Ozempic, a drug used to treat diabetes, has recently caught the eye as celebrities, a tech mogul and TikTok influencers described taking it to lose weight in a short period of time.
The Food and Drug Administration first approved the injectable drug for the treatment of diabetes in 2017; the agency approved a drug with a higher dose of Ozempic’s active ingredient, called semaglutide, to treat obesity in 2021, under the brand name Wegovy. Since then, drug talk has been popping up on the internet. Elon Musk, when asked how “fit, muscular and healthy” he looks, tweeted that he was taking Wegovy. Andy Cohen job on the growing popularity of Ozempic. In September, Variety reported that cast and producers are “quietly singing the praises of drugs” on Signal, an encrypted messaging app. On TikTok, the hashtag #Ozempic has been viewed more than 273 million times, with people alternately expressing shock at their supposed drug-induced weight loss and swapping stories about side effects.
Now the FDA has listed both Ozempic and Wegovy as two of dozens of drugs in short supply. A representative from Novo Nordisk, which manufactures the drugs, wrote in a statement that the company is experiencing “intermittent supply disruptions on various doses of Ozempic due to a combination of incredible demand coupled with supply constraints. global worlds”. The representative added that the Wegovy shortage should resolve soon and that the company is “on track” to make all doses of the drug available in December.
It’s not unusual for doctors to prescribe drugs for “off-label” use or for purposes other than what the drug is explicitly intended for, said Dr. Disha Narang, an endocrinologist at Northwestern Medicine Lake Forest Hospital. As interest in Ozempic has grown, some doctors believe more and more people have been looking for ways to take the drug for weight loss, either by finding a doctor who would prescribe it for them off-label or by researching the drug on line. Dr. Narang herself has seen patients “who somehow got their hands on it” taking the off-label drug, she said. (Dr. Narang previously served on an advisory board for Novo Nordisk, a common practice for experts in the field.)
She fears that as the drug becomes more popular, people will associate it with ‘vanity’, not an essential drug for diabetic patients.
Here’s what we know about what the drug can and can’t do and who should take it.
How does Ozempic work?
Both Ozempic and Wegovy are designed to be injected once a week into the stomach, thigh, or arm.
Semaglutide lowers blood sugar and regulates insulin, which is crucial for people with type 2 diabetes. The drug also mimics a hormone called glucagon-like peptide-1 that we naturally produce in our intestines. , curbing appetite by signaling our bodies that we feel full and prompting our stomachs to empty more slowly. As a result, obese people and the accompanying health problems lost weight by taking it. People feel full faster, said Dr. Janice Jin Hwang, chief of the division of endocrinology and metabolism at the University of North Carolina School of Medicine. For patients on medication, “foods that used to be really exciting for them aren’t anymore,” she said. The drug has not been studied significantly in people without diabetes or excess weight.
The drug may also reduce the risk of cardiovascular disease in people with diabetes, said Dr. Robert Gabbay, scientific and medical director of the American Diabetes Association.
The FDA has not approved Ozempic for weight loss, noted Dr. Andrew Kraftson, associate clinical professor in the division of metabolism, endocrinology and diabetes at Michigan Medicine. But after the FDA cleared Wegovy for weight loss, there was such demand for the drug that some suppliers turned to Ozempic when they couldn’t get Wegovy, he said.
Just as some people are prescribed drugs to treat high blood pressure or high cholesterol indefinitely, some obese patients may be prescribed drugs like Wegovy for an ongoing period, Dr. Kraftson said. Those who stop taking the drug can regain the weight lost during treatment with Wegovy, he added.
“These drugs weren’t designed for normal-weight people who want to get super thin,” Dr. Hwang said.
Who is supposed to take Ozempic and Wegovy?
After the FDA approved Ozempic for people with type 2 diabetes, the agency approved Wegovy for adults who are obese or overweight with at least one “weight-related condition,” which the agency agency considers problems such as high blood pressure, type 2 diabetes or high cholesterol. The FDA defines obesity and overweight using body mass index, a well-established but widely debated measure.
The drug is expensive without insurance — Wegovy’s list price is over $1,300 for a 28-day supply, and Ozempic can cost around $892 for a monthly supply without insurance — and people who don’t meet the criteria for FDA will likely have a hard time getting insurance to cover it.
Despite these obstacles, the increase in the number of people using Ozempic off-label could worsen the shortage, Dr. Narang said, noting that patients with diabetes and obesity are struggling to access it.
“It was really, really terrible – patients don’t know where to turn,” she said. “We’ve been like hamsters in a wheel trying to figure this out.”
“While we recognize that some health care providers may prescribe Ozempic to patients whose goal is to lose weight, it is up to each health care provider’s clinical discretion to choose the best treatment approach for their patients. “, said a representative of Novo Nordisk. wrote in a statement, adding that the company does not “promote, suggest or encourage the off-label use of our medicines.”
What are the side effects?
People taking Ozempic and Wegovy for FDA-approved and off-label use may experience nausea and dehydration. They may also experience fatigue and discomfort. Their stools may change, with some patients experiencing diarrhea and others becoming severely constipated. “It can be so bad that people go to the emergency room,” Dr. Kraftson said. “This is not a joke.” Patients should be monitored while taking these drugs, he said, and doctors may prescribe anti-nausea drugs and laxatives or stool softeners. In rare cases, the medicine could increase the risk of pancreatitis, a painful condition that inflames the pancreas. Some patients may also form gallstones. Dr. Gabbay said he had seen patients with vomiting so severe that they had to stop taking the drug.
Doctors usually start patients on a lower dose of drugs like Ozempic and Wegovy, then increase them gradually, to minimize these side effects, Dr. Gabbay said.
Is off-label use of these drugs dangerous?
Doctors say there is not enough evidence to know whether these drugs could be beneficial or harmful for people who do not meet FDA criteria. As tempting as the prospect of a weight-loss drug might be, experts have warned people seeking the drug for off-label use. People taking Ozempic and Wegovy should be closely monitored, Dr. Kraftson said. “If you just put this online, there won’t be the same layers of protection,” he said. “I don’t want to see people playing roulette with their health.”
The drug has not been systematically tested in people with lower body weights, Dr. Hwang said, and it’s possible that patients outside the group the drug is intended for may experience more intense side effects. Without more research, it’s unclear how harmful these side effects might be.
“Walking into the unknown is associated with potential risk,” Dr Gabbay said. “And we don’t know what it is.”