These drugs can help you lose weight, but diabetics need them too

The '90s were filled with bizarre weight-loss trends. From the Fletcher Doctrine to eating a grapefruit with every meal, people have resorted to various methods to shed some extra pounds. With only a handful of known medical advances in obesity management—many of which quickly lost the support of the Food and Drug Administration—various weight loss strategies were inevitable. Head to work with ankle weights, a cup of coffee, and a frozen WeightWatchers lunch (with Kelly Ripa and her “Dancin' on Air” exercising) is simply not present in today's weight management trends. But why is progress so slow?

Science's metaphorical pendulum swings toward shortcuts — like pills, surgery, or even engineered food. It really took off in the early 2000s, when doctors and scientists collaborated to develop breakthrough technologies to combat the growing obesity epidemic in a cost-effective and easy-to-use manner. For example, sleeve gastrectomy is a popular bariatric surgery for people with a body mass index over 35 and is covered by most health insurance providers.

Yet nearly half of Americans are now classified as obese, and that number is rising. The above-normal population condition has sparked a new weight loss trend that is distinct and dangerous from others: semaglutide injections are only a matter of time.

Semaglutide, commonly known by the brand name Ozempic, is a type 2 diabetes drug that works by increasing insulin secretion, which in turn lowers blood sugar levels. Originally created and manufactured by the pharmaceutical company Novo Nordisk in 2012, Ozempic has shown incredible results in the treatment of type 2 diabetes. However, the significant side effects of weight loss have not gone unnoticed. Participants in Ozempic clinical trials showed a 15% reduction in their overall body weight while improving physical function.

As expected, the FDA recently approved semaglutide under the trade name Wegovy for weight loss management in obese people. Since its approval in summer 2021, semaglutide has soared in popularity. However, a large part of this popularity comes from the wrong crowd.

Without health insurance, a monthly dose of semaglutide (sold as a pen injector) can cost nearly $1,000 out of pocket. That price tag isn't out of reach for Hollywood A-listers using semaglutide to shed those last few stubborn pounds. While few celebrities have publicly disclosed their recreational use of semaglutide, Elon Musk took to Twitter Shows a noticeably slimmer body thanks to (parts of) Wegovy. Injections have even made their way onto Gen-Z-heavy platform TikTok as a weight-loss trend.

Recreational use of semaglutide is not in itself selfish. But it turns me off when Ozempic and Wegovy are in severe shortage. Diabetic and obese people who relied on semaglutide before it became famous are now caught in a shortage they didn't cause.

Insurance also has a role to play in this crisis. Insurance companies are transitioning to stingy plans that only cover small doses, forcing non-recreational users to ration doses. Furthermore, unprecedented indicators of advanced diabetes are required to maintain coverage. To make matters worse, people are turning to telemedicine companies for non-FDA-approved alternatives to Ozempic.

For the average person who needs semaglutide to maintain their health, the Ozempic and Wegovy crisis is a slap in the face. University of Michigan undergraduates with health problems indicated by semaglutide were no exception.

Both State Street Walgreens and CVS, two popular pharmacies with UM students, have experienced periodic inability to fill semaglutide prescriptions. In an interview with The Michigan Journal, pharmacist technologist Derek Plew shared how the drug epidemic is affecting those who rely on prescription drugs.

“There's nothing we can do at the moment,” Plew said. “We must respect doctors' prescriptions for semaglutide, regardless of whether the person at number 42 on the list ‘needs it' more than the person at number 3.”

The Ozempic shortage is eerily similar to the Adderall shortage in 2019, when college students who needed the drug couldn't get it. Clearly, University Health Services should step in to ensure that students, especially obese and diabetic out-of-state students, can source semaglutide in Ann Arbor during the shortage. Without it, uncontrolled diabetes can lead to glaucoma, heart disease, and painful neuropathy; it's simply not fair that the University only provides paper pharmacy services without guaranteeing the necessary medications to help some of our students lead healthy, successful lives of.

At the national level, Americans' confidence in timely access to resources for marginalized health conditions is undoubtedly declining. In an era of misconceptions surrounding the “self-harm” of obesity and diabetes, it is vital that these drugs are available for their original, protected uses. Now is the time for regulations to ensure the supply of other medicines before the government steps in. Previous policy resolutions, such as the Department of Health and Human Services' regional drug distribution and ending pre-authorization requirements for minors, offer a promising start to keeping weight-loss drugs in circulation. There is an irony in the lack of urgency and commitment to protecting the obese and diabetic by those empowered to help.

Human psychology does not change. We cannot rely on people's moral compass to self-assess their real need for semaglutide. Actionable steps must be taken at the government and UM level to prevent future shortages of the next in-demand drug. The ozone layer causes a public health crisis to collide at a time of limited resources: uncooperative insurance companies, buying prescription drugs from the wealthy, and a lack of government intervention. As long as the responsible distribution of all medicines remains on the fringes of the government and Big Pharma's agenda, a healthier America is at a standstill.

Moses Nelapudi is an opinion columnist and can be reached at nelapudi@umich.edu

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