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Over the summer I was lucky enough to be invited to a 60th birthday party where the after-dinner entertainment was a private performance by one of the UK’s top male pop stars. However, more surprising than the actual show was how amazing said star looked. He was a mere shadow of himself, prancing across the stage in a silver catsuit. Her secret from him? Semaglutide, or Ozempic as it’s called, a new diet drug that everyone (but everyone, my dear, including one of the world’s most famous supermodels) is apparently taking.
Originally developed to treat type 2 diabetes, it is used off-label (for a different purpose than it was licensed for) in both the US and the UK to treat obesity. In research by its billionaire manufacturer, Denmark-based pharmaceutical company Novo Nordisk, patients lost an average of 17 percent of their total body weight over 68 weeks. This compares to five to nine percent of “old school” obesity drugs like metformin.
Only available in the UK on the NHS if you have type 2 diabetes, Ozempic can be obtained through a private doctor, and if you’re willing to take it without medical supervision, not recommended by doctors (see panel), you can get it online at through various weight loss programs. It is sometimes taken in tablet form, but more commonly as an injection.
Originally developed to treat type 2 diabetes, Semaglutide is used off-label. It has been billed as a new diet drug that apparently everyone is taking.
Unsurprisingly, Hollywood has been aware of Ozempic for much longer than we have: Variety magazine recently quipped that the drug deserved its own Emmy acceptance speech, since so many stars on the podium had obviously been taking it. Elon Musk praised his more powerful sister drug, Wegovy, on Twitter; Kim Kardashian is hotly rumored to have used semaglutide to lose 16 pounds in order to fit into Marilyn Monroe’s dress for the Met Ball. On TikTok, the hashtag #ozempic has had more than 285 million views.
Thanks to the hype, there has been a spike in demand, causing shortages on both sides of the Atlantic, with backlash against influencers and celebrities hoarding supplies before desperate diabetes sufferers. Unsurprisingly, Big Pharma has come up with an alternative: tirzepatide (brand name Mounjaro), made by Eli Lilly, but it has not yet been approved by the US Food and Drug Administration for weight loss.
Novo Nordisk issued a statement to say its supplies will be replenished by the end of the year, but it has not eased anxiety. At least two middle-aged friends of mine who started using it in September are getting tangled up because they got caught before the holidays. As a private GP in London told me: “It’s like the HRT panic last spring.”
So what exactly is this drug? Semaglutide belongs to a class called GLP-1 agonists, which not only regulate blood sugar but, as was discovered a decade ago, also mimic appetite-regulating gut hormones, which tell the brain when we’re hungry. or if we are full. There are, of course, side effects: acid reflux, nausea, exacerbation of IBS symptoms, and fatigue (but much less than in older GLP-1 agonists like Saxenda), as well as pancreatitis, gallstones, and, in very high doses, , has caused thyroid tumors in rats. Meanwhile, when you stop using it, the effect wears off immediately, and in some cases, it won’t work at all.
“I would describe semaglutide as an example of very smart science,” says leading consultant endocrinologist Dr. Efthimia Karra from her private practice in Harley Street, London. But it is not a panacea for everyone. About a fifth of users do not respond. This is because the human body favors weight gain, therefore when you lose weight your body will do anything to get back to your higher BMI. The heavier you are, the harder it is to lose weight. If a patient hasn’t progressed in three months, I’ll take it away.
The banker’s wife, Laura, a native New Yorker in her 50s who had swung decades, started using it in January. ‘The paleolithic diet, 5:2, CBT, NLP, bootcamp, diet delivery services – I’ve tried them all,’ she says from the family home in Hampshire, ‘and have always returned. After my last annual checkup, I seriously thought about giving up. So my doctor suggested semaglutide.
After just a month, she noticed that her clothes had become loose. From there, her weight began to drop. “The strange thing was that she wasn’t eating anything different. She simply couldn’t have any more seconds, and the thought of pudding after a full meal had lost its appeal to her. Three months later, she’s five pounds lighter, though she does occasionally get heartburn if she eats too late at night or drinks alcohol, and when we spoke in the fall, she was hoping to lose another pound by Christmas.
‘There’s an annoying voice telling me it’s risky and lazy to take a weight-loss drug, and I’m worried it’ll all build up again if I stop taking it. But if it does, I’ll seriously consider taking it indefinitely.
Private London GP Dr Martin Galy has been prescribing semaglutide for about a year to clients who are unable to lose the weight they gained in the menopause. He has also seen it have a life-changing effect in much younger women with PCOS. “People with PCOS are difficult to deal with, and you can imagine how body image plays a huge role when it comes to self-esteem.”
But according to Tom Sanders, professor of nutrition and dietetics at King’s College London, it’s not a magic wand. Commenting on a study on semaglutide published in The New England Journal of Medicine in 2021, he says, “The post-weight loss challenge is to prevent weight regain,” he wrote. It may be helpful in the short term, but “public health measures that encourage behavior change, such as regular physical activity and moderation of dietary energy intake, are still needed.”
That said, given our rising national obesity statistics and the escalation of accompanying health problems like heart failure, cancer, and obstructive sleep apnea clogging hospital beds, we’re going to need something. Semaglutide may be the drug of rich people today, but could it be approved for more widespread use? Only time will tell.