Semaglutide sold under the brand names Ozempic and Wegovy is the first FDA-approved injectable drug for weight management and it arrived on the scene with a thunderous roar. These drugs aren’t exactly new, oral semaglutide received FDA approval back in September 2019 for use as an adjunct therapy for adults with Type 2 Diabetes to improve glycemic (blood glucose) control. One noticeable side effect was dramatic weight loss, and the rest is history.
“The drug class, GLP-1 (glucagon-like peptide) receptor agonists have been on the market for diabetes treatment for more than 15 years,” says Donna H. Ryan, MD Professor Emerita at Pennington Biomedical Research Center in Baton Rouge, Louisiana. “A similar compound, liraglutides was approved for obesity in 2012, but the semaglutides plus lifestyle changes are producing a 15-17% weight loss (or reductive change in body weight) on average.”
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As a result of the dramatic weight loss, Ozempic and its cousins have taken Hollywood by storm. Suspected but not confirmed, Ozempic was the likely reason Kim Kardashian was able to fit into Marilyn Monroe’s dress for the 2022 Met Gala, after losing more than 15 pounds in three weeks. Other celebrities got the memo, and so did anyone who wanted to lose weight and who could afford it. The drugs are injectables and cost between $1200 and $1500 per month out of pocket.
Despite the fact that many celebrities jumped on the bandwagon, the medication has merit and may be a game-changer for people who are overweight or obese struggling to lose weight. “People who are overweight, obese, diabetic or prediabetic have the same metabolic issues although the former are not called “diseases,” explains Nina Karol, MD an internal medicine specialist who trained at The Albert Einstein College of Medicine in New York and currently practices at Concierge Physicians of Westport in Connecticut. “They are just at different points on a trajectory of progression where the body may no longer be able to compensate as well and require drugs (prediabetes vs. diabetes).”
Without treating people who are overweight or obese, they can turn into prediabetics. And of course, many prediabetics will turn into diabetics. Semaglutides have the potential to stop this progression in its tracks and save people from going on and developing diabetes, lowering the risk of high blood pressure, nerve damage, cardiovascular disease and stroke.
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According to Dr. Ryan, if you go off of the drug, there is a good chance the weight could come back, “Just like with high blood pressure, if you stop the drug, the blood pressure goes up. If you stop semaglutide, weight will be regained.” Short term use of the drug has not been demonstrated in a clinical trial, so it is likely semaglutide will be a long-term commitment.
And they are not without side effects. Like any medication, side effects are a reality: semaglutides can cause nausea, vomiting, diarrhea, kidney issues and potentially a thyroid tumor in susceptible people. But the demand is still there and for many, the pro’s strongly outweigh the con’s. “The company was unprepared for the demand,” says Dr. Ryan. And as a result, some Type 2 diabetics who have been on Ozempic are having a hard time getting them. “We can switch them to another GLP-1 Receptor agonist – dulaglutide, liraglutide, or exenatide – as a temporary measure.”
This drug class is definitely here to stay and when used as intended it has the potential to lessen and prevent serious morbidities and mortality among so many people who have struggled with being overweight, obese and prediabetic. “Doctors are allowed to prescribe off label,” says Dr. Karol, “but ethically this should be done for a good medical reason, not to help someone lose a few pounds to look good.”
The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy.
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