TCA, vol. 19: Suddenly, weight loss drugs are everywhere.
In late January, Chelsea Handler said in an interview that she had unknowingly been taking the diabetes drug Ozempic after her anti-aging doctor gave it to her. She followed it up by saying that same doctor gives it to all her patients, and this blew the lid off of the “worst kept secret in Hollywood”: people taking diabetes medications to lose weight.
What is Ozempic?
Ozempic (semaglutide) is an injected drug made by Novo Nordisk for the management of Type 2 Diabetes (T2D). Semaglutide is also sold under the names Wegovy and Rybelsus…. the only difference is the dose and what they are approved to treat.
Ozempic (0.5mg, 1mg, 2mg) is FDA approved to treat T2D
Wegovy (2.4mg) is approved to treat obesity
Rybelsus (3mg, 7mg, 14mg) is approved to treat T2D
While Wegovy is the only one of the three approved for weight loss purposes, many doctors have been prescribing Ozempic “off-label” for weight loss as well. It is taken as a self-administered injection subcutaneously (under the skin) once a week.
Semaglutide is very similar to a human hormone named Glucagon-like-peptide-1 (GLP-1) and it works in the same way. This hormone is released by the intestines after you eat and it travels through the bloodstream to dock with a receptor called GLP-1R. This receptor is found in the pancreas and in the brain. In the pancreas, insulin is secreted when GLP-1 binds to the receptor and this leads to your cells taking in more sugar from the bloodstream to be used for energy (reducing blood sugar levels). In the brain, GLP-1 binding reduces appetite and increases satiety (feeling ‘not hungry’).
GLP-1 has other functions too, like slowing down the rate of stomach emptying and digestion (which also decreases appetite). It stimulates beta cells (the pancreatic cells that make insulin) and protects them from exhaustion (its hard work making insulin). It may also have protective effects on the cells in the brain as well.
Does it work for weight loss?
Yep.
In a study of non-diabetic obese adults, Wegovy resulted in an average of 15% loss of body weight (compared to 2.5% of those on placebo) along with diet and exercise.
K… What’s the catch?
Once you stop taking it, you’ll gain the weight back. Pretty much like every other ‘diet’ out there. One study found that within a year of stopping Wegovy, participants had regained two-thirds of the weight they had lost.
There are also side effects of taking semaglutide.
Common: Nausea and vomiting (28% over placebo)
Less common: Constipation, abdominal pain, headache and fatigue (13%, 10%, 4% and 6% over placebo, respectively)
Heart rate increases (7-10% over placebo)
Rare but serious: Pancreatitis, gall bladder disease, hypoglycemia, kidney damage
Cancer risk: semaglutide was shown to increase the risk of thyroid tumors in animals (not seen in humans, but those with a family history of thyroid tumors should not take the drug).
Fetal harm: damage to the fetus and miscarriage was seen in pregnant animals taking semaglutide. Those intending to get pregnant should stop taking semaglutide at least 2 months before getting pregnant.
How much does it cost?
Ozempic costs about $1000/month and Wegovy costs between $1300-1500/month (before insurance).
There is another cost as well. The dramatic increase in demand of Ozempic has led to a shortage in supply and some Type-2 diabetics are having a hard time getting their prescriptions filled.
The hot take
Semaglutide will most likley make you lose weight, but there are side effects, its expensive and you’ll most likely gain the weight back after you stop taking it. My advice is to learn to love the body that you are in and stay healthy through nutrition, physical activity, quality sleep, stress relief and healthy relationships.
Stay happy, healthy and informed,
Jessica at TCA
Wang, et al. GLP-1 Receptor Agonists for the Treatment of Obesity: Role as a Promising Approach
Ozempic product insert, Novo Nordisk
Wegovy product insert, Novo Nordisk