A brand new class of weight reduction medicine available on the market have been making waves since they had been licensed as a therapy for weight problems in 2021. Semaglutide injections, which you’ll know as Wegovy or Ozempic, have develop into wildly standard over the previous a number of months, because of the excitement they’ve obtained from TikTok influencers (and rumors of use amongst some celebrities).
The prescription injections had been launched as a diabetes therapy in 2017, however folks quickly realized that the drugs — which assist folks with diabetes to handle their blood sugar ranges — additionally led to important weight reduction in folks with weight problems who’d struggled to reduce weight with different remedies.
From there, curiosity within the medicine grew, and after scientific trials confirmed what folks suspected — that semaglutide injections assist folks reduce weight — demand soared, a lot in order that pharmacies throughout the nation are experiencing shortages in each Wegovy and Ozempic. Weight problems specialists perceive the hype; this type of prescription weight reduction remedy has been a very long time coming.
“For these of us who deal with weight problems, this can be a game-changer we’ve by no means seen earlier than,” mentioned Dr. Dan Azagury, a bariatric surgeon at Stanford Well being Care. “That is the primary time ever that now we have actually efficient medicine to deal with weight problems.”
Weight problems is among the commonest power well being situations in the USA, however till lately, we haven’t had very efficient medicine to deal with the well being problems it’s generally linked to, corresponding to excessive ldl cholesterol and hypertension. Other than way of life modifications like weight-reduction plan and train, the go-to intervention for weight problems has been surgical procedure (suppose: gastric bypass or the duodenal change).
In keeping with Azagury, many weight problems specialists seen that, within the wake of receiving bariatric surgical procedure, many sufferers had been immediately now not diabetic. Upon investigating the explanation for this, researchers recognized new intestine hormones, together with one referred to as glucagon-like peptide (GLP-1), that reacted to meals going into the intestine.
Additional testing revealed that GLP-1, which will increase after bariatric surgical procedure, improves blood sugar ranges, and consequently helps with diabetes. “That’s why main diabetes goes away inside days of surgical procedure,” Azagury mentioned.
After this discovery, pharmaceutical firms got down to kind a diabetes drug that might activate these GLP-1 receptors. That’s what led to the event of semaglutide ― an artificial compound that mimics the consequences of GLP-1 ― and later the semaglutide-based diabetes drug Ozempic, which obtained approval from the Meals and Drug Administration in 2017.
The opposite key discovering about GLP-1: It slows down digestion and reduces meals consumption, in keeping with Dr. Janelle Duah, a Yale Drugs internist. That is why Ozempic, which is meant for diabetes, has been and continues to be prescribed off-label for weight reduction, Azagury mentioned.
The burden loss results of GLP-1 (that are revved up by semaglutide), mixed with the wild demand for Ozempic, drove the drug producer, Novo Nordisk, to create a really related drug particularly for weight reduction: Wegovy. Primarily only a stronger dosage of Ozempic, Wegovy obtained FDA approval in June 2021.
Who’s a candidate for the drugs?
Wegovy, a once-a-week shot, is for adults who’ve a physique mass index over 30, or who’ve a BMI above 27 with a minimum of one weight-related well being concern (suppose: hypertension, diabetes or excessive ldl cholesterol). It’s additionally meant to complement bodily exercise and dietary modifications, which is why weight problems specialists like Azagury advocate that sufferers work with a complete group of suppliers, together with dietitians and therapists, if they’ll afford to. Sufferers can get the prescription by their main care physician, too.
Many individuals discover that the injections assist them really feel fuller longer and cut back sugary cravings. It “makes them crave protein and fiber extra — thus serving to them follow weight-reduction plan modifications that may additional improve their weight reduction,” Duah mentioned. Some folks say it additionally decreased their want to drink alcohol, and helped them to get higher sleep.
Ozempic is authorized for Sort 2 diabetes, not weight problems or weight reduction, though individuals are getting it off-label for weight reduction functions. It’s fully authorized for medical doctors to prescribe meds off-label, however that is doubtless including to ongoing drug shortages — which is a significant concern for folks with diabetes who can’t pay money for the drugs.
What’s the general tackle these weight reduction drugs?
Weight problems medical doctors are thrilled. Typically, folks retain weight due to well being issues out of their management, not for lack of willpower or self-discipline. Many sufferers with weight problems have tried all of it, solely to see minimal outcomes. “Now now we have one thing to assist them,” Azagury mentioned.
In keeping with Duah, the current surge in prescriptions, for essentially the most half, is for good purpose. “It’s by far essentially the most efficacious weight reduction remedy available on the market, with customers dropping as much as 20% of their beginning physique weight,” Duah mentioned.
And regardless that curiosity in these medicine is hovering, Azagury thinks they can assist nonetheless extra folks. The unique class of weight problems medicine from the Sixties and ’70s had nasty penalties and sure soured many individuals on the entire concept. It would take some convincing for extra folks to simply accept that there’s lastly an efficient drug for weight reduction obtainable, Azagury mentioned.
There’s additionally the problem of value. These medicine aren’t at all times lined by insurance coverage, Azagury mentioned, so it will probably get costly (to the tune of $1,500 to $1,800 a month). “That’s the greatest problem folks will face,” Azagury mentioned. “It’s FDA-approved; that doesn’t imply insurance coverage goes to pay for it.”
In keeping with Duah, this is among the principal causes suppliers find yourself prescribing Ozempic as a substitute. Not like Wegovy, Ozempic is usually lined for diabetes or insulin resistance, so sufferers on the lookout for semaglutide injections can get entry to them at an affordable value.
There are some dangers related to semaglutide injections
As with every drug, there are dangers — however the injections are surprisingly effectively tolerated, Azagury mentioned. The commonest unintended effects are gastrointestinal points, like nausea, vomiting, constipation, gasoline and heartburn. These GI-related unintended effects ought to subside as your physique will get used to the injections; till then, they’ll principally be dealt with by consuming smaller, extra frequent meals or taking over-the-counter drugs like bismuth subsalicylate or heartburn reduction tablets, Duah mentioned. (If the unintended effects persist, be sure you discuss to your physician about discovering reduction or different, extra tolerable choices.)
In uncommon circumstances, semaglutide injections can result in thyroid tumors, which will be cancerous. Different potential critical unintended effects embody pancreatitis, gallbladder issues, low blood sugar, kidney points, allergic reactions and melancholy. The injections additionally shouldn’t be used with different medicine that include semaglutide or that concentrate on GLP-1 receptors.
We’re nonetheless studying about long-term unintended effects, for the reason that drug is comparatively new. The injections aren’t a fast repair, and most of the people should keep on the drugs for a minimum of a yr (and sure longer) to satisfy their weight reduction targets and enhance their well being, in keeping with Azagury. One research discovered that many individuals who cease taking the drugs quickly achieve the burden again, supporting the rising perception that the injections are supposed to be taken for the lengthy haul.
Aside from a barely larger threat of gallstones (which is frequent with many kinds of fast weight reduction), we haven’t seen any long-term results with liraglutide, the same drug that’s been available on the market since 2010. Azagury expects the identical will probably be true with semaglutide-based drugs, given their similarity ― however, in fact, time will inform.
In the event you’re taken with semaglutide injections, discuss to your physician. Perceive the dangers and advantages, and understand that resulting from inflation, provide points and rising demand, these medicine are typically back-ordered — usually for the individuals who want them most. Hopefully, provide will ramp up quickly and extra insurers will cowl the price. That, Duah mentioned, will assist extra folks get the medicine at a good value.
“If insurances lined weight reduction drugs like Wegovy and provide was elevated, we wouldn’t be seeing these points with preserving Ozempic stocked on our pharmacies’ cabinets,” Duah mentioned.