More weight loss drugs like Ozempic and Wegovy are coming, but are they really good for us?
While other weight loss drugs are already available, including one Professor Cowley has developed himself, they return more modest results than Ozempic, with people only losing up to 5 per cent of their body weight and also suffering various side effects.
Novo Nordisk, the manufacturer of Ozempic, says it has experienced “stronger than anticipated demand” leading to worldwide shortages. Desire for the drug has been driven in part by users of social media platforms TikTok and Facebook who have raved about its effectiveness in helping them lose weight.
There have been worldwide shortages of diabetes drug Ozempic due to off label prescribing for weight loss. Source: AAP / Jason Bergman/Sipa USA
Professor Cowley said semaglutide is the first really effective drug for weight loss.
“So for the first time people who are living with obesity have a pharmaceutical option – they can actually lose meaningful amounts of body weight,” he said.
How does semaglutide work and what are its drawbacks?
Loss of muscle mass is another side effect, and it's unclear whether people regain the muscle when they stop using the drug.
It's important to keep muscle mass as you get older as it helps to keep people active. Source: Getty / FreshSplash
“You can imagine you end up in this cycle of weight loss and weight regain … that erodes your muscle mass. And we know that muscle mass is the most important thing to keep as you age,” Professor Cowley said.
While social media posts suggest celebrities and other healthy weight people are also using Ozempic to drop a few kilos, Professor Cowley said the drug had not been tested in people who are not overweight, so the health impacts on them were unclear.
Ozempic posts are prolific on TikTok.
Debate around shortages has ‘vilified' people with obesity
Novo Nordisk, the manufacturer of Ozempic and Wegovy, said more supplies of Ozempic were due to become available in Australia by the end of March but it's unclear how long it will take to get Wegovy.
But Ms Petre said there was hope the development of Ozempic would also raise awareness about biological drivers of obesity, and correct the misconception that losing weight to improve health was just about willpower.
There's been this real misconception that people are just taking Ozempic because they want to be skinny.
The Obesity Collective director Tiffany Petre
According to The Obesity Collective, obesity stigma is associated with physical and mental health consequences including depression and anxiety, disordered eating, and decreased self-esteem. It also leads to inequities in employment, health care and educational achievement.
People living with obesity face harmful stereotypes
“I feel like we have to really prove ourselves more than other people do because of our weight, I feel we have to go the extra mile to prove that we are good at our job,” he said.
Andrew Wilson says people living with obesity face stigma. Source: Supplied
Mr Wilson, who is living with obesity, hoped the discussion around Ozempic would make people interested in learning more about obesity and its causes.
Mr Wilson has welcomed more treatment options like Ozempic as long they are readily available. But at the moment this is not the case.
No subsidy for weight loss drugs
But those who have obesity with a doctor's prescription to use Ozempic for weight loss, have to pay up to $200 for a month's supply as they are buying it off-label for a different use.
People are paying up to $200 a month for Ozempic if they want to use it for weight loss.
A spokeswoman for the Federal Department of Health and Aged Care said a medicine can't be listed on the PBS unless it is recommended by the independent expert Pharmaceutical Benefits Advisory Committee (PBAC).
Professor Cowley said drugs like Wegovy should be subsidised as losing weight was good for patients, making them healthier and costing the economy less.
“I hope that we can de-stigmatise the disease to the point where we can use PBS to support the interventions, whatever drug people want to use, or whatever surgical people want to use, because it's beneficial to society,” he said.
How do weight loss drugs impact mental health?
“There's evidence [of] psychological outcomes, like increased depression for those that have taken weight loss drugs, but [who] then cease that and then regain that weight,” Dr Messer said.
“You may lose weight, you may improve your physical health but also be aware that weight loss is not everything and you can value yourself in other ways.”
What do new drugs like Ozempic mean for ‘fat acceptance' and ‘body positivity'?
Organisations such as the National Association to Advance Fat Acceptance in the United States, which aims to change perceptions of fat and end size discrimination, are already warning that drugs like Ozempic risk entrenching stigma and activists fear people may be pressured to take them if they want access to the same rights as those who are non-fat.
Lizzo has urged people to uplift the “big” bodies that created the body positivity movement. Source: AAP / AP / Charles Sykes
‘No silver bullet': Lifestyle intervention should still be the first step
Obesity expert Dr Nicholas Fuller of the University of Sydney, said the first step for anyone seeking to lose weight for health reasons should be lifestyle intervention.
But Dr Fuller said drugs like Ozempic should only be used after multiple failed attempts at lifestyle intervention first. He noted Ozempic stopped working once people stopped taking it, and so people still had to make changes to their lifestyle, their eating habits, activity and sleep routine.
As a population we're always looking for that next thing, we're always looking for the quick fix, we want the magic bullet, we want to lose the weight now.
Dr Nicholas Fuller, University of Sydney