Pop culture continues to shine a light on Ozempic, a diabetes drug, and its weight-loss counterpart Wegovy. Because of society’s jagged 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 taking them and whether you can continue taking them. Semaglutide injections (the ingredient in both drugs) are currently on the US Food and Drug Administration’s shortage list. Compared to earlier weight-loss drugs on the market, Ozempic and Wegovy appear to be safer, despite frequent side effects such as nausea and vomiting, said Dr. Christoph Buettner, professor of medicine and head of the endocrinology department at the medical school. Rutgers Robert Wood Johnson”.
“There doesn’t really seem to be anything comparable right now,” Buettner said, except for Mounjaro, which is currently approved for diabetes but is expected to be approved soon for weight loss.
Ozempic and Wegovy are relatively new to the market and have rare, more serious risks of side effects on their labels, including thyroid cancer and pancreatitis. Like medications for other health conditions, Ozempic and Wegovy are designed to be chronic medications—ones that only work while you take them. With that comes 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 to treat type 2 diabetes, but in some cases it is also used off-label as a weight-loss drug. Both are weekly injectables that you administer much like you would an EpiPen, and both are made by the same pharmaceutical company, Novo Nordisk.
Semaglutide works by interfering with insulin production and stabilizing blood sugar levels. It also makes food move more slowly as it leaves your stomach and reduces your appetite, changing the body’s response to hunger and satiety.
The bodies of people with type 2 diabetes cannot process insulin properly, and the main purpose of Ozempic is to control blood sugar levels while reducing the risk of heart disease, stroke, and other health events that people with diabetes are more likely to experience. . In terms of blood sugar management – the goal of type 2 diabetes treatment – semaglutide has been shown to be very effective in studies.
Wegovy is also effective within its approved use as a weight loss medication in adults withover 27 years of age and at least one health condition, such as high blood pressure, as well as adults with a BMI over 30. Compared to 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-long concerns about diet drugs and weight stigma and has also had other unintended consequences, including drug shortages.
Popular recipes led to shortages
High demand for Wegovy translated into greater demand for Ozempic as some people who couldn’t get Wegovy turned to the other, lower-dose diabetes drug prescribed off-label by their doctors .
It makes sense that many people can get these prescriptions: According to the US Centers for Disease Control and Prevention, about 73% of US adults had a BMI in the overweight or obese range as of 2017-18. BMI is imperfect and often an imprecise indicator of health, but is used to define obesity, which the CDC considers a chronic disease.
This high demand, like other drug shortages, is causing problems for some diabetes patients when trying to get their Ozempic prescriptions. Mounjaro, another popular drug with the active ingredient tirzepatide, is also approved to treat type 2 diabetes, but it is also used off-label in some cases for weight loss.
There are other treatments for diabetes patients, such as insulin, Buettner said. Although comparing insulin to semaglutide is a bit of a “fraught issue,” he added, because while semaglutide may carry a lower risk of hypoglycemia, or low blood sugar, some patients do need insulin. This can make comparisons difficult. As always when finding a substitute for a medication, check with your doctor or pharmacist first.
There is another diabetes medicine with the same active ingredient called Rybelsus, but it is taken orally. Other drugs include Vicoza, Trulicity and Bydureon, and these may be options if people with diabetes have difficulty filling their prescriptions, as reported by Everyday Health.
The dangerous history of diet pills – and their uncertain future
The popularity of semaglutide is all too well known to Tigers Osborne, president of the National Association for the Promotion of Fat Acceptance. Osborne, like many fat rights and body neutral activists and some health care providers, rejects the idea of obesity as a disease. Some of the same medical frameworks now used for Ozempic and Wegovy were also at work during waves of earlier diet pills, Osborne said, including Fen-Phen, a pseudonym for an appetite suppressant that eventually bill was pulled from the market in the late 1990s because it caused heart damage in many people who took it.
“We’ve heard this from you before,” Osborne said of the widespread support for the current wave of weight-loss drugs. “It’s safe, it’s all right, it’ll make you healthier,” she said.
In addition to causing heart problems, some earlier pills caused psychiatric side effects, such as depression, according to Buettner. Rimonabant, which was approved in Europe and was also withdrawn from the market, was found to cause harmful side effects for mental health.
“When you give drugs that work in the brain, effects on depression or suicidal thoughts 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 the loss of some of the facial fat that is associated with a younger or more youthful appearance.
Weight stigma and its ongoing effects on health are also real factors. Research on weight questions whether prescribing weight loss for health based on BMI alone is valid to begin with. Thevs. 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, Osborne said.
“Anti-obesity breaks our heart – your drugs actually change our hearts,” she said. “How are we going to choose between these things?”
Those who do choose to use these drugs face another problem: continued access. Beyond the current shortage, part of the future of these drugs depends on what insurance companies are willing to cover. Many patients report problems getting prescription drugs covered by insurance when they are labeled for obesity—one example of how health care for larger bodies is complicated by cultural biases, even when the goal is weight loss. That may 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 are not celebrities or have deep pockets and who need semaglutide for their health, access is an issue. Wegovy costs about $1,400 a month out of pocket, according to NPR. A patient who is unable to fill their semaglutide prescription may face health challenges from either lack of diabetes treatment or rapid weight regain.
Most patients will regain the weight they lost on semaglutide when they stop taking it, meaning it must be taken continuously to remain effective. Weight cycling, where people repeatedly lose and regain weight due to dieting or other methods, is associated with a variety of health risks, including increased mortality. Meanwhile, if you take medication to keep your blood sugar levels stable and then quit cold turkey, a return to high blood sugar can increase your risk of other health problems, such as stroke.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.