Semaglutide, which is sold under the Ozempic and Wegovy brand names, is the first FDA-approved injectable weight management drug and came onto the scene with a thunderous roar. These drugs aren’t exactly new; oral semaglutide received FDA approval back in September 2019 for use as an add-on therapy for adults with type 2 diabetes to improve glycemic (blood sugar) control. One noticeable side effect was dramatic weight loss, the rest is history.
“The GLP-1 receptor agonist (glucagon-like peptide) class of drugs has been on the market for the treatment of diabetes for more than 15 years,” said Donna H. Ryan, MD Professor Emerita at the Pennington Biomedical Research Center in Baton Rouge, Louisiana . “A similar compound, liraglutide, was approved for obesity in 2012, but the semaglutide plus lifestyle changes result in an average of 15-17% weight loss (or a reductive change in body weight).”
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Due to the dramatic weight loss, Ozempic and his cousins have taken Hollywood by storm. Suspected but unconfirmed, Ozempic was the likely reason Kim Kardashian was able to fit into Marilyn Monroe’s dress for the 2022 Met Gala after she lost more than 15 pounds in three weeks. Other celebrities got the memo, as did anyone who wanted to lose weight and could afford it. The drugs are injectable and cost between $1200 and $1500 a month out of pocket.
Despite the fact that many celebrities have jumped on the bandwagon, the drug has merits and can be a game changer for overweight or obese people struggling to lose weight. “People who are overweight, obese, diabetic, or pre-diabetic have the same metabolic problems, although the former aren’t labeled ‘diseases,'” explains Nina Karol, MD, a board-certified internal medicine doctor who works at the Albert Einstein College of Medicine in New York York trained and currently practices with Concierge Physicians of Westport in Connecticut. “They’re just at different points on a path of progression where the body may no longer be able to compensate and may need medication (prediabetes vs. diabetes).”
Without treatment, overweight or obese people can become prediabetic. And of course, many pre-diabetics become diabetics. Semaglutide has the potential to halt this progression and prevent people from getting diabetes further by lowering the risk of high blood pressure, nerve damage, cardiovascular disease and stroke.
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according to dr Ryan has a good chance the weight will return once you stop the drug: “Just like with high blood pressure, when you stop the drug, blood pressure goes up. If you stop semaglutide, the weight will come back.” The drug’s short-term use has not been proven in a clinical trial, so it’s likely that semaglutide represents a long-term commitment.
And they are not without side effects. As with any drug, side effects are a reality: Semaglutide can cause nausea, vomiting, diarrhea, kidney problems, and possibly a thyroid tumor in susceptible individuals. But the demand is still there and for many the pros far outweigh the cons. “The company was not prepared for the demand,” says Dr. Ryan. As a result, some type 2 diabetics who have received Ozempic have trouble getting it. “We can temporarily switch her to another GLP-1 receptor agonist — dulaglutide, liraglutide, or exenatide.”
This class of drugs is definitely here to stay, and when used as directed, has the potential to reduce and prevent serious morbidity and mortality in so many people struggling with overweight, obesity and prediabetics. “Doctors are allowed to prescribe off-label,” says Dr. Karol, “but ethically this should be done for a good medical reason and not to help someone shed a few pounds to look good.”
The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policies.
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