Pop culture continues to focus on diabetes drug Ozempic and its weight-loss drug Wegovy. As society has had a mixed relationship with diet pills, some people have started asking questions about the drugs — whether they're safe enough, whether it's ethical to take them, and who should use them in the first place.
The answer may depend on why you started taking them and whether you are able to continue taking them. Injectable semaglutide (the ingredient in both drugs) is currently on the U.S. Food and Drug Administration's shortage list. Ozempic and Wegovy appear to be safer than earlier marketed weight-loss drugs, 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 University's Robert Wood Johnson Medical School.
“There really doesn't seem to be anything comparable at the moment,” Buettner said, except for Mounjaro, which is currently approved for diabetes but is expected to be approved for weight loss soon.
Both Ozempic and Wegovy are relatively new drugs on the market, and their labels carry the risk of rare, more serious side effects, including thyroid cancer and pancreatitis. Like medicines for other health conditions, Ozempic and Wegovy are designed to be chronic medicines — medicines that only work as long as you take them. With that come benefits and risks.
“It can be argued that there is no such thing as a free lunch,” Bittner said.
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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 higher amounts and is FDA-approved specifically for weight loss. Ozempic was first approved to treat type 2 diabetes, but it is also used as an off-label weight loss drug in some cases. Both are weekly injections that you give in a similar way to an EpiPen, and are made by the same pharmaceutical company, Novo Nordisk.
Semaglutide works by interfering with insulin production and stabilizing blood sugar levels. This also causes food to move more slowly as it leaves the stomach and reduces appetite, which changes how the body responds to hunger and fullness.
In people with type 2 diabetes, whose bodies cannot process insulin properly, the main goal of Ozempic is to control blood sugar levels while reducing the risk that people with diabetes are more likely to suffer from heart attacks, strokes, and other health events. In controlling blood sugar (the goal of type 2 diabetes treatment) , semaglutide proved to be very effective in trials.
Wegovy is also effective to the extent that it is approved for use as a weight loss BMI Adults over the age of 27 with at least one medical condition (such as high blood pressure) and a BMI over 30. People who took Wegovy and did not have diabetes lost an average of 12.4 percent of their body weight compared with those who received a placebo, the FDA said in its approval notification.
But the growing popularity of Ozempic and Wegovy has sparked decades of concern about diet pills and weight stigma, and has had other unintended consequences, including drug shortages.
Popular prescriptions lead to shortages
High demand for Wegovy turned into more demand for Ozempic, as some people who couldn't get Wegovy turned to its lower-dose sister drug, prescribed by doctors to treat diabetes.
It makes sense that many people can get these prescriptions: According to the Centers for Disease Control and Prevention, as of 2017-18, about 73% of U.S. adults had a BMI in the overweight or obese range. BMI is an imperfect and often inaccurate measure of health, but it is used to define obesity, which the CDC considers a chronic disease.
Similar to other drug shortages, this high demand has caused problems for some diabetics trying to get their prescription Ozempic. Mounjaro, another popular drug whose active ingredient is tirzepatide, is also approved to treat type 2 diabetes, but it is also used off-label for weight loss in some cases.
Buettner said there are other treatments available for people with diabetes, such as insulin. Comparing insulin to semaglutide is a bit of a “heavy question,” because while semaglutide may have a lower risk of hypoglycemia, or hypoglycemia, some patients do require insulin, he added. This can make comparisons difficult. As always, when looking for alternatives to medications, consult your doctor or pharmacist first.
There is another diabetes treatment drug with the same active ingredient called Rybelsus, but it is taken by mouth. Other drugs include Vicoza, Trulicity and Bydureon, which may be an option if diabetics have difficulty prescribing the drug, as Everyday Health reports.
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The Dangerous History of Diet Pills — and Their Uncertain Future
Tigress Osborn, president of the National Association to Promote Fat Acceptance, is all too familiar with the popularity of semaglutide. Like many fat rights and body neutrality activists, as well as some health providers, Osborne rejects obesity as a disease. Some of the same medical framework now used for Ozempic and Wegovy also played a role in the wave of earlier weight-loss drugs, including Fen-Phen, the nickname for an appetite suppressant drug that was eventually pulled from the market in late 2018, Osborn said. in the 1990s because it caused heart damage in many people who took it.
“We've heard it from you before,” Osborne said of the widespread support for the current wave of diet pills. “‘It's safe, it's okay, and it will make you healthier,'” she said.
In addition to causing heart problems, some early pills also caused psychiatric side effects, such as depression, Buettner said. Rimonabant, approved and withdrawn in Europe, was found to cause harmful mental health side effects.
“When you take drugs that work in the brain, the effects on depression or suicidal ideation are common,” Bitner said. Ozempic and Wegovy also work in the brain, so they have appetite-suppressing properties, but as GLP-1 receptor agonists, they “signal very differently” in specific areas of the brain, he said.
Common side effects of Ozempic and Wegovy include stomach pain, nausea, vomiting, diarrhea, and other stomach symptoms. Although rare, there have been reports of serious side effects, including pancreatitis. Because losing weight also causes you to reduce the fat stored in your face, some people report an “ozone face,” or a reduction in facial fat that is associated with a younger or more youthful appearance.
Weight stigma and its ongoing effects on health are also real factors. Weight research questions the effectiveness of prescribing weight loss for health based on BMI alone.this deep-rooted prejudice Opposition to larger bodies and constant pressure to lose weight puts people in a difficult position between trying new tools to lose weight or choosing to keep the status quo, Osborn said.
“Anti-Cellulite Therapy Broke Our Hearts – Your Drugs Actually Changed Our Hearts,” she said. “How are we going to choose between these things?”
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Those who do choose to use these drugs face another problem: continued access. Beyond current shortages, the future of these drugs depends in part on how much insurers are willing to cover them. Many patients report having difficulty obtaining insurance-covered prescription drugs when they are labeled as obese—an example of how healthcare for the larger body can be complicated by cultural biases, even when weight loss is the goal. This could change in the future as the list of weight-loss drugs grows, putting more pressure on Medicare and insurance companies to change their policies.
For those who aren't famous or deep pockets, and who need semaglutide to maintain their health, access is a problem. Wegovy's monthly out-of-pocket costs are about $1,400, according to NPR. Patients unable to refill their semaglutide prescriptions may face health challenges, either due to lack of diabetes treatment or rapid weight regain.
Most patients regain their weight when they stop taking semaglutide, which means that semaglutide must be continued to maintain its benefits. Weight cycling, when people repeatedly lose and regain weight through dieting or other methods, is associated with various health risks, including increased mortality. At the same time, if you take medication to keep your blood sugar levels stable and then quit smoking, having high blood sugar again could increase your risk of other health problems, such as stroke.
The information contained herein is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider if you have any questions about a medical condition or health goals.
