Ozempic, a used drug to treat diabetesis attracting the attention of celebrities, a tech mogul and TikTok influencers have reportedly taken it to lose weight in a short period of time.
The Food and Drug Administration (FDA) first approved this injectable drug for the treatment of diabetes in 2017; the agency has approved a drug with a higher dose of the active ingredient in Ozempic, called semaglutide, to treat obesity in 2021, under the Wegovy brand.
Since then, drug talk has been popping up all over the internet. When asked about his appearance of him being “muscular, healthy and fit,” Elon Musk tweeted that he was taking Wegovy.
Talk show host Andy Cohen has posted about the growing popularity of the Ozempic. In September, Variety magazine reported that actors and producers were “quietly singing the drug’s praises” on Signal, an encrypted messaging app.
In Tick tockthe #Ozempic hashtag was viewed more than 273 million times, with people alternately expressing surprise at the drug’s alleged weight loss and swapping stories about the side effects.
Now, the FDA has included both Ozempic and Wegovy on the list of drugs that in short supply. A representative of Novo Nordisk, which makes the drugs, wrote in a statement that the company is experiencing “intermittent supply disruptions of various doses of Ozempic due to the combination of a incredible request with the general limitations of world supply”.
The rep added that Wegovy’s shortage will likely be resolved soon and that the company is “on track” to have all doses of the drug available in December.
It’s not unusual for doctors to prescribe drugs for “off-label” use or for a purpose other than what the drug is explicitly intended for, said Disha Narang, an endocrinologist at Northwestern Medicine Lake Forest Hospital.
As interest in Ozempic grows, some doctors believe that more people are looking for ways to take the drug for weight loss, either by finding a prescriber or searching for it on the Internet.
Narang has seen patients “who somehow managed to achieve this” taking the drug for a different purpose than its original purpose, he said. (Narang was previously on an advisory group for Novo Nordisk, a standard practice for industry experts.) He worries that as the drug becomes more popular, people will associate it with “vanity” and not see it as a crucial drug for diabetic patients.
Here’s what we know about what the drug can and can’t do, and who should take it.
How does Ozempic work?
Both Ozempic and Wegovy are to be injected once a week in the abdomen, thigh or arm.
Semaglutide lowers blood sugar levels and regulates insulin, which is crucial for people with type 2 diabetes. The drug also mimics a hormone called glucagon-like peptide-1 that we naturally produce in the gut to curb appetite signaling to the body that we are full and making the stomach empty more slowly.
As a result, people with obesity and related health problems lost weight while taking it. Janice Jin Hwang, chief of the division of endocrinology and metabolism at the University of North Carolina School of Medicine, observed that people feel full more quickly. In patients taking the drug, “foods that used to be very appealing to them aren’t anymore,” she said. The drug has not been significantly studied in people without diabetes or without excess weight.
The drug may also reduce the risk of cardiovascular disease in people with diabetes, said Robert Gabbay, medical and scientific director of the American Diabetes Association.
The FDA has not approved Ozempic for weight losssaid Andrew Kraftson, associate clinical professor in Michigan Medicine’s division of metabolism, endocrinology and diabetes. But after the FDA approved Wegovy for weight loss, demand for the drug was such that some suppliers they appealed to Ozempic not being able to get the Wegovy, he explained.
Just as some people are prescribed drugs to treat high blood pressure or high cholesterol indefinitely, some obesity patients may be prescribed drugs like Wegovy for an ongoing period, Kraftson explained. Those who stop taking the drug can regain the weight they lost while taking Wegovy, she added.
“These drugs weren’t designed for people of normal weight who want to get super thin,” Hwang said.
Who should take Ozempic and Wegovy?
After the FDA approved Ozempic for people with type 2 diabetes, the FDA approved Wegovy for obese or overweight adults with at least one “weight related problem”, which, according to the body, are conditions like high blood pressure, type 2 diabetes, or high cholesterol. The FDA defines obesity and overweight by body mass index, a widely used but also questioned indicator.
The drug is expensive without health insurance: the list price for Wegovy is higher than $1,300 for 28 daysand the Ozempic can cost a little $892 per month without insurance — and people who don’t meet FDA criteria will likely have a hard time getting insurance to cover it.
Despite these hurdles, more people using unauthorized Ozempic could exacerbate the shortage, Narang said, noting that patients with diabetes and obesity have difficulty accessing it. “Patients don’t know where to turn,” she said.
“While acknowledging that some healthcare professionals may prescribe Ozempic for patients whose goal is weight loss, depends on good clinical judgment It is up to each healthcare provider to choose the best treatment strategy for their patients,” a Novo Nordisk representative wrote in a statement, adding that the company does not “promote, suggest or encourage the off-label use of our medicines.”
What are the side effects?
People taking Ozempic and Wegovy, whether for FDA-approved or off-label use, can experience nausea and dehydration. They may also experience fatigue and discomfort. Bowel movements can change, with some patients experiencing diarrhea and others experiencing severe constipation.
“The problem can be so bad that people have to deal with it emergencies“This is no joke,” Kraftson said. “Patients should be monitored while taking these medications, he added, and doctors may prescribe anti-nausea medications and laxatives or stool softeners.
In rare cases, the drug may increase the risk of pancreatitis, a painful condition that inflames the pancreas. Some patients may also form gallstones. Gabbay said he has seen some patients vomit so badly that they have had to stop taking the drug.
Doctors often start patients on a low dose of drugs like Ozempic and Wegovy and then gradually increase the dose to minimize these side effects, Gabbay said.
Is unauthorized use dangerous?
Doctors say there isn’t enough evidence to know whether these drugs are helpful or dangerous for people who don’t meet FDA criteria. As tempting as the prospect of a weight-loss drug is, experts point to the risk of people seeking the drug for a use not originally intended.
People taking Ozempic and Wegovy should be closely monitored, Kraftson said. “If you buy this over the Internet, you won’t get the same degree of protection,” he added. “I don’t want people playing roulette with their health.”
The drug hasn’t been systematically tested in people with lower body weights, Hwang said, and it’s possible that patients outside the drug’s intended group will experience more intense side effects. Without further research, it’s unclear how harmful these side effects could be.
“Going into the unknown is associated with some potential risk,” Gabbay said. “And we don’t know what it is.”
The New York Times. Special
Translation: Elisa Carnelli
PS
