Editor’s note: This story has been updated to reflect current news events.
Even Oprah Winfrey is on board.
Ozempic, a diabetes medication turned off-label obesity drug, has sparked a weight-loss frenzy with some, like Weight Watchers CEO Sima Sistani, saying the drug and others like it could mark “the end of diet culture.” Though pop-culture icon Winfrey won’t say which brand name she uses, she recently revealed she has used weight-loss medication to manage her weight and prevent diet “yo-yoing.”
Ozempic is the brand name of an injectable form of the drug semaglutide that stimulates insulin secretion when blood sugar is high. It imitates the hormone GLP-1 that also lowers glucagon secretion in the liver and slows the rate food leaves the stomach. As a result, patients tend to eat less and feel full longer, mimicking the effects of bariatric surgery.
Wegovy, developed by Danish health-care company Novo Nordisk that also manufactures Ozempic, is also semaglutide but at a higher dosage. Many researchers, advertisers and people on social media have hyped Ozempic as a “miracle drug” for its effectiveness in aiding weight loss.
But Ozempic’s popularity has led to global shortages, causing concern among those who rely on it to manage diabetes. On Dec. 6, Health Canada advised against most new prescriptions of Ozempic and other GLP-1 agonists except for cases when “there is a clinical reason to do so” and there are “no suitable alternatives.”.
Critics also have expressed their reservations since semaglutide does have side effects, notably nausea and diarrhea but also more serious side effects like low blood sugar and kidney failure.
A number of lawsuits have been filed against Novo Nordisk and Eli Lilly, the company that markets weight-loss drugs Trulicity and Mounjaro, this year. Since August, nearly 20 lawsuits have been brought against the two companies, claiming they downplayed or failed to warn patients about the risk of side effects like stomach paralysis and intestinal paralysis or obstruction.
Ozempic is also not a cure. Patients who stop taking it can regain some or all of the weight they lose. There is also the issue of affordability: Ozempic isn’t cheap. Although less expensive than in many other countries, in Canada Ozempic costs about $200 to $300 per month.
But questions around Ozempic’s rise to mainstream popularity extend beyond the drug’s medical impacts. Obesity in our society is incredibly stigmatized and biases likewise exist within the medical system. Although obesity is correlated with several comorbidities such as heart disease and diabetes, critics highlight the complexity of using weight to define concepts like “health,” as well as the fallibility of metrics like Body Mass Index (BMI).
Further, when a drug is in high demand and has proven to be as relatively safe and effective as Ozempic, what role do physicians have to play as gatekeepers? What responsibility do doctors have in determining who should and should not be able to access it? And how might prescribers’ own biases around weight influence their willingness to prescribe these medications?
We asked a panel of experts what the most important factors are when considering prescribing Ozempic for weight loss.