Ozempic, a drug used to treat diabetes, has recently garnered attention as celebrities, a tech mogul and TikTok influencer have described taking it to lose weight in a short period of time.
The Food and Drug Administration first approved the injectable drug to treat diabetes in 2017; The agency approved a drug with a higher dose of the active ingredient in Ozempic called Semaglutide for the treatment of obesity in 2021 under the brand name Wegovy. Since then, talk of the drug has been appearing on the Internet. When asked how he looked “fit, muscular and healthy,” Elon Musk tweeted that he was taking Wegovy. Andy Cohen has reported on Ozempic’s growing popularity. In September, Variety reported that actors and producers were “softly singing the praises of the drug” on Signal, an encrypted messaging app. On TikTok, the hashtag #Ozempic has been viewed over 273 million times, with people taking turns expressing shock at their perceived weight loss from medication and sharing stories of side effects.
Now the FDA has listed both Ozempic and Wegovy as two of dozens of deficiency drugs. A representative for Novo Nordisk, which makes the drugs, wrote in a statement that the company is experiencing “intermittent supply disruptions on various Ozempic doses due to the combination of incredible demand coupled with general global supply shortages.” The rep added that the shortage of Wegovy is likely to be resolved soon and that the company is “on track” to make all dosage strengths of this drug available in December.
It’s not uncommon for doctors to prescribe drugs for “off-label” use or for a purpose other than what the drug is specifically intended for, said Dr. Disha Narang, an endocrinologist at Northwestern Medicine Lake Forest Hospital. As interest in Ozempic has increased, some doctors believe more people have been looking for ways to take the weight-loss drug — either by finding a doctor to prescribe it off-label or by looking for the drug online. dr Narang herself has seen patients “who kind of got their hands on this” taking the drug off-label, she said. (Dr. Narang previously served on an advisory board for Novo Nordisk, a common practice for professionals in the field.)
She worries that as the drug grows in popularity, it will be associated with “vanity” rather than a critical drug for diabetes patients.
Here’s what we know about what the drug can and can’t do, and who should take it.
How does Ozempic work?
Ozempic and Wegovy are both designed to be injected once a week into the stomach, thigh, or arm.
Semaglutide lowers blood sugar levels and regulates insulin, which is crucial for people with type 2 diabetes. The drug also mimics a hormone called glucagon-like peptide-1, which we naturally produce in our gut, and limits appetite by signaling our body that we’re feeling full and causing our stomach to slow down drain. As a result, people with obesity and associated health problems have lost weight while taking it. People feel full faster, said Dr. Janice Jin Hwang, chief of the Department of Endocrinology and Metabolism at the University of North Carolina School of Medicine. For patients taking the drug, “foods that used to be really exciting to them aren’t exciting anymore,” she said. The drug has not been significantly studied in people without diabetes or obesity.
The drug may also reduce the risk of cardiovascular disease for people with diabetes, said Dr. Robert Gabbay, Chief Scientific and Medical Officer of the American Diabetes Association.
The FDA hasn’t approved Ozempic for weight loss, noted Dr. Andrew Kraftson, a clinical associate professor in the Department of Metabolism, Endocrinology and Diabetes at Michigan Medicine. But after the FDA approved Wegovy for weight loss, there was such a demand for the drug that some vendors turned to Ozempic when they couldn’t get Wegovy, he explained.
Just as some people are prescribed medications to treat high blood pressure or high cholesterol indefinitely, some patients with obesity may be prescribed medications like Wegovy for an ongoing period of time, Dr. Kraftson. Those who stop taking the drug may regain the weight lost while taking Wegovy, he added.
“These drugs weren’t designed for normal-weight people who want to get super thin,” said Dr. Hwang.
Who should take Ozempic and Wegovy?
After the FDA approved Ozempic for people with type 2 diabetes, the agency approved Wegovy for adults who are obese or overweight with at least one “weight-related medical condition” that the agency defines as problems such as high blood pressure, type 2 diabetes, or high cholesterol. The FDA defines obesity and overweight using body mass index, an established but much-discussed metric.
The drug is expensive without insurance — Wegovy’s list price is over $1,300 for a 28-day supply, and Ozempic can cost around $892 for a monthly supply without insurance — and people who don’t meet the FDA’s criteria don’t meet will likely have trouble getting insurance for it.
Despite these obstacles, the increase in people using Ozempic off-label could exacerbate the shortage, said Dr. Narang, noting that patients with diabetes and obesity have difficulty accessing it.
“It was really, really awful — the patients don’t know where to turn,” she said. “We were like hamsters on a wheel trying to figure this out.”
“While we recognize that some healthcare providers may prescribe Ozempic to patients whose goal is to lose weight, it is within the clinical judgment of each healthcare provider to select the best treatment approach for their patients,” a Novo Nordisk representative wrote in a statement adding that the company “does not promote, suggest or encourage the off-label use of our drugs.”
What are the side effects?
Individuals taking Ozempic and Wegovy for both FDA-approved and off-label use may experience nausea and dehydration. You may also feel tired and unwell. Your bowel movements may change, with some patients developing diarrhea and others severe constipation. “It can be so bad that people go to the emergency room,” said Dr. Kraftson. “It is no joke.” Patients should be monitored while taking these drugs, he said, and doctors may prescribe anti-nausea drugs and laxatives or stool softeners. In rare cases, the drug could increase the risk of pancreatitis, a painful condition that inflames the pancreas. Some patients may also form gallstones. dr Gabbay said he’s seen some patients vomit so badly that they had to stop taking the drug.
Doctors typically start patients on a lower dose of drugs like Ozempic and Wegovy and then gradually build up to minimize these side effects, Dr. Gabbay.
Is off-label use of these drugs dangerous?
Doctors say there isn’t enough evidence to know whether these drugs might be beneficial or dangerous for people who don’t meet the FDA’s criteria. As tempting as the prospect of a weight-loss drug might be, experts warned that people are seeking the drug for off-label use. People taking Ozempic and Wegovy should be monitored closely, said Dr. Kraftson. “If you’re only doing this online, there won’t be the same layers of protection,” he said. “I don’t want to see people playing roulette with their health.”
The drug has not been systematically tested on people with lower body weight, said Dr. Hwang, and it’s possible that patients outside of the group the drug is intended for could experience more severe side effects. Without further research, it’s unclear how harmful these side effects could be.
“The march into the unknown comes with some potential risk,” said Dr. Gabbay. “And we don’t know what that is.”