The nuances of Ozempic. Is it more harm than good?

This article is written by Louise Bennion ANutr. Louise is a Registered Associate Nutritionist currently working in the NHS with a background in obesity and weight management. To follow Louise head over to her Instagram page @Loutritionist 

 

What is Ozempic and which circumstances is it best used in?

Ozempic (semaglutide), also sold under the brand ‘Wegovy’ injection comes in 0.5mg, 1mg, or 2mg doses as an injectable prescription medicine. This is used in 2 ways:

  • Alongside diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes.
  • Reducing the risk of major cardiovascular events such as heart attack, stroke, or death in adults with type 2 diabetes with known heart disease.

The drug works to support weight management by lowering and stabilising blood-sugar levels through mimicking the hormone, GLP1 and slows down food leaving the stomach by making us feel fuller more quickly. More than one quarter of adults in the UK are living with ob*sity. So, there is a clear demand for this product. In fact, many of these people are on a waiting list to be able to access Ozempic through the NHS. BBC Panorama documentary ‘Britain’s Obesity Crisis: Are Weight-Loss Drugs the Answer’ has illustrated the need for support in managing ob*sity and how injections like Ozempic and Wegovy might help. So far, studies have found the use of these injections have helped to reduce body weight by an average of 15% in just over 1 year. This drug has clearly revolutionised the way we treat ob*sity and made a huge impact in reducing cases of those with a BMI of 30+ and those who are overweight or living with ob*sity.

Will new medications change how we think about being fat and being thin?

The “ideal” female body of the past decade has been developed through the explosion of social media and Instagram in particular. Young women all over the internet are copying the shape-a sculpted small waist with larger hips. Unfortunately, this prototype body was as technologically mediated as the era that produced it. Women have attained this look through dangerous dieting, surgery, injecting themselves with artificial substances and posting heavily photoshopped images on social media for the world to see. For many, people have been able to manage their weight with greater ease without having to think about food as much or trying fad diets which we all know aren’t sustainable. The availability of Ozempic suggests a quick way of losing weight with minimal effort, right? However, like most things, the use of semuglatide is more complicated than we might initially think. It also needs to be made clear that these drugs are not to be used for cosmetic purposes.

Multiple health professionals have warned that if these drugs fall into the wrong hands, we could end up in major crisis with patients experiencing serious consequences. Furthermore, is this drug helping people improve their self-esteem or relationship with their bodies? Or is it convincing EVERYONE to want to lose weight, regardless of their medical history, BMI or other health outcomes? We know that the soaring demand of Ozempic has resulted in the drug selling out, creating the opportunity for private sales of the injections as well as the creation of alternative products for the black-market. The increase in demand for Ozempic could in fact lead to an increase in private practice prescription of the drug or black-market purchases of the injections without medical advice and a surge in cases of disordered eating habits and body dysmorphia. We need to make people aware that Ozempic is to be used to help people achieve a healthier weight, not to become “skinny” as many people are perceiving the injections via the internet.

Is it safe?

Ozempic is generally considered safe in doses up to 2mg for adults with type 2 diabetes, but some experts have said that there are some groups of people who shouldn’t take it. It is not known if Ozempic can be used in people who have had pancreatitis and it’s not for use in people with type 1 diabetes. The safety of Ozempic for use in children under 18 years has not yet been determined either. We are still in the early days of using this drug. So an increase in research into the effects of semuglatide on long-term weight management is required.

Research has found that 45% of users have reported unpleasant side effects including fatigue, sickness, nausea, hypoglycaemia, headaches, constipation and diarrhoea. Most of these are temporary, but it’s vital that we’re aware of the risks of using Ozempic. More serious side effects include thyroid tumours including cancer, pancreatitis, kidney failure, increased heart rate and even depression and thoughts of suicide. This is why it’s crucial that you take personalised advice from your healthcare team before starting Ozempic treatment and report any side effects if you experience any. The evidence shows that with or without this prescription, this injection can be dangerous. We must ask ourselves, do the benefits outweigh the risks?

Has it been exploited and put in the wrong hands by initially being too accessible?

We may not all have realised it, but celebrity and social media influencers have largely shaped aesthetic trends in today’s society. Changing demands for aesthetic and plastic surgeries based on these influences have been repeatedly demonstrated. As a result, demand for the prescribed type 2 diabetes medication has spiralled over the last couple of years after it hit the headlines for being Hollywood’s secret weight loss drug, known as the “skinny jab”. Under UK law, it is currently illegal to sell semaglutide as a medicine without a prescription. As pharmacies across the UK struggled to get hold of the medication, an illicit black-market selling semaglutide “diet kits” began to grow online, many of which have been found to be very different to the original Ozempic pens, containing other active ingredients and potentially harmful and poisonous substances like fentanyl or even lead. The recent Channel 4 ‘The Truth about the Skinny Jab’ documentary shows just how accessible it was to the general public via black-market online sales and private Harley Street doctors. This makes it more difficult to manage and regulate its use. This further proves that this drug should not be made accessible to just anybody.

This is ob*sity management medication, not a “skinny jab” as it has been recently labelled. Unfortunately, money talks and this has skewed the morals of ethics of some doctors and other health professionals. Unfortunately, people will always want to lose weight and want to do so in a quick and easy way. So, this is the perfect opportunity for people with or without medical qualifications to take advantage of that demand by selling Ozempic and similar products which may be harmful or might not even contain semaglutide. There is a significant rise in people sharing their stories and journeys using Ozempic on social media. Many of these cases are through private practice often with little-to-no support.

Is Ozempic the quick fix for weight loss we’ve been searching for?

While the benefits of Ozempic are heavily documented, unfortunately, this isn’t a magic pill for sustained weight loss and improved health outcomes. It’s much more complex than a simple jab in the stomach or leg. Ozempic has been made available on the NHS for those living with ob*sity or type 2 diabetes as a long-term solution to managing their conditions and improving overall alongside improved diet, exercise and psychological support. This isn’t a drug that should be used without prescription or proper medical advice just to shift a few pounds. Furthermore, it should most certainly not be sourced from anyone other than an accredited health professional without being given a full health and nutritional assessment beforehand.

Ozempic has certainly changed the way we support weight loss and manage conditions like type 2 diabetes and ob*sity, but it must be used appropriately. This is not suitable for those who are already of a healthy weight, and it is not a sustainable long-term fix. It must also be noted that Ozempic is not something we should be using life-long. The Department of Health advise that people use these drugs for no longer than 2 years. Many users have reported a significant increase in appetite after coming off Ozempic and re-gaining the lost weight. A balanced diet and sufficient exercise are essential alongside the injections. In addition to this, increased awareness, understanding of the drug, and further scientific studies will help us to increase the regulation of Ozempic and support the delivery of the safest possible outcomes for our patients.

Do you work with Ozempic? Or have you used these injections yourself? We’d love to hear your thoughts.

 

 

Sources

Crabtree, T., Adamson, K., Bickerton, A., Evans, A., Phillips, S., Gallagher, A., … & Ryder, R. E. (2023). The factors predicting glucose and weight response to injectable semaglutide (Ozempic): real-world data from the Association of British Clinical Diabetologists’ audit programme. British Journal of Diabetes23(2), 94-100.

Goldman, J. D. (2020). Cardiovascular safety outcomes of once‐weekly GLP‐1 receptor agonists in people with type 2 diabetes. Journal of Clinical Pharmacy and Therapeutics45, 61-72.

Han, S. H., Safeek, R., Ockerman, K., Trieu, N., Mars, P., Klenke, A., … & Sorice-Virk, S. (2024). Public interest in the off-label use of glucagon-like peptide 1 agonists (Ozempic) for cosmetic weight loss: a google trends analysis. Aesthetic Surgery Journal44(1), 60-67.

Thompson, T., Rahman, H., Sprando, A., & Friedlander, M. P. In overweight adult patients with type 2 diabetes, is tirzepatide as effective for weight loss compared to existing GLP1 agonists (ie Ozempic)?. Evidence-Based Practice, 10-1097.

Wright Jr, E. E., & Aroda, V. R. (2020). Clinical review of the efficacy and safety of oral semaglutide in patients with type 2 diabetes considered for injectable GLP-1 receptor agonist therapy or currently on insulin therapy. Postgraduate medicine132(sup2), 26-36.

https://www.ozempic.com/

https://assets.publishing.service.gov.uk/media/6385ce3f8fa8f54d560ea209/Ozempic.pdf

https://www.diabetes.org.uk/about-us/news-and-views/ozempic-and-weight-loss-facts-behind-headlines

https://www.bbc.co.uk/iplayer/episode/m001v682/panorama-britains-obesity-crisis-are-weightloss-drugs-the-answer

https://www.bbc.co.uk/news/av/health-67424905

https://www.bbc.co.uk/news/world-europe-67217729

https://www.bbc.co.uk/news/health-67414203

https://www.channel4.com/programmes/the-truth-about-the-skinny-jab

https://www.diabetes.org.uk/about-us/news-and-views/our-response-serious-supply-issues-drugs-people-living-type-2-diabetes

https://www.gov.uk/government/news/falsified-ozempic-semaglutide-pens-identified-at-two-wholesalers-in-the-uk#:~:text=Ozempic%20(semaglutide)%20has%20been%20approved,off%2Dlabel%20for%20that%20purpose.

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