What you need to know about Ozempic, Wegovy and the new weight loss market

Pop culture continues to shine a light on Ozempic, a diabetes drug, and its weight-loss counterpart, Wegovy. Because of society’s erratic relationship with diet pills, some people are asking questions about the drugs — whether they’re safe enough, whether they’re even ethical to take, and who should be using them in the first place.

The answers may depend on why you started using them and whether you can continue using them. Injections of semaglutide (the ingredient in both drugs) are currently on the U.S. Food and Drug Administration’s list of shortages. Compared with previous medications marketed for weight loss, Ozempic and Wegovy appear to be safer despite common side effects such as nausea and vomiting, said Dr. Christoph Buettner, a professor of medicine and chief of the division of endocrinology at Rutgers Robert Wood Johnson. Medical School.

“It doesn’t seem like there’s really anything comparable right now,” Buettner said, with the exception of Mounjaro, which is currently approved for diabetes but is expected to be approved for weight loss soon.
Ozempic and Wegovy are both relatively new to the market and have rare, more serious side effects on their labels, including thyroid cancer and pancreatitis. Like medications for other health conditions, Ozempic and Wegovy are meant to be chronic medications — drugs that only work while you’re taking them. This entails both benefits and risks.
“There’s no free lunch, so to speak,” Buettner said.

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 a higher amount of it and is FDA-approved specifically for weight loss. Ozempic was first approved for the treatment of type 2 diabetes, but in some cases it is also used off-label as a weight loss drug. Both are weekly injected medications that you administer the same way you would use an EpiPen, and both are manufactured 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 your stomach and reduces your appetite, altering the body’s response to hunger and fullness.
The bodies of people with type 2 diabetes cannot process insulin correctly, and the main purpose of Ozempic is to control blood sugar levels while also reducing the risk of heart disease, stroke, and other health events that people with diabetes are more likely to experience. In terms of controlling blood sugar – the goal of treating type 2 diabetes – semaglutide has been shown to be very effective in studies.
Wegovy is also effective within its approved use as a weight loss medication for adults with diabetes body mass index over the age of 27 and at least one health problem, such as high blood pressure, as well as adults with a BMI over 30. Compared with individuals who received a placebo, the FDA said in its approval notice, those taking Wegovy without diabetes lost an average of 12.4% of their body weight.
But the growing popularity of Ozempic and Wegovy has fueled decades-old concerns about weight loss drugs and weight stigma, as well as other unintended consequences, including drug shortages.

Popular recipes have led to a shortage

The 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 intended to treat diabetes, prescribed off-label by their doctors.
It makes sense that many people can get these prescriptions: According to the U.S. Centers for Disease Control and Prevention, about 73% of U.S. adults were overweight or obese between 2017 and 2018. BMI is an imperfect and often inaccurate indicator of health, but it is used to define obesity, which is considered a chronic disease by the CDC.
That high demand, similar to other drug shortages, has caused problems for some diabetic patients trying to get their Ozempic prescription. Mounjaro, another popular drug containing the active ingredient tirzepatide, is also approved for the treatment of type 2 diabetes, but is also used off-label for weight loss in some cases.
There are other treatments available for patients with diabetes, such as insulin, Buettner said. While comparing insulin to semaglutide is a bit of a “loaded question,” he added, because while semaglutide carries a lower risk of hypoglycemia, or low blood sugar, some patients really need insulin. This can make it difficult to compare. As always when finding a drug substitute, talk to your doctor or pharmacist first.
There is another drug for the treatment of diabetes with the same active ingredient called Rybelsus, but it is taken orally. Other medications include Vicoza, Trulicity, and Bydureon, and these may be options if people with diabetes have trouble filing their medication prescriptions, as Everyday Health reports.

The dangerous history of diet pills – and their uncertain future

Tigress Osborn, president of the National Association to Advance Fat Acceptance, knows the popularity of semaglutide all too well. Osborn, like many fat rights and body neutrality activists and some healthcare providers, rejects the idea of ​​obesity as a disease. Some of the same medical framing now used for Ozempic and Wegovy was also at play during waves of earlier weight-loss pills, Osborn said, including Fen-Phen, a nickname for an appetite-suppressing drug that was eventually pulled off the market late last year. fetched. 1990 because it caused heart damage in many people who took it.

“We’ve heard this from you before,” Osborn said of the widespread support for the current wave of weight-loss drugs. “‘This is safe, it’s OK, it will make you healthier,'” she said.
According to Buettner, some of the earlier pills caused not only heart problems but also psychiatric side effects, such as depression. Rimonabant, which was approved in Europe and also withdrawn from the market, was found to cause adverse mental health side effects.
“When you give drugs that work in the brain, effects on depression or suicidal ideation are common,” Buettner said. Ozempic and Wegovy also work in the brain, hence their appetite-suppressing properties, but “they signal very differently” as GLP-1 receptor agonists 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, serious side effects including pancreatitis have also been reported. Because weight loss also causes you to lose fat stored in your face, some people report “Ozempic face,” or a loss of some facial fat associated with a younger or more youthful appearance.
Weight stigma and its ongoing health effects are also real factors. Research on weight casts doubt on whether prescribing weight loss for health based on BMI alone is valid at all. The deep-seated prejudices against larger bodies and the constant pressure to be thin puts people in a difficult position between trying to lose weight with new tools or choosing to stay as they are, Osborn said.
“Anti-fatty breaks our hearts — your drugs actually change our hearts,” she said. “How shall we make a choice between those things?”
Those who choose to use these drugs face another problem: continued access. Aside from the current shortage, part of the future of these drugs depends on what insurance companies are willing to cover. Many patients have reported having trouble getting prescription drugs under insurance when they’re labeled obese—an example of how larger-body health care is complicated by cultural biases, even when weight loss is the goal. That could change in the future as the catalog of weight loss drugs grows, putting more pressure on Medicare and insurance companies to change their policies.
For people who aren’t celebrities or don’t have deep pockets, and who need semaglutide for their health, access is a problem. Wegovy costs about $1,400 a month out of pocket, according to NPR. A patient who cannot refill their semaglutide prescriptions may develop health problems, either from a lack of treatment for diabetes or from gaining weight again quickly.
Most patients will regain the weight they lost from semaglutide when they stop taking it, meaning it must be taken continuously to remain effective. Weight cycling, when people repeatedly lose and gain weight through diet or other methods, is associated with several health risks, including increased mortality. Meanwhile, if you’re on medication to keep your blood sugar stable, and then you quit cold turkey, the return to high blood sugar could increase your risk of other health problems, such as stroke.

What you need to know about Ozempic, Wegovy and the new weight loss market

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