A Guy's Guide to a Miracle 'Weight Loss' Drug
YOU CAN'T GO anywhere these days without hearing about Ozempic. Maybe you overheard your partner talking about it on the phone with their friends or it came up over dinner with colleagues or, hell, maybe one of your buds mentioned it at the gym. For me, I was at a party last year when someone casually mentioned it over cocktails. The drug, widely used by people with diabetes to improve insulin production, also helps people lose weight quickly (you can probably see where I’m going with this). Over the past year or so, people who don't have diabetes have been scrambling to get their hands on the medication to help shed pounds, creating a shortage and putting people with diabetes' health at risk. Hence why you’re still hearing about it today.
Weight loss fads are nothing new (let’s pour one out for Fen-Phen and Olestra), but before you write off Ozempic as yet another flash-in-the-pan skinnifying fad—or worse, a misinformation-spreading Instagram trend—you should know that the drug actually does have some serious science behind it. Below, discover everything you need to know about Ozempic so you don’t have to pretend to know what you’re talking about the next time it comes up in conversation—and maybe even determine if it’s right for you.
What Is Ozempic?
Ozempic is the brand name for a medication that’s classified as a glucagon-like peptide-1 agonist—a class of drugs that includes semaglutide, the active ingredient in Ozempic, which mimics a naturally-occurring hormone in our bodies called glucagon-like peptide-1 (GLP-1). GLP-1 helps to stimulate insulin production, lower blood sugar levels, and suppress appetite.
How Long Has Ozempic Been Around For?
In 2017, the FDA approved Ozempic for the treatment of type 2 diabetes, thanks to its ability to regulate insulin. But it’s not the first GLP-1 agonist to be approved. “The first was Exenatide, which was approved back in 2005,” says Fatima Cody Stanford, MD, an obesity medicine physician and assistant professor of medicine at Harvard Medical School and Massachusetts General Hospital who's also a Men's Health advisor. “Exenatide never received approval for obesity because nobody at the time was thinking about obesity as a disease. But if you go back and look at those early studies, you see them reporting a decent amount of weight loss [from the drug].”
It wasn’t until years later that liraglutide, another GLP-1 agonist, was approved for both diabetes and obesity, albeit under two different brand names: Victoza for diabetes and Saxenda for obesity. The manufacturer of both, Novo Nordisk, realized the potential the drug had in treating obesity and obesity-related illnesses, but found that higher doses of liraglutide were needed to treat obesity (hence the two different names of essentially the same drug). Dr. Stanford notes that this trajectory is standard.
“Moving something through the FDA with an indication [like diabetes]” is easier because “people believe it’s a disease and they believe it is damaging,” she says. Once it’s approved and safety has been shown, it’s easier for it to be approved for other indications. Ozempic, also made by Novo Nordisk, followed a similar trajectory. It was approved by the FDA for the treatment of type 2 diabetes in 2017 and then in 2021 for the treatment of obesity under a new name, Wegovy.
Why Are We Hearing So Much About Ozempic Now?
We can thank the Kardashians. Well, kind of. While Kim Kardashian has never owned up to using Ozempic, fans on social media have speculated that she used the drug to fuel her recent drastic weight loss. It’s become the worst-kept celebrity weight loss secret of the moment with people like Elon Musk tweeting about taking Wegovy and Andy Cohen commenting on Ozempic’s widespread use. But while celebrities may have been the spark, social media is the fire. On TikTok, the hashtag #ozempic has 508.9 million views, with the hashtag #ozempicweightloss trailing behind with 189.4 million views. This created a demand for Ozempic, mostly among people who don't have diabetes, that the manufacturer and pharmacies haven’t been able to keep up with.
Who Is Ozempic For?
This is where things get a little messy. Remember that Ozempic is the specific name for a medication approved for type 2 diabetes, so it’s prescribed for patients diagnosed with that health condition. Wegovy, on the other hand, is the same medication in higher doses approved for the treatment of obesity. Dr. Stanford, who has been prescribing Wegovy to her patients since it was first available in 2021, says that technically “a patient with a body mass index (BMI) of 30 or higher or a patient with a BMI of 27, plus an obesity-related illness [like high blood pressure], would meet the criteria for these medications.”
There are other additional factors, like whether a patient is responsive to the medication (some people are not), what other things they have done to attempt to lose weight, whether their insurance will cover the drug, and if they have the means to pay out of pocket (without insurance, the drugs can run upwards of $1,500 a month—definitely not cheap).
Who semaglutide (remember, this is the main ingredient in Ozempic) is not for, Dr. Stanford is quick to note, is someone who is a few extra pounds overweight and wants a quick fix so they can fit into their skinny jeans. When people who don’t technically need the drug use Ozempic or Wegovy for weight loss, it’s considered an off-label use and not technically approved. “[Ozempic or Wegovy] is a long-term strategy for the treatment of a disease like diabetes or obesity. It is not a vanity drug. It has real potential to improve metabolic health, but only if it's used correctly and for the right reasons.”
So What’s the Big Ozempic Debate About?
For the right candidates, GLP-1 agonists like Ozempic and Wegovy are actually pretty groundbreaking. So, why isn’t the conversation about them overwhelmingly positive? Well, that’s where things get even messier. There are a few issues at play.
Due to the sharp increase in demand over the last few months, both Ozempic and Wegovy are now listed by the FDA as in short supply. Novo Nordisk has publicly stated that this is due both to the increase in demand and supply chain issues, and they are working to increase production of both to meet the higher demand. But the main issue comes from people using Ozempic for weight loss, instead of Wegovy. Since they’re the same drug, just prescribed in different doses, many people are using them interchangeably (even though using Ozempic for weight loss is technically off-label). Part of what’s made the news is that the increase in usage of the drug for weight loss has taken the medication away from those who use it to treat diabetes.
Thanks to the celebrity and social media factors, the drug has become increasingly popular among people who want to use it casually and are willing and able to pay the high price to use it. While Dr. Stanford is adamant that semaglutide should not be used as a quick fix and doesn’t prescribe it that way, there are many doctors out there who will. That, in effect, does take it out of the hands of those who actually do need it, whether to treat diabetes or obesity. And while Dr. Stanford says it hasn’t exactly driven up the price because the drug has always been expensive, it does create a shortage. That shortage has the potential to be life-threatening to those who depend on it to treat their type 2 diabetes, as guys like Anthony Anderson have publicly noted.
Another issue is compliance. A medication like Wegovy for weight loss should be used consistently for many years (most likely indefinitely), according to Dr. Stanford, and should be monitored by a physician. People who use it briefly to look good in a swimsuit are likely to see those pounds regained later, which leads to yo-yoing in weight that can be potentially harmful to long-term health.
How Exactly Does Ozempic and Wegovy Work?
Do these GLP-1 agonists, which are taken through either daily or weekly self-injections, have some magical ability to melt away fat? Not exactly. Taking the insulin-regulating factors out of the equation for a moment, semaglutide helps with weight loss in two ways. First, it targets your brain. “There are two pathways in the brain,” says Dr. Stanford. “One tells us to eat more and store more food, the other tells us to eat less and store less food.” The second way it works is that it slows movement through the GI tract. “If things move through your GI tract really slowly, what are you going to feel? You’re going to feel full,” she says. Put simply: semaglutide makes you want to eat less.
There is some overlap with how Ozempic works for diabetes as well. Semaglutide has the ability to improve insulin secretion, which your body uses to regulate blood sugar. For someone who has diabetes, their body either doesn’t produce enough insulin or they are insulin resistant, meaning their body is not using the insulin they produce properly. The goal of most type 2 diabetes treatments is to increase insulin, but a common side effect is weight gain, which is why “80 percent of people with type 2 diabetes also have obesity,” notes Dr. Stanford. Ozempic’s ability to address both, unlike many old school treatments, is what makes it so desirable.
Are There Side Effects?
A weight loss drug without side effects is basically a fantasy. Most of semaglutide’s side effects are tied to the GI tract, thanks to its ability to slow it down. About half of patients experience nausea, says Dr. Stanford, which is sometimes, but not always, accompanied with vomiting. The second most common side effect, again unsurprisingly, is constipation. Others may include heartburn, headaches, dizziness, and stomach flu symptoms. “The key thing I’ve learned, however, is that these side effects are usually more pronounced when you first start the treatment or increase dosage,” explains Dr. Stanford. Issues like nausea and constipation tend to decrease with time. She also notes that a physician experienced with these medications can control them better by extending time between dosage increases.
What’s Next for Ozempic and Wegovy?
It’s safe to say that GLP-1 agonists like Ozempic and Wegovy are not going anywhere. In fact, once supply chain and production issues are resolved, Dr. Stanford is hopeful that they’ll become standard in the treatment of obesity and obesity-related illnesses like high blood pressure or heart disease (it’s still, however, more widely prescribed as a treatment for diabetes). But a few things need to happen in order to do that.
First, she says, companies should take a more democratic approach to these medications by lowering the prices so that more people who need them can access them. “The demand is going to be so high, you can have the Camry approach. You don’t have to have the Rolls-Royce approach where only a few people have the cars. This needs to be more accessible.” Eventually, some GLP-1 agonists will become generic, which would further help bring down the price and solve problems of accessibility by allowing more doctors to prescribe them to patients who actually need them.
Second, the insurance factor. Insurance often does not cover GLP-1 agonists like Ozempic and Wegovy. Some “really good” private insurance does, but until more insurance carriers do, it will remain out of reach for many people. Older patients on Medicare could really benefit from the drugs, but often can’t afford the high out-of-pocket price.
There are also new similar drugs on the horizon to take some of the pressure off Ozempic and Wegovy. Mounjaro, the brand name for tirzepatide, was approved for diabetes last year and is “being fast-tracked through the FDA currently for approval for obesity,” says Dr. Stanford. This new drug is a dual-agonist, which means it contains not only a GLP-1 agonist but another drug called glucose-dependent insulinotropic peptide (GIP), and the “safety and benefit profile is really quite impressive.” Early studies have shown it may work even better than Ozempic and Wegovy.
Whatever happens, it’s important to remember that these drugs exist for a reason. If you fall into the category of someone who could actually benefit from them for diabetes or obesity treatment (or both!), they really can be lifesaving. But if you’re hoping to jab yourself with a needle a few months before your beach vacation, it’s worth reminding yourself that there may be other people with more to lose.
You Might Also Like