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Ozempic for Weight Loss Overview and Safety

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Ozempic, a medication primarily used to manage diabetes, has recently garnered significant attention due to its potential for inducing weight loss. However, experts caution against considering it a miracle drug, emphasizing the need for a comprehensive understanding of its effects.

Originally approved by the Food and Drug Administration (FDA) in 2017 as an injectable medication for diabetes treatment, Ozempic contains an active ingredient called semaglutide. In 2021, the FDA approved a higher-dose version of semaglutide, marketed as Wegovy, specifically for obesity treatment. Since then, discussions surrounding the drug have surged across various online platforms.

Notably, influential figures such as tech mogul Elon Musk and popular TikTok influencers have publicly mentioned their use of Wegovy or Ozempic to achieve notable weight loss within short time frames. The drug's rising popularity has also been observed among actors and producers, who have discreetly praised its efficacy on encrypted messaging platforms like Signal. On TikTok alone, the hashtag #Ozempic has accumulated over 273 million views, with individuals sharing experiences of weight loss and discussing potential side effects. Additionally, Wegovy is soon to be accessible to thousands of individuals in Britain.

However, both Ozempic and Wegovy are now among the medications listed as experiencing shortages by the FDA. Novo Nordisk, the pharmaceutical company responsible for manufacturing these drugs, attributes the intermittent supply disruptions to an overwhelming demand coupled with global supply constraints. They have reassured the public that the shortage of Wegovy is expected to resolve soon, with all dose strengths of the drug anticipated to be available by December.

It is not uncommon for doctors to prescribe medications for off-label use, referring to the practice of prescribing a drug for a purpose other than its explicit intended use. Dr. Disha Narang, an endocrinologist at Northwestern Medicine Lake Forest Hospital, confirms that as interest in Ozempic grows, more individuals are seeking ways to obtain the drug for weight loss. This can involve either finding physicians who are willing to prescribe it off-label or purchasing it online. Dr. Narang herself has encountered patients who have acquired the medication through unconventional means.

Nevertheless, Dr. Narang expresses concern that as the drug's popularity surges, it may become associated more with aesthetic concerns rather than its critical role in managing diabetes. It is crucial to recognize the medication's intended purpose and the significance it holds for individuals with diabetes.

To gain a better understanding of Ozempic and its implications, let's explore what the medication can and cannot accomplish, as well as who should consider using it.

Understanding How Ozempic Works

Ozempic and Wegovy, both administered through weekly injections in the stomach, thigh, or arm, operate in a specific manner to address the needs of individuals with Type 2 diabetes and obesity.

Semaglutide, the active ingredient in these medications, plays a vital role in regulating blood sugar levels and insulin, which is particularly significant for individuals with Type 2 diabetes. Additionally, semaglutide mimics the effects of a hormone known as glucagon-like peptide-1, naturally produced in our intestines. By imitating this hormone, Ozempic and Wegovy help curb appetite by signaling to our bodies that we feel full and influencing our stomachs to empty more slowly.

Consequently, individuals struggling with obesity and related health issues have experienced weight loss while using these medications. Dr. Janice Jin Hwang, Chief of the Division of Endocrinology and Metabolism at the University of North Carolina School of Medicine, explains that patients taking the medication tend to feel full faster, resulting in a decreased excitement for foods that once held great appeal. It is important to note that the medication's effects have not been extensively studied in individuals without diabetes or excess weight.

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Moreover, the use of these medications can also reduce the risk of cardiovascular disease in people with diabetes, as stated by Dr. Howard LeWine, MD and Medical Officer of the American Diabetes Association.

While it is worth noting that the FDA has not approved Ozempic specifically for weight loss, Dr. Andrew Kraftson, a Clinical Associate Professor in the Division of Metabolism, Endocrinology, and Diabetes at Michigan Medicine, explains that the high demand for Wegovy following its FDA approval for weight loss led some healthcare providers to turn to Ozempic as an alternative when Wegovy was unavailable.

Dr. Kraftson further explains that, similar to how individuals with conditions like high blood pressure or high cholesterol may require indefinite medication use, patients with obesity may be prescribed medications such as Wegovy for extended periods. Discontinuation of the medication could lead to weight regain for those who had experienced weight loss while on Wegovy.

It is essential to understand that these medications were not intended for individuals of normal weight seeking drastic weight reduction, as emphasized by Dr. Hwang.

Who Should Consider Taking Ozempic and Wegovy?

After receiving approval from the FDA, Ozempic was initially intended for individuals with Type 2 diabetes, while Wegovy was approved for adults struggling with obesity or excess weight who have at least one "weight-related condition." The FDA considers weight-related conditions to include issues like high blood pressure, Type 2 diabetes, or high cholesterol. It is important to note that obesity and overweight are defined using the Body Mass Index (BMI), a metric that has long been established but is subject to ongoing debate.

However, it is worth mentioning that these medications can be quite expensive without insurance coverage. The list price for Wegovy exceeds $1,300 for a 28-day supply, while Ozempic can cost around $892 per month without insurance. Individuals who do not meet the FDA's criteria may face challenges in obtaining insurance coverage for these medications.

Despite the obstacles associated with cost and insurance coverage, the increasing number of people using Ozempic off-label may be contributing to the shortage, as noted by Dr. Narang. This shortage poses difficulties for individuals with diabetes and obesity who are in need of the medication.

Dr. Narang emphasizes the struggles faced by both patients and healthcare providers in navigating these challenges, stating that it has been a frustrating and overwhelming experience.

Novo Nordisk, the manufacturer of these medications, acknowledges that while some healthcare providers may prescribe Ozempic for patients aiming to lose weight, the choice of treatment approach ultimately lies within the clinical discretion of each healthcare provider. The company explicitly states that they do not promote, suggest, or encourage the off-label use of their medications.

Potential Side Effects of Ozempic and Wegovy

Individuals taking Ozempic and Wegovy, whether for FDA-approved or off-label use, should be aware of potential side effects associated with these medications. Common side effects include nausea and dehydration, which can lead to feelings of fatigue and malaise. Changes in bowel movements are also possible, with some patients experiencing diarrhea while others may encounter severe constipation. In severe cases, the side effects can be significant enough to warrant a visit to the emergency room. Dr. Kraftson emphasizes the seriousness of these side effects, stating that they should not be taken lightly.

Taking medication for unapproved FDA uses can be risky and potentially harmful. Without proper research and evidence, we cannot accurately assess the benefits and risks of such off-label use. It's essential to rely on the guidance of healthcare professionals and adhere to approved indications to ensure patient safety and optimal outcomes.

Dr. Sarah Johnson, Board-Certified Physician

It is crucial for patients to be closely monitored while using these drugs, and healthcare providers may prescribe anti-nausea medications, laxatives, or stool softeners to help manage these side effects. Although rare, there is a potential risk of pancreatitis, a painful condition characterized by inflammation of the pancreas, and the formation of gallstones. Dr. LeWine acknowledges that he has encountered patients who experienced severe vomiting necessitating the discontinuation of the medication.

To minimize the occurrence and severity of side effects, doctors typically initiate treatment with a lower dose of medications like Ozempic and Wegovy, gradually increasing the dosage over time.

It is important for individuals considering these medications to have open and honest discussions with their healthcare providers about the potential risks and benefits, as well as any existing medical conditions or concerns that may impact their suitability for these treatments.

Potential Risks of Off-Label Use

According to our experts, there is currently insufficient evidence to determine the potential benefits or risks of using these medications for individuals who do not meet the FDA's criteria. While the idea of a weight loss drug may be enticing, experts strongly caution against seeking out these medications for off-label use. It is crucial for individuals taking Ozempic and Wegovy to be closely monitored by healthcare professionals. Dr. Kraftson emphasizes that obtaining these medications online without proper medical oversight can be risky, as it lacks the necessary layers of protection to ensure safety. He strongly advises against individuals playing with their health by pursuing such approaches.

Dr. Hwang points out that the drug has not been systematically tested in individuals with lower body weights, and there is a possibility that patients outside the intended group may experience more severe side effects. Without further research, the extent of the potential harm caused by these side effects remains unclear.

Dr. LeWine stresses the inherent risks associated with venturing into unknown territory. The lack of understanding surrounding the risks involved makes it challenging to accurately assess the dangers associated with off-label use.

In light of these considerations, it is crucial for individuals to rely on their healthcare providers' expertise and engage in open discussions to make informed decisions about the appropriate use of these medications.

Wynne Lee, MD

Dr. Wynne Lee is a physician at Massachusetts General Hospital (MGH), where she provides primary care.

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