A new class of weight-loss drugs has been making waves on the market since it was licensed as an obesity treatment in 2021. Semaglutide injections, which you may know as Wegovy or Ozempic, have become very popular in recent months. , thanks to the buzz they have received from TikTok Influencers (and rumors of use among some celebrities).
Prescription injections were introduced as a treatment for diabetes. in 2017But people soon realized that the drugs, which help people with diabetes control their blood sugar levels, also led to significant weight loss in people with obesity who had struggled to lose weight with other treatments. .
From there, interest in the drugs grew, and after clinical trials confirmed what people suspected (that semaglutide injections help people lose weight), demand skyrocketed, so much so that drugstores across the country are experiencing shortages in both Wegovy Y Ozempic. Obesity specialists understand the hype; this type of prescription weight loss drug has been a long time coming.
“For those of us treating obesity, this is a game changer that we’ve never seen before,” said Dr. dan azagury, bariatric surgeon at Stanford Health Care. “This is the first time that we have really effective drugs to treat obesity.”
Obesity It’s one of the most common chronic health conditions in the United States, but until recently we didn’t have very effective drugs to treat the health complications it’s commonly associated with, like high cholesterol and high blood pressure. Aside from lifestyle changes like diet and exercise, the intervention for obesity has been surgery (think: gastric bypass or duodenal switch).
According to Azagury, many obesity specialists noticed that after undergoing bariatric surgery, many patients were suddenly no longer diabetic. By investigating the reason for this, the researchers identified new gut hormones, including one called glucagon-like peptide (GLP-1), which reacted to food entering the intestine.
Additional tests revealed that GLP-1, which increases after bariatric surgery, improves blood sugar levels and consequently helps with diabetes. “That’s why major diabetes disappears within a few days of surgery,” Azagury said.
Following this discovery, pharmaceutical companies set out to develop a diabetes drug that could activate those GLP-1 receptors. That is which led to the development of semaglutide ― a synthetic compound that mimics the effects of GLP-1, and later the semaglutide-based diabetes drug Ozempic, which gained approval from the Food and Drug Administration in 2017.
The other key finding about GLP-1: It slows down digestion and reduces food intake, according to Dr. janelle duah, a Yale Medical Internist. This is why Ozempicwhich is intended for diabetes, has been and continues to be prescribed without brand to lose weight, Azagury said.
The weight loss effects of GLP-1 (which are accelerated through semaglutide), combined with the high demand for Ozempic, led the drug maker, Novo Nordisk, to create a very similar drug specifically for weight loss. : Wegovy. Essentially just a stronger dose of Ozempic, Wegovy got FDA approval in June 2021.
Who is a candidate for the drugs?
Wegovy, an injection once a week, is for adults who have a body mass index greater than 30, or who have a BMI greater than 27 with at least one weight-related health problem (think: high blood pressure, diabetes, or high cholesterol). It’s also meant to supplement physical activity and dietary changes, which is why obesity specialists like Azagury recommend that patients work with a comprehensive team of providers, including dietitians and therapists, if they can afford it. Patients can also obtain the prescription through their primary care physician.
Many people find that injections help them feel full longer and reduce sugar cravings. “It makes them crave more protein and fiber, which helps them stick with dietary changes that can further enhance their weight loss,” Duah said. Some people say it also reduced their desire to drink alcohol and helped them sleep better.
Ozempic it’s approved for type 2 diabetes, not obesity or weight loss, although people are getting it off-label for weight loss purposes. It is completely legal for doctors to prescribe drugs for off-label uses, but this is likely to add to the continuing drug shortages — which is a major problem for people with diabetes who can’t get their medicines.
What is the general opinion on these weight loss drugs?
Obesity specialist doctors are delighted. Often, people retain weight due to health problems beyond their control, not a lack of willpower or discipline. Many obese patients have tried everything, only to see minimal results. “Now we have something to help them,” Azagury said.
According to Duah, the recent increase in prescriptions, for the most part, is for good reason. “It is by far the most effective weight loss drug on the market, with users losing up to 20% of their starting body weight,” Duah said.
And while interest in these drugs is growing, Azagury believes they can help more people. The original class of obesity drugs of the 1960s and 1970s had unpleasant consequences and probably made many people angry at the idea. More people may need to be convinced to accept that an effective weight-loss drug is finally available, Azagury said.
There is also the issue of cost. These medications aren’t always covered by insurance, Azagury said, so you may Be expensive (to the tune of $1,500 to $1,800 per month). “That is the biggest challenge people will face,” Azagury said. “It is FDA approved; That doesn’t mean insurance is going to pay for it.”
According to Duah, this is one of the main reasons why providers end up prescribing Ozempic. Unlike Wegovy, Ozempic is often covered for diabetes or insulin resistance, so patients looking for semaglutide injections can access them at a reasonable price.
There are some risks associated with semaglutide injections.
As with any drug, there risks — but the injections are surprisingly well tolerated, Azagury said. The most common side effects are gastrointestinal problems, such as nausea, vomiting, constipation, gas, and heartburn. These GI-related side effects should go away as your body gets used to the injections; Until then, they can mostly be managed by eating smaller, more frequent meals or taking over-the-counter medications such as bismuth subsalicylate or heartburn relief tablets, Duah said. (If side effects persist, be sure to talk to your doctor about finding relief or other more tolerable options.)
In rare cases, semaglutide injections can cause thyroid tumors, which may be cancerous. Other possible serious side effects they include pancreatitis, gallbladder problems, low blood sugar, kidney problems, allergic reactions, and depression. The injections should also not be used with other medications that contain semaglutide or that target GLP-1 receptors.
We are still learning about long-term side effects, since the drug is relatively new. The injections are not a quick fix, and most people will need to stay on the drugs for at least a year (and probably longer) to reach their weight loss goals and improve their health, according to Azagury. One study found that many people who stop taking the drugs quickly regain the weight, supporting the growing belief that injections should be given long-term.
Other than a slightly increased risk of gallstones (which is common with many types of rapid weight loss), we have seen no long-term effects with liraglutide, a similar drug It has been on the market since 2010. Azagury hopes the same will happen with the semaglutide-based drugs, given their similarity, but of course, time will tell.
If you are interested in semaglutide injections, talk to your doctor. Understand the risks and benefits, and keep in mind that due to inflation, supply issues, and increasing demand, these drugs tend to get behind schedule, often to the people who need them most. Hopefully supply will increase soon and more insurers will cover the cost. That, Duah said, will help more people get the drugs at a fair price.
“If insurance covered weight-loss drugs like Wegovy and increased supply, we wouldn’t be seeing these issues keeping Ozempic stocked on our pharmacy shelves,” Duah said.
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