Ozempic or Wegovy may be a godsend, but their non-medical use is alarming | Devi Sridhar
SSince anti-obesity drugs such as semaglutide (brand name Ozempic or Wegovy) were approved, they have gone from being niche medications prescribed by doctors to treat people with type 2 diabetes to a widely used weight loss drug. In the United States, a survey among adults found that 12% had taken Ozempic or a similar type of drug – they are known as GLP-1 agonists – and 6% (around 15 million people) took it regularly. This was despite the monthly cost of the drug, which nearly $1,000 for those without insurance.
In the UK, Ozempic-like drugs have been prescribed on the NHS (free of charge) to people with type 2 diabetes, or where the drug is deemed medically necessary. However, as in the US, sales have soared for UK online retailers, including pharmacies and beauty companies, as they have offered the weekly injection solution to people looking to lose excess weight, at prices as low as around £72 ($92) per month. As a result, too many people (including those whose weight poses no health risks) are taking the drug when they don’t need it. In many cases, they don’t understand how it works in the body, or what the side effects are. An ER doctor recently warned that young women are developing potentially fatal complications from taking the weight-loss drug.
This is how Ozempic (and similar types of medications) work. The active ingredient semaglutide suppresses appetite by mimicking the role of a natural hormone called GLP-1, which is produced by the body when we eat. This hormone tells the brain that we have eaten and makes us feel full. Semaglutide also helps the pancreas produce insulin, which is why it is approved to help manage type 2 diabetes.
But Ozempic-like drugs have potential side effects including nausea and stomach pain, and have been implicated in gallbladder problems, kidney damage, pancreatitis and thyroid cancer, although research is still ongoing. They can also cause unwanted aesthetic effects, such as the “Ozempic face,” where the skin sags and becomes wrinkled. And ultimately, we don’t know what the long-term health effects will be, because the drugs have been widely used for less than a decade.
Another disadvantage is that the medication must be taken continuously, otherwise the weight lost due to appetite suppression can come back. For example, one study found that once people stopped taking semaglutide, they regained two-thirds of their weight within a year. Users sign up for a weekly injection for the rest of their lives.
The debate over the ‘Osmpic’ situation is heated, between those who see this as a miraculous breakthrough population-level efforts to reduce obesity, and those who warn that anti-obesity drugs make it easier for governments to ignore deeper problems, such as the ubiquity of unhealthy processed foods. My view is a little different, as a professor of public health and as someone who trained as a personal trainer and has seen firsthand that weight loss is harder for some people than for others.
When someone comes to me asking about losing weight, I shift the conversation to improving their overall health goals, including being pain-free and happy in their body. I don’t believe that focusing solely on weight and weight loss is the best way to achieve good health and prevent chronic disease and pain. It ignores the key role that exercise and diet play in wellness.
Exercising and staying active is good for our minds and bodies, not because we lose weight, but because exercise improves our health and lung function; it improves our muscle-to-fat ratio, which helps us stay active and independent in daily tasks as we age; and it also helps us avoid back pain and other chronic ailments associated with sedentary behavior. Moving our bodies releases “hope molecules” in our brains, which also make us happier in general.
In the same way, what we eat may be more important than how much we eat. Diet is about the quality of the nutrients, minerals, and energy sources that nourish us, and how they sustain our organs, bones, and circulatory system—rather than whether we lose or gain weight from calories. Again, higher quality food is usually good for weight loss, but it’s almost a side effect.
In short, Ozempic and other anti-obesity weight loss injections are useful in certain cases and can be a valuable tool for people who are severely obese and need support to lose weight. However, using them as a quick fix to lose 15 pounds puts the focus on body size rather than improved health. Exercise and a better diet are two of the best ways to improve your health and feel better, with the side effect for most people being getting to a healthy weight. Taking a medication to suppress your appetite doesn’t provide those overall benefits and comes with real risks. It’s unfortunate that this message has gotten lost in the focus on getting a beach body (what does that term even mean?) and reaching a certain size.