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Should diabetes drug Ozempic be used for weight-loss?

Semaglutide or Ozempic, one of the popular brand names for the diabetes drug, is increasingly being used for weight-loss. Is it safe?

An Ozempic injection helps the pancreas release more insulin when your blood sugar is high
An Ozempic injection helps the pancreas release more insulin when your blood sugar is high (iStock)

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Imagine not getting the life-altering drug you desperately need because celebrities and wealthy people want it to lose weight. That is happening now with the drug Ozempic, generically known as semaglutide or under different brand names like Wegovy. This wonder drug has been sweeping the world over the past two years; however, I only just heard about it at the 2023 Oscars, where Jimmy Kimmel made a joke, saying, “Everybody looks so great. When I look around this room, I can’t help but wonder ‘Is Ozempic right for me?”

The weekly injection, according to its website, has three different jobs. The first is to help the pancreas to release more insulin when your blood sugar is high, the second to alert your liver to stop making and releasing too much sugar, and finally, slow down “gastric emptying,” which is how long it takes your food to digest and leave your stomach. Delaying gastric emptying is what makes you feel fuller longer. People have reported becoming disinterested in food and having to remind themselves to eat. The common side effects of taking Ozempic are related to delayed gastric emptying, such as nausea, constipation, diarrhoea, stomach pain, and vomiting.

Here’s what is interesting, however. Ozempic isn’t marketed as a weight-loss medication, nor has it been approved by the USFDA to do so; only its cousin, Wegovy has. It’s a drug meant to treat Type 2 diabetes; it just so happens that it can help people lose weight. The New England Journal of Medicine reported that a semaglutide study showed that participants with Type 2 diabetes, drug and lifestyle changes over 68 weeks, showed an average drop of over 14% in body weight. However, for those suffering from Type 2 diabetes, it’s a game changer for their health and lifestyle. Type 2 diabetes is a disease that affects 6.28% of the world’s population, according to the Journal of Epidemiology and Global Health, which, back in 2020 when this article was published, equates to approximately 462 million people.

Type 2 diabetes is characterized by the pancreas not producing enough insulin to help drive glucose into your cells, which means that constantly high levels of circulating blood glucose can wreak havoc on your circulatory, nervous, and immune systems. There is no cure for Type 2 diabetes, but lifestyle changes, diet, and exercise, are always prescribed to help someone manage it, and if those measures cannot help, medication such as metformin can be prescribed. According to Diabetes UK, losing weight for those under the risk of developing Type 2 Diabetes can benefit health, as extra weight can contribute to insulin resistance. And a little bit will do you wonders; according to Diabetes UK, even a 5% decrease in body fat will help tip the scales in your favour.

However, the rest of the world wants Ozempic now, not for diabetes but for stubborn weight or simply because conventional slow-burn methods such as diet and exercise aren’t appealing. People are flocking to doctors for prescriptions for its unintended use, leaving an unintended problem in the marketplace—there isn’t enough for those who need it. The word is getting out not because doctors are pushing it but because social media may be driving the trend. The hashtag #ozempic on TikTok had over 350 million views. It’s everywhere but nowhere at all once, and everyone wants it.

According to an article released by NPR, the hard-to-get weekly injection could now run someone over $1,500 a month, a hefty sum in the current economic climate, considering it used to cost $25. I checked a few prices in India, and single injections ranged from 10,000 - 30,000. It’s a solution that’s not for the masses.

Doctors and nutritionists are starting to voice some concerns to the public. First, as discussed, the drug is no longer available for those who need it the most; that’s a moral issue that I think that each individual taking it without Type 2 diabetes must be personally reconciled with. The second is that celebrities and influencers taking this drug showcase their new physique through their work on screen or through their personal branded social media, and that distorts someone’s perception of what is ‘real’, which they will judge themselves against. Finally, the weight-loss results are temporary and last only as long as you’re on the drug. No study on this drug has lasted more than two years, and the medication itself may be a weight-loss Band-Aid; the moment you come off of it, the weight can come back on. If you have buttoned down your diet, exercise and lifestyle, you can expect a potential weight rebound.

Some celebrities have been forthcoming about their usage—Tesla CEO Elon Musk publicly tweeted that his new physique came from Wegovy, and American comedian Chelsea Handler admitted to taking Ozempic until she found out it was a diabetic drug. On the one hand, it would be responsible for all celebrities, when asked about their sudden weight-loss, to be candid about where it came from, so the public had a more realistic view of weight-loss success to stop their self-punishing diet cycle. On the other hand, celebrities are still people with their own health concerns and body image, and their right to keep this information to themselves should be respected. It could also be argued that if celebrities were upfront about not just Ozempic use but other weight-loss aids, people would be more inclined to self-administer these medications without a doctor’s oversight.

“For those of you who don’t know, gaslighting is when someone tries to convince you that your own perceptions of reality are wrong. Like when celebrities say they lost weight by drinking water, but really it’s because everyone’s on Ozempic,” Chelsea Handler has famously said.

I don’t think anyone has set out to fool anyone about their weight-loss. However, we all know that weight-loss is hard. And, if you had the opportunity to make it melt off with a weekly injection, it may seem like a tempting alternative to measuring macros or counting calories. However, there are not only side-effects but potential health risks along with potential kidney problems and thyroid cancers; one of the most talked about unfortunate results is the “Ozempic face,” characterized by sunken, sallow cheekbones from dramatic, short-term weight-loss and the skin not rebounding with elasticity. The US Dermatology Partners tells us you can fix “Ozempic face” with fillers, plastic surgery, or skin tightening procedures. Some people may feel like this is a small price to pay for having control over their physique; for some people, it’s a rabbit hole of fixing and correcting that may not be worth the effort.

However, we must remember that celebrity weight-loss results do not replace scientific observation. Studies have extolled its value to Type 2 diabetes and overweight patients, but none for people of average weight looking to get thin, and no studies to this date have extended past two years in observation. There is a lot that we don’t know, and that should be enough to give the average person pause. However, if you’re interested in trying out Ozempic, please talk to your doctor first. Self-medicating, as one doctor quoted in an article in The New York Times put it, it’s like “playing roulette with your health.”

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