake. GLP-1 plays a crucial role in regulating blood sugar levels after meals.
- Blood Sugar Control: When you inject Ozempic, it acts as an agonist, binding to the GLP-1 receptors in the body. This action stimulates the release of insulin from the pancreas in response to elevated blood sugar levels. Insulin helps transport glucose from the bloodstream into cells, reducing blood sugar levels.
- Slowing Gastric Emptying: Ozempic also slows down the rate at which the stomach empties its contents into the small intestine. This delay in gastric emptying helps control the post-meal rise in blood sugar levels by allowing for a slower absorption of nutrients.
- Appetite Suppression: Some GLP-1 receptor agonists, including Ozempic, have been associated with appetite suppression. This can lead to reduced food intake and potential weight loss.
- Reduced Glucagon Production: Ozempic also decreases the production of glucagon, another hormone that raises blood sugar levels. Lower glucagon levels contribute to better blood sugar control.
In summary, Ozempic helps manage diabetes by regulating blood sugar levels through several mechanisms, including increasing insulin release, slowing gastric emptying, suppressing appetite, and reducing glucagon production. It is typically prescribed to individuals with type 2 diabetes who require better blood sugar control, and it may also have the side effect of promoting weight loss in some people. However, it should only be used under the guidance of a healthcare professional.
“They shape the public discourse around how we see these drugs” @lhfang outlines the coordinated campaign to get Americans on Ozempic to treat obesity pic.twitter.com/be0yvKaQub
— Russell Brand (@rustyrockets) October 2, 2023
Who is supposed to take Ozempic and Wegovy?
After the FDA approved Ozempic for individuals with Type 2 diabetes, it subsequently approved Wegovy for adults dealing with obesity or excess weight who also have at least one “weight-related condition” such as high blood pressure, Type 2 diabetes, or high cholesterol. The FDA employs the Body Mass Index (BMI) as a measure to define obesity and overweight, although this metric is widely debated.
Both medications come with a substantial price tag when not covered by insurance. Wegovy’s list price exceeds $1,300 for a 28-day supply, while Ozempic can cost around $892 per month without insurance. Unfortunately, individuals who do not meet the FDA’s criteria may struggle to get insurance coverage for these drugs.
Dr. Narang has noted that the increasing use of Ozempic off-label may be contributing to the shortage of the medication. This shortage is affecting patients dealing with diabetes and obesity, leaving them with limited options for treatment.
Patients facing these challenges are in search of solutions, as access to these medications becomes increasingly difficult. However, it’s important to note that while some healthcare providers may prescribe Ozempic for weight loss, the choice of treatment approach ultimately lies with the clinical discretion of each healthcare provider.
Novo Nordisk, the manufacturer of Ozempic, has stated that it neither promotes nor encourages the off-label use of its medications. They emphasize that healthcare providers make individualized treatment decisions for their patients.
In summary, the rising demand for Ozempic for off-label use, combined with the high cost of these medications and insurance limitations, has created significant challenges for individuals seeking treatment for diabetes and obesity.
What are the side effects?
Individuals using Ozempic and Wegovy, whether for FDA-approved or off-label purposes, may encounter a range of side effects. These can include nausea, dehydration, fatigue, and a general feeling of malaise. Changes in bowel movements are also common, with some experiencing diarrhea while others may suffer from severe constipation. In some cases, these side effects can be so severe that individuals seek emergency medical attention.
It is crucial for patients taking these medications to be closely monitored by healthcare professionals. Doctors may prescribe anti-nausea medications as well as laxatives or stool softeners to alleviate these side effects. In rare instances, there is a potential increased risk of pancreatitis, a painful inflammation of the pancreas, and the formation of gallstones. Some individuals may experience such severe vomiting that they must discontinue the medication. In extreme cases, prolonged use of these medications can lead to malnourishment due to a reduced intake of nutrients.
To minimize these side effects, doctors often initiate treatment with a lower dosage of medications like Ozempic and Wegovy, gradually increasing it as the patient’s tolerance develops. This approach helps patients better manage the side effects associated with these medications.
Is off-label use of these medications dangerous?
According to medical experts, there is insufficient evidence to determine the potential benefits or risks of using drugs like Ozempic and Wegovy for individuals who do not meet the FDA’s criteria. While the idea of a weight loss medication may be enticing, experts strongly discourage individuals from seeking these drugs for off-label use. Monitoring by healthcare professionals is essential for individuals taking Ozempic and Wegovy, as these medications can have significant side effects.
Dr. Kraftson emphasized the importance of close monitoring, warning against obtaining these medications online, as it lacks the layers of medical oversight necessary for safe use. He urged against individuals taking unnecessary risks with their health.
Additionally, these drugs have not been systematically studied in individuals with lower body weights, which means that those outside the intended patient group may experience more severe side effects. The extent of potential harm from these side effects remains uncertain without further research.
Dr. Gabbay emphasized that venturing into uncharted territory carries potential risks, and the full extent of these risks remains unknown.
