Monday Musing: Oh Oh Oh – Ozempic

Are Ozempic and Wegovy the answer to weight loss?

When I first heard about Ozempic (semaglutide), it was during its first ad campaign in which the actors all said “OH!” when supposedly learning something about what the drug could do. I admit, it irritated the heck out of me. I probably wasn’t the only one because the campaign changed. The new ads were not as obnoxious, but little did I know that I’d be hearing a lot more about Ozempic beyond those 30-second bits and it would pop up all over my newsfeeds. Suddenly, this drug is a weight loss miracle, many claimed.

First, what is Ozempic?

Ozempic is a once-weekly injectable medication marketed toward adults with type 2 diabetes. Its goal is to help improve blood glucose levels and reduce the risk of complications associated with having type 2 diabetes, such as heart attacks and strokes. The U.S. Food & Drug Administration (FDA) approved the drug in 2017. In the ads, however, at least one actor always mentions losing weight while taking it. It didn’t take long for people to pick up on that, especially when celebrities started touting the drug’s effects.

In 2021, the FDA approved Wegovy, which is also semaglutide, for “chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity.” It is also approved for teens. The difference between Ozempic and Wegovy is the dosage – the former’s highest dose is 2 mg once a week, the latter is 2.4 mg (after gradual escalation).

There is an oral form of semaglutide made by the same company that is also heavily marketed, Rybelsus, but I’ve not yet read too much about people taking it for weight loss. The FDA approved Rybelsus in 2019 to control blood sugar among people with type 2 diabetes. It’s available in 7 or 14 mg tablets. It looks like this is going to change though.

Yesterday I read the abstracts of two studies published in The Lancet that investigated semaglutide in pill form at higher doses – much higher in some cases. One study looked at how effective it was for weight loss (50 mg), the other as treatment for uncontrolled type 2 diabetes (14 mg, 25 mg, or 50 mg doses). This could be a big seller if they come to market because pills are much easier to take and carry around, especially if you travel a lot.

Are they safe?

I’m not going to get into a debate about the best ways to lose weight – there are plenty of people doing that already. What I am concerned about is these medications. Are they safe? Is the weight loss permanent? Will they cause other complications?

Using a drug for weight loss may seem like a simple thing. You take a weekly injection and the pounds come off. But what are the side effects? According to the pharmaceutical company that makes it, the most common side effects are:

• Nausea

• Vomiting

• Abdominal pain

• Constipation

• Diarrhea

There are also less common but more severe side effects that have been reported, such as:

• Hypoglycemia (low blood sugar)

• Pancreatitis

• Vision changes

• Kidney damage

• Gallbladder problems

And these are short-term – we don’t know what is coming because the drug hasn’t been around long enough. Some doctors are reporting seeing patients who are malnourished. There are also concerns about the drug worsening eating disorders.

We also can’t forget that some people should not take semaglutide because of previous or family history of certain types of medical problems. This can be dangerous if people buy semaglutide from somewhere they shouldn’t.

And what happens when you stop?

NPR looked at the cost of Wegovy, which comes in at about $1,400 per month without insurance. (Ozempic costs a little less than $1,000, according to the drug maker.) The article featured a woman whose insurance covered Wegovy and she lost 60 lbs. But she switched jobs and her new insurance wouldn’t cover it. She stopped taking the drug and the weight is coming back.

Photo by Giorgio Trovato on Unsplash

According to the manufacturer, they know that will happen. In other words, the company has you in their grip. To be fair, this happens if you stop following a diet or exercise plan too. But cutting back your food intake or exercising aren’t as pricey as these drugs, nor do they carry the same risks.

According to Karin Conde-Knapp, Novo Nordisk’s senior vice president of global drug discovery who was interviewed for the CNBC article, “…available data suggests most individuals will recover most of their weight within five years of stopping an obesity drug, and roughly 50% of their weight after two to three years.”

Then she said something else that I think most people don’t realize. “Some individuals may actually gain more weight after stopping an obesity drug than they initially lost.”

So, is it worth the risks? What do you think? Let me know in the comment section below.

[Edited at 8:45 am june 26 to clarify that this post is about using the medication for weight loss, not for treating type 2 diabetes.]