A new class of weight-loss drugs hitting the market has been making waves since they were licensed as a treatment for obesity in 2021. Semaglutide injections, which you may know as Wegovy or Ozempic, have become very popular. popular over the past few months, thanks to the buzz they’ve received from TikTok influencers (and rumors of use among some celebrities).
Prescription injections were introduced as a treatment for diabetes in 2017but people soon realized that the drugs – which help people with diabetes manage their blood sugar levels – also caused significant weight loss in obese people who had struggled to lose weight with other treatments.
From there, interest in the drugs grew and after clinical trials confirmed what people suspected – that semaglutide injections help people lose weight – demand skyrocketed, so that pharmacies across the country are experiencing shortages of both. Wegs and Ozempic. Obesity experts understand the hype; this kind of prescription weight loss drugs has been a long time coming.
“For those of us treating obesity, this is a game changer we’ve never seen before,” said Dr. Dan Azagury, a bariatric surgeon at Stanford Health Care. “This is the first time that we have really effective drugs to treat obesity.”
Obesity is one of the most common chronic diseases in the United States, but until recently we didn’t have very effective medications to treat the health complications it’s commonly linked to, like high cholesterol and hypertension arterial. Besides lifestyle changes like diet and exercise, the intervention of choice for obesity has been surgery (think: gastric bypass or duodenal switch).
According to Azagury, many obesity specialists have noticed that following bariatric surgery, many patients suddenly no longer have diabetes. Investigating the reason for this, the researchers identified new gut hormones, including one called glucagon-like peptide (GLP-1), that reacted to food entering the gut.
Further tests revealed that GLP-1, which increases after bariatric surgery, improves blood sugar levels and therefore helps in the fight against diabetes. “That’s why major diabetes goes away a few days after surgery,” Azagury said.
After this discovery, pharmaceutical companies set out to develop a diabetes drug that could activate these GLP-1 receptors. It is which led to the development of semaglutide ― a synthetic compound that mimics the effects of GLP-1―and later the diabetes drug semaglutide Ozempic, which gained Food and Drug Administration approval in 2017.
The other key finding about GLP-1: it slows digestion and reduces food intake, according to Dr. Janelle Duah, a Yale Medicine internist. That is why Ozempicwhich is for diabetes, has been and continues to be prescribed off-label for weight loss, Azagury said.
The weight loss effects of GLP-1 (which are accelerated by semaglutide), combined with wild demand for Ozempic, prompted drugmaker Novo Nordisk to create a very similar drug specifically for weight loss. : Wegovy. Basically just a stronger dose of Ozempic, Wegovy got FDA approval in June 2021.
Who is a drug candidate?
Wegs, a once-a-week vaccine, is for adults who have a body mass index over 30 or have a BMI over 27 with at least one weight-related health condition (think: high blood pressure, diabetes, or cholesterol levels raised). It is also intended to complement physical activity and dietary changes, which is why obesity specialists like Azagury recommend that patients work with a full team of providers, including dieticians and therapists, if they have the means. Patients can also obtain the prescription from their attending physician.
Many people find the injections help them feel full longer and reduce sugar cravings. This “makes them crave more protein and fiber, helping them stick to diet changes that can further improve their weight loss,” Duah says. Some people say it also reduced their desire to drink alcohol and helped them sleep better.
Ozempic is approved for type 2 diabetes, not for obesity or weight loss, although people are getting it off-label for weight loss purposes. It is perfectly legal for doctors to prescribe off-label drugs, but it probably adds to ongoing drug shortages — which is a major problem for people with diabetes who cannot afford the drugs.
What is the overall take on these weight loss drugs?
Obesity doctors are thrilled. Often people keep their weight off because of health issues beyond their control, not a lack of willpower or discipline. Many obese patients have tried everything, only to see minimal results. “Now we have something to help them,” Azagury said.
According to Duah, the recent surge in prescriptions, for the most part, is for good reason. “It is by far the most effective weight loss drug on the market, with users losing up to 20% of their starting body weight,” Duah said.
And even as interest in these drugs skyrockets, Azagury believes they can help even more people. The original class of obesity drugs of the 1960s and 1970s took its toll and probably embittered many people about the idea. It may take a bit of convincing to get more people to accept that there is finally a drug that works for weight loss, Azagury said.
There is also the issue of cost. These drugs aren’t always covered by insurance, Azagury said, so he can get expensive (up to $1,500 to $1,800 per month). “That’s the biggest challenge people will face,” Azagury said. “It’s FDA approved; it does not mean that the insurance will pay for it.
According to Duah, this is one of the main reasons providers end up prescribing Ozempic instead. Unlike Wegovy, Ozempic is often covered for diabetes or insulin resistance, so patients looking for semaglutide injections can access it at a reasonable price.
There are some risks associated with semaglutide injections
As with any medicine, there are risks — but the injections are surprisingly well tolerated, Azagury said. The most common side effects are gastrointestinal issues, such as nausea, vomiting, constipation, gas, and heartburn. These gastrointestinal side effects should lessen as your body adjusts to the injections. until then, they can mostly be treated by eating smaller, more frequent meals or taking over-the-counter medications like bismuth subsalicylate or heartburn relief tablets, Duah said. (If side effects persist, be sure to talk to your doctor about finding relief or other more tolerable options.)
In rare cases, semaglutide injections can lead to thyroid tumors, which may be cancerous. Other serious potential Side effects include pancreatitis, gallbladder problems, low blood sugar, kidney problems, allergic reactions, and depression. The injections should also not be used with other medications that contain semaglutide or that target GLP-1 receptors.
We are still learning about long-term side effects because the drug is relatively new. Injections aren’t a magic bullet, and most people will need to take the drugs for at least a year (and likely longer) to achieve their weight loss goals and improve their health, according to Azagury. One to study found that many people who stop taking the drugs quickly regain weight, supporting the growing belief that the injections are meant to be taken for the long term.
Other than a slightly higher risk of gallstones (which is common with many types of rapid weight loss), we saw no long-term effects with liraglutide, a similar drug which has been on the market since 2010. Azagury expects the same to happen with semaglutide drugs, given their similarity – but, of course, time will tell.
If you are interested in semaglutide injections, talk to your doctor. Understand the risks and benefits, and keep in mind that due to inflation, supply issues, and growing demand, these medications tend to run out of stock, often for people who need them. most need. Hopefully the supply will increase soon and more insurers will cover the costs. This, Duah said, will help more people get the drugs at a fair price.
“If insurance covered weight-loss drugs like Wegovy and the supply was increased, we wouldn’t see these issues with Ozempic stocking on our drugstore shelves,” Duah said.