the skinny on these new diet drugs

By now, you have probably heard all the buzz about a new class of weight loss drugs called Semaglutide. Ozempic and Wegory are the two brand names that have been favored in the press. High profile people like Elon Musk and Kim Kardashian are also linked with the drugs due to their ever vanishing waistlines and off-label use of Ozempic for weight loss despite its principal purpose: the treatment of Type II Diabetes.  Ozempic for weight loss, has become so common that the Food and Drug Administration has said the drug is now in short supply which causes major concern for those who truly need the drug to treat Diabetes. 

With its reported ability to cause major weight loss, as a side effect to blood sugar management, the drug has become known as a “miracle drug” to those who have tried it. “Patients consider it a wonder drug” says New York dermatologic surgeon Paul Jarrod Frank, MS, who like many doctors, is inundated with requests for information about the drug. “Other than Viagra and Botox, I’ve seen no other medication so quickly become a part of modern culture’s social vernacular.”

So, how do these drugs actually work? Ozempic and Wegory are both designed to be injected into a fatty part of the body once a week. The Semaglutide will lower blood sugar levels and regulate insulin, which is very important for people with Type II Diabetes. The drug also imitates a hormone called glucagon-like peptides, which takes control of your appetite by signaling to the body that it feels full. As a result, people who are obese have lost weight while taking it. “People get fuller faster,” said Janice Jin Hwang, Chief of the division of endocrinology and metabolism at the University of North Carolina, school of medicine. Nonetheless, on the flip side, some people are experiencing some more serious side effects. The list includes nausea, diarrhea, vomiting, dizziness, and stomach pains, just to mention a few. The severity of these effects can vary widely - from substantial weight loss and minimal discomfort on one end of the spectrum to extreme effects on the other.

However, the concern remains. These serious medications should not be taken lightly by those who are not diagnosed with diabetes or obesity (BMI greater than 30). Obesity medicine experts who prescribe these meds to those that really need it though, say the drugs can transform a patient's life and health. The weight loss effects can mitigate comorbidities such as hypertension, stroke, and high cholesterol. It can also allow patients to participate in activities and have a much more highly functioning quality of life. “By treating obesity, you’re potentially treating over 200 other weight related diseases,” said Dr. Ania Jastreboff, an associate professor of medicine at the Yale School of Medicine.

But here comes the rub. The recreational use of these drugs has skyrocketed and become so popular that Jimmy Kimmel was quoted at the Oscars mentioning the drug, implying that everyone in the room was taking it. Media like that has made the wider public more aware and has exploded the market. The numbers are remarkable. There were 1.2 million prescriptions filled for the drug Ozempic just this past December. That was up 64% from the same period of time last year! The operating profits of Novo Nordisk, the company that produces Ozempic and Wegory, are up 58% since 2017 when they were first introduced to the market. All of this begs the question, how are people getting these drugs off label, how much do they cost, and does health insurance pay for this? The answers are varied.

If you’re getting Ozempic from your physician, the price is around $1000 a month; which is an out of pocket cost if it is being used off label. It has also been found to be alarmingly simple to buy it online or at compounding pharmacies which charge a fraction of the actual price. These have become so trendy that it has created a cottage industry for people who want to get it without seeing a physician in person. NBC News Senior Consumer Investigative Reporter, Vicki Nguyen reported on how easy it was to obtain these drugs. She and her team discovered more than a dozen telehealth websites including one that stated that people could request an online prescription without even being seen. “You simply fill out a questionnaire and pay a $69 consultation fee”. That same day, she received a prescription when no one ever even spoke to her. Many physicians find this alarming and dangerous. Dr. Priya Jaisinghani, an endocrinologist at NYU Langone states, “It is not appropriate for people to receive a prescription without having had appropriate counseling. People need to realize that this is a serious medication and it should be taken properly, for the right diagnosis and very seriously.”  Despite this valid concern, the reality is that there is widespread off-label use and while no one endorses that,  this “magic drug” is appealing to many people who have struggled with weight loss.

Quick weight loss is not a panacea and is likely too good to be true. The best way to lose weight and keep it off for good remains long term healthy nutrition, and exercise habits that are aligned with maintaining a healthy weight. These healthy habits include intentional nutrition, eating adequate amounts of protein, lifting weights at least 2-3 times a week, stress management and adequate sleep to name a few lifestyle shifts that should be addressed. If however, you are prescribed Ozempic or Wegory for weight loss and are simultaneously supervised by a medical professional or health coach, your chances of permanent success is much more likely. Losing weight and keeping it off is not an easy thing to navigate alone. It takes a multi pronged approach. Coaching has to encompass education on nutrition, awakening around current habits and patterns and a reset of one’s mindset around food, exercise and lifestyle.

Addressing the underlying reason for why people overeat, why they eat and drink what they do, and what habits they need to change is crucial for long term results. Rumor has it, the minute you discontinue the drugs the weight comes creeping back. It is important to consider your choices carefully and responsibly.  Doing things without a measured approach and adequate support and guidance will likely result in a return to pre-medicated numbers.