If you have a TikTok, follow celebrity news, or engage with mainstream media, you’ve probably been wondering: What is Ozempic, and why is everyone talking about it?
Ozempic is an injectable diabetes drug that has recently gone viral for helping people lose weight, as it increases insulin sensitivity and suppresses appetite. You might also know it as its generic, semaglutide, which is also sold under brand name Wegovy.
This new class of medication, called GLP-1 (glucagon-like peptide-1) agonists, has become a controversial topic over the past year, and in just the past month, model Remi Bader opened up about her experience taking Ozempic, Chelsea Handler confessed she had used it but was unaware at the time, and The New York Times, NPR, the Today show, and more have reported on the phenomenon that is “Ozempic face.”
Now critics are questioning the ethics of normalizing Ozempic as a weight loss drug when it’s intended for the treatment of type 2 diabetes—especially since it’s faced shortages so severe that many who need it can’t access it. Still, the demand for and interest in Ozempic hasn’t slowed, especially as tabloids, most notably celebrity gossip Instagram @deuxmoi, allege that celebrities are continually turning to the drug as a makeshift diet aid. Ozempic is also trending for non-celebrities: At the time of writing, Ozempic and Wegovy have a combined total of over 1 billion views on TikTok.
Not everyone who takes Ozempic and GLP-1 agonists does so as part of a get-thin-quick scheme, however. Ozempic is prescribed for type 2 diabetes, and Wegovy was created and approved by the FDA (food and drug administration) for the treatment of obesity. These drugs have also been found to help people with several conditions that aren’t weight-related, such as prediabetes, polycystic ovary syndrome (PCOS), reducing insulin resistance, and other related conditions. Therefore, Ozempic and similar drugs should not be reduced to some sort of weight-loss hack; these are real medicines that benefit people with chronic conditions.
“The real story is that highly effective, safe medicines for weight loss and weight management are finally here, and we can finally treat the obesity epidemic with tools that work,” Spencer Nadolsky, DO, an obesity and lipid specialist physician and medical director of Sequence, tells Glamour. “There is a lot of stigma and bias against those with obesity: Why would anyone object to someone having an improved quality of life and the prevention of future illness just because they used a medicine to lose the weight? We should be happy for them.”
That said, Dr. Nadolsky isn’t surprised by some critics’ frustration over the phenomenon. “I understand the anger when those who are healthy and don’t have obesity are getting the high-demand medicine just for their small amount of vanity weight, which is something I don’t recommend.”
Lastly, these innovations in obesity treatment shouldn’t make anyone feel that they “need” to lose weight. Glamour has addressed this: Body types are not trends that go in and out of style, and research has found that diet culture does much more harm to one’s health than good. If someone has a condition that Ozempic, Wegovy, or other GLP-1 agonists can medically treat, however, they deserve to fully understand what these medications are and how they work.
Ahead, doctors break down everything you need to know about taking Ozempic and Wegovy for the treatment of chronic conditions—as well as who qualifies, what’s causing the shortage, side effects, and more.
What is Ozempic?
Ozempic is a brand-name for semaglutide , which is FDA-approved for the treatment of type 2 diabetes. Semaglutide is also available under the brand name Wegovy however, which is FDA-approved for obesity, and in pill form as Rybelsus, which, like Ozempic, is intended for type 2 diabetes. Both Ozempic and Wegovy are products of pharmaceutical company Novo Nordisk.
Semaglutide is a GLP-1 agonist, which means it mimics GLP-1, a hormone the body produces that releases insulin and reduces appetite after eating food. “But semaglutide has a much longer half-life than our natural GLP-1, meaning it lasts longer in our system,” Dr. Nadolsky explains. Translation? It makes you feel full for longer.
“Medications that enhance the activity of the GLP-1 hormone cause you to feel satisfied—less hungry—more often, which typically leads to decreased food intake,” says Jessica Cutler, MD, a weight-loss surgeon at the Maryland Bariatric Center at Mercy in Baltimore. That is how the drug causes people to lose weight: via appetite control in the brain.
Semaglutide has more straightforward health benefits too, such as helping to lower blood glucose. “These medicines help lower blood sugar levels—only if they are elevated, not when they are normal—by helping our pancreas release more insulin, which lowers blood sugars, and decreasing glucagon, a hormone that increases blood sugars, along with slowing down our gastric emptying, which slows down our GI tract,” Dr. Nadolsky says. Ozempic and Wegovy are taken via a once-weekly injection in either the thigh or stomach, or if someone else is injecting on the patient’s behalf, in the upper arm.
Who is qualified to take Ozempic?
According to Heather Martin, DO, family physician and medical director of the primacy care program at K Health, most prescribers have very strict criteria when it comes to prescribing these drugs.
“Patients must have a BMI over 30, or a BMI over 27 with one weight-associated condition like hypertension or type 2 diabetes, and must have been unable to lose and keep off weight with lifestyle changes alone like diet and exercise,” she says. “We also do a full intake which includes blood tests to ensure you’re a good fit.”
What is causing the Ozempic shortage?
“Unfortunately, manufacturers sometimes make mistakes and sometimes can’t keep up with demand,” Dr. Nadolsky says. Dr. Cutler agrees: “We have seen a lot of supply-chain issues which have limited the availability of these medications. I wish we lived in a world where every person who could benefit from a medication would have the choice to take it."
What about compounded semaglutide?
Some people are turning to compounding pharmacies, which can mix specific formulations in-house, for compounded semaglutide, as this route doesn’t contribute to the shortage or take resources away from patients who need them. However, Dr. Nadolsky notes that while compounded drugs do require a prescription, they are technically not FDA-approved.
“I highly recommend against compounded GLP-1 agonists as I cannot attest to the quality and efficacy of them,” he says. “If one is using a GLP-1 agonist for vanity weight loss, then they are already using it for an off-label reason. The compounded versions would add an extra element of unstudied territory.”
How many GLP-1 medications are there, and how do they differ from one another?
There are at least eight GLP-1 medications that are FDA-approved, the newest of which are semaglutide as Rybelsus and Wegovy, and tirzepatide, otherwise known as Mounjaro. “Mounjaro is a new medication which also works to enhance the activity of GLP-1, but also another molecule known as GIP, or gastric inhibitory polypeptide,” Dr. Cutler explains. Like GLP-1, GIP stimulates the release of insulin. “Put together, augmentation of both these molecules seems to produce a very strong effect on appetite suppression," she says. Mounjaro has also been given an FDA “fast track” approval process, meaning it’s likely to be approved for obesity in 2023.
“There are other GLP-1 agonists, including liraglutide, which comes in the branded form of Saxenda—approved for obesity—and Victoza, which is approved for type 2 diabetes,” Dr. Nadolsky continues. “Another popular GLP-1 agonist is dulaglutide, which is branded under the name Trulicity. This is approved for type 2 diabetes.”
Some of the currently approved GLP-1 brands are Trulicity, Bydureon, Byetta, Ozempic, Victoza, Saxenda, Rybelsus, Wegovy, and Mounjaro.
What are Ozempic and similar medications supposed to treat?
“The FDA has approved Ozempic, Victoza, Rybelsus, and Mounjaro for the treatment of type 2 diabetes, and they are effective medications for this condition,” Dr. Cutler says. “However as more people started to use them, their benefits in appetite suppression and weight loss became more evident, to the extent that some of them have been rebranded and submitted to the FDA again as medications for weight loss, like Wegovy and Saxenda.”
That said, GLP-1 agonists have been also found to help other conditions related to insulin resistance, such as prediabetes, fatty liver, and PCOS, Dr. Cutler says (Metformin, another diabetes medication, is also used to treat PCOS). “Indirectly, conditions like high blood pressure, high cholesterol, sleep apnea, and others may improve with weight loss that comes along with these medications.”
What are the possible risks and/or side effects of Ozempic?
“The new class of GLP-1 receptor agonists are safe,” says Dr. Martin. Like most medications, however, they do have some common side effects that some patients may experience, including bloating, nausea, vomiting, diarrhea, or constipation, she continues. “When we prescribe these medications to our patients, our strategy is to slowly increase the dosage of the medication as tolerated to minimize side effects. Sometimes we even decrease dosage or pause on increasing the dosage if the side effects become unbearable.”
There are more serious side effects and risks that can arise too. “Other potential effects of losing body weight quickly could include forming gallstones and associated problems like pancreatitis; loose skin; or vitamin deficiency if a person is not making sure to get enough nutrition in their diet,” says Dr. Cutler. While there is a small risk of gallstones and gallbladder disease associated with the medication, that risk is also common for quick weight loss. Dr. Nadolsky says, “As a result, it’s debated how much is from the medicine itself.”
Such is also the case for what has been dubbed Ozempic face, the rapid aging in the face as a result of extreme weight loss. "This is likely seen more so in those who didn’t struggle with obesity or type 2 diabetes who are taking [these medications] for small amounts of vanity weight loss, something I do not recommend,” says Dr. Nadolsky. “It’s not from the medicine itself, but the weight lost from the medicine.” Essentially, if you don’t have a lot of weight to lose to begin with, you will start to lose it from places like your face.
What’s some advice for someone starting GLP-1 medications?
“The medicines affect everyone differently. Some people have a very small response at first, while others may experience more severe nausea,” says Dr. Nadolsky. “Most people tolerate GLP-1 medications pretty well. I always recommend to keep the dose low and only go up as tolerated each month according to the label. My general rule of thumb is that patients should be on the lowest dose that’s effective.”
Therefore, if a patient is already losing weight at a healthy rate, they don’t need to start taking a higher dose of Ozempic or semaglutide, let alone the maximum one. Adds Dr. Nadolsky, “If you're experiencing moderate to severe side effects, it’s likely not a good idea to increase your medication dose. You absolutely want to get in enough protein, electrolytes, and vitamins and minerals. So, if you can’t eat actual food, you’ll need to supplement with shakes. Many patients notice large, heavy meals do not sit well.”
Dr. Cutler also advises speaking with your healthcare provider, as well as a dietician, nutritionist, or other nutrition professional. “Some of these medications can suppress appetite to the point where a person has to remind themselves to eat—so if they are not being careful about getting in enough protein and vitamins, they may end up losing weight, but become unhealthy for different reasons.”
Danielle Sinay is the associate beauty editor at Glamour. Follow her on Instagram @daniellesinay.
.png)
