What to know about Ozempic, Wegovy and the new weight loss market

Pop culture continues to shed light on Ozempic, a diabetes drug, and its weight-loss counterpart, Wegovy. Because of society’s jagged relationship with diet pills, some people are asking questions about the drugs: whether they’re safe enough, whether they’re even ethical to take, and who should be using them in the first place.

The answers may depend on why you started taking them and whether you are able to continue taking them. Semaglutide injections (the ingredient in both drugs) are currently on the United States Food and Drug Administration’s shortage list. Compared to previously marketed weight-loss drugs, Ozempic and Wegovy appear to be safer, despite common side effects such as nausea and vomiting, said Dr. Christoph Buettner, professor of medicine and chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School.

“It doesn’t seem like there’s really anything comparable right now,” Buettner said, with the exception of Mounjaro, which is currently approved for diabetes but expected to be approved for weight loss soon.

Ozempic and Wegovy are both relatively new to the market and carry risks of rare and more serious side effects on their labels, including thyroid cancer and pancreatitis. Like medications for other health conditions, Ozempic and Wegovy are meant to be chronic medications—ones that only work while you’re taking them. With this come both benefits and risks.

“There’s no free lunch, so to speak,” Buettner said.

What are Ozempic and Wegovy? How do they work?

Ozempic and Wegovy are similar drugs that contain the same active ingredient, semaglutide, although Wegovy contains a higher amount and is FDA-approved specifically for weight loss. Ozempic was first approved for the treatment of type 2 diabetes, but is also used off-label as a weight loss drug in some cases. Both are weekly injected drugs that you administer in a similar way to how you would use an EpiPen, and both are made by the same pharmaceutical company, Novo Nordisk.

Semaglutide works by interfering with the production of insulin and stabilizing blood sugar levels. This causes food to move more slowly as it leaves the stomach and decreases appetite, changing the body’s response to hunger and fullness.

The bodies of people with type 2 diabetes cannot process insulin properly, and Ozempic’s main goal is to control blood sugar levels, while also reducing the risk of heart disease, stroke, and other health events that people with type 2 diabetes suffer from. diabetes are more likely to experience. In terms of blood sugar management – the goal of type 2 diabetes treatment – semaglutide has been shown to be very effective in studies.

Wegovy is also effective under its approved use as a weight loss drug for adults with a body mass index over 27 and at least one health condition, such as high blood pressure, as well as adults with a BMI over 30. Compared with people who received a placebo, the FDA said in its approval note, those taking Wegovy without diabetes they lost an average of 12.4% of their body weight.

But the growing popularity of Ozempic and Wegovy has ignited decades-old concerns about weight-loss drugs and weight stigma, and it’s had other unintended consequences as well, including a drug shortage.

Popular prescriptions have led to a shortage

High demand for Wegovy turned into increased demand for Ozempic, as some people who couldn’t get Wegovy turned to its low-dose sister drug meant to treat diabetes prescribed off-label by their doctors.

It makes sense that many people would be able to get these prescriptions: According to the US Centers for Disease Control and Prevention, about 73 percent of US adults had a BMI in the range of overweight or obesity in 2017-18. BMI is an imperfect and often inaccurate indicator of health, but it is used to define obesity, which the CDC considers a chronic disease.

That high demand, similar to other drug shortages, has caused problems for some diabetes patients when trying to get their prescribed Ozempic. Mounjaro, another popular drug with the active ingredient tirzepatide, is also approved for the treatment of type 2 diabetes, but is also used off-label for weight loss in some cases.

There are other treatments available for patients with diabetes, such as insulin, Buettner said. Though comparing insulin to semaglutide is a bit of a “difficult question,” she added, because while semaglutide may result in a lower risk of hypoglycemia or low blood sugar, some patients actually need insulin. . This could make comparisons difficult. As always when finding a drug replacement, talk to your doctor or pharmacist first.

There is another medicine for the treatment of diabetes with the same active ingredient, called Rybelsus, but it is taken orally. Other drugs include Vicoza, Trulicity and Bydureon, and these may be options if people with diabetes are having trouble filling up their drug prescriptions, reports Everyday Health.

The dangerous history of diet pills and their uncertain future

Semaglutide’s popularity is all too familiar to Tigress Osborn, president of the National Association to Advance Fat Acceptance. Osborn, like many fat rights and body neutrality activists and some health professionals, rejects the idea of ​​obesity as a disease. Some of the same medical frameworks used now for Ozempic and Wegovy were also in play during waves of previous diet pills, Osborn said, including Fen-Phen, a nickname for an appetite-suppressing drug that was eventually retired by the market in the late 1990s because it caused heart damage to many people who took it.

“We’ve heard it from you before,” Osborn said of the widespread support for the current wave of weight-loss drugs. “‘That’s for sure, it’s okay, it’ll make you healthier,'” he said.

In addition to causing heart problems, some previous pills have caused psychiatric side effects, such as depression, according to Buettner. Rimonabant, which has been approved in Europe and also withdrawn from the market, has been found to induce adverse mental health effects.

“When you give drugs that work in the brain, effects on depression or suicidal ideation are common,” Buettner said. Ozempic and Wegovy also work in the brain, hence their appetite-suppressing properties, but they “signal very differently” as GLP-1 receptor agonists in specific areas of the brain, she said.

Common side effects of Ozempic and Wegovy include stomach pain, nausea, vomiting, diarrhea, and other gastric symptoms. Although rare and serious side effects, including pancreatitis, have also been reported. Because weight loss also causes you to lose fat stored in your face, some people report “facial ozempico,” or a loss of some facial fat associated with a younger or more youthful appearance.

Weight stigma and its ongoing effects on health are also real factors. Weight research questions whether prescribing weight loss for health based on BMI alone is valid to begin with. THE deeply rooted prejudices against larger bodies and the constant pressure to be thin puts people in a difficult position between trying to lose weight with new tools or choosing to stay the way they are, Osborn said.

“The anti-fat breaks our hearts — your drugs actually alter our hearts,” she said. “How are we going to make a choice between these things?”

Those who choose to use these drugs face another problem: continued access. Beyond the current shortage, part of the future of these drugs depends on what insurance companies are willing to cover. Many patients have reported difficulty obtaining insurance coverage of prescription drugs when they are labeled for obesity—one example of how health care for larger bodies is complicated by cultural biases, even when the goal is weight loss. weight. That could change in the future as the catalog of weight-loss drugs grows, putting more pressure on Medicare and insurance companies to change their policies.

For people who aren’t celebrities or don’t have deep pockets and need semaglutide for their health, access is a problem. Wegovy costs about $1,400 a month out of pocket, according to NPR. A patient who cannot refill their semaglutide prescriptions could face health problems, due to lack of diabetes treatment or rapid weight gain.

Most patients will regain the weight they lost taking semaglutide when they stop, meaning it must be taken continuously to remain effective. Weight cycling, when people repeatedly lose and regain weight due to diet or other methods, is linked to various health risks, including increased mortality. Meanwhile, if you take medication to keep your blood sugar stable and then quit cold turkey, a return to high blood sugar could increase your risk of other health problems, such as stroke.

First posted February 7, 2023 at 7:00am PT.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a doctor or other qualified healthcare professional with any questions you may have about a medical condition or health goals.