Written by Danica Kwan | Edited by Amanda Fang
Photo by Annushka Ahuja
A class of drugs known as GLP-1 receptor agonists (GLP-1 RAs), which mimic a hormone that lowers blood sugar and signals for appetite reduction, has recently captured the public’s eye for the drugs’ ability to induce weight loss. The most well-known of them, Ozempic, has been viewed as a topic over one billion times on TikTok alone. And it is not just social media: research studies have been conducted on GLP-1RAs, such as a long-term study on the usage of nine GLP-1 RAs among patients in the University of California Health Data Warehouse from 2014 to 2022. This study demonstrated that GLP-1 RA products containing semaglutide as an active ingredient (e.g. Ozempic, Wegovy, Rybelsus) all saw an average monthly growth rate of more than 85% in the number of users during their first 12 months of availability [5]. Given Ozempic and other semaglutide products’ rapid rise into the spotlight, it is essential to also raise awareness of the potential concerns surrounding their use for weight loss.
A priority for those looking to lose weight with semaglutide is to fully understand what they are taking, including how effective certain options are. Wegovy is approved for the management of obesity, while Ozempic and Rybelsus are only approved to treat type 2 diabetes [1]. Though all three medications have semaglutide as their active ingredient, each is only available by prescription and should only be used for their approved purpose. A study in the New England Journal of Medicine found a 14.9% reduction in average body weight after 68 weeks of once-a-week semaglutide administration and lifestyle intervention such as dietary modifications and increased exercise [6]. With that said, patients should prepare for some lifestyle changes to be prescribed alongside their new weight-management medication.
The increased demand for semaglutide medication has led to a nationwide drug shortage: a drug shortage report for semaglutide injection was first listed by the FDA on March 31, 2022 and is active as of November 1, 2023 [4]. A shortage of the drugs intended to treat diabetes, such as Ozempic, is of particular concern, as this can pose a threat to those whose immediate health relies on access to these medications [3]. To minimize accessibility concerns, both patients and providers have a responsibility to seek out the right drugs for their needs.
More concerning, drug shortages have led some individuals to turn to compounded (i.e. mixed or altered by a pharmacist) versions of semaglutide made from its salt form. The FDA has noted that these compounded versions may not be effective and can cause unknown adverse effects due to a lack of regulation over their ingredients [1]. Known adverse effects of taking semaglutide commonly arise in the gastrointestinal system, including nausea, vomiting, constipation, and diarrhea [6]. In more serious cases, it can slow the passage of food, which may lead to stomach paralysis [2].
When prescribed and used with care, semaglutide medication can be a safe and effective option for weight-management. No matter where you hear about it first, the best option for weight loss is one discussed with a healthcare professional. It is crucial that patients communicate with their primary care providers in order to understand the emerging research about the benefits and drawbacks of these influential drugs.
References:
1. Center for Drug Evaluation and Research. “Medications containing semaglutide marked for type 2 diabetes or weight loss.” U.S. Food and Drug Administration, 31 Oct. 2023. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss.
2. “In-demand weight-loss drugs are no magic bullet, UCI Health Experts Say.” UCI Health, 28 July 2023. https://www.ucihealth.org/news/2023/07/ozempic-wegovy-caution?utm_source=uci-digest&utm_medium=email
3. Shmerling, R. H. “What happens when a drug goes viral?” Harvard Health Publishing, Harvard Medical School, 21 Feb. 2023, https://www.health.harvard.edu/blog/what-happens-when-a-drug-goes-viral-202302212892.
4. U.S. Food and Drug Administration. (2022, March 31). “FDA drug shortages.” U.S. Food and Drug Administration, 31 Mar. 2023. https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Semaglutide+Injection&st=c&tab=tabs-1
5. Watanabe, J. H., Kwon, J., Nan, B., & Reikes, A. (2023). Trends in glucagon-like peptide 1 receptor agonist use, 2014 to 2022. Journal of the American Pharmacists Association, S1544-3191(23)00309-6
6. Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11):989–1002.