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The truth about the weight-loss drugs Ozempic and Wegovy

Drugs like Ozempic and Wegovy are not ‘quick fixes,’ but clinically proven ways of addressing the hormonal underpinnings of obesity and overweight

By Dr. Ana Maria Kausel, MD
And Dr. Sarah Musleh, MD

A recent Wall Street Journal article about Ozempic (semaglutide) has been widely circulated, perpetuating many misconceptions about this effective diabetes drug.1O’Brien SA. How a diabetes drug became the talk of Hollywood, tech and the Hamptons. Wall Street Journal. Published October 12, 2022. Accessed October 17, 2022. While some may categorize this and other similar pharmaceuticals as get-thin-quick solutions, this is simply not the case.

Ozempic (semaglutide), Wegovy (semaglutide) and others can all comprise a safe, comprehensive weight-loss plan when managed by a qualified physician in combination with nutritional counseling, lifestyle modification, and exercise.

In a nation where more than 40% of the population struggles with obesity,2Adult obesity facts. Centers for Disease Control and Prevention. Updated May 17, 2022. Accessed October 17, 2022. vilifying people who turn to these proven weight-loss solutions is wrong. It’s time to de-demonize, destigmatize, and demystify these drugs.

Understanding Ozempic and Wegovy

Ozempic and Wegovy belong to a class of drugs known as GLP-1 agonists, which stands for glucagon-like peptide 1.These drugs are approved by the FDA for treating type 2 diabetes.
Clinical research has demonstrated that they are a safe and effective solution for lowering A1c levels in people with the disease and other complicating conditions, such as kidney disease or heart failure.3Collins L, Costello RA. Glucagon-like peptide-1 receptor agonists. In: StatPearls. StatPearls Publishing; 2022.

But we are only just beginning to understand the therapeutic potential of these drugs. For example, Ozempic and Wegovy also have some other amazing effects stemming from how GLP-1 agonists work. One of those effects is weight loss.4Collins L, Costello RA. Glucagon-like peptide-1 receptor agonists. In: StatPearls. StatPearls Publishing; 2022. As such, in 2021, the FDA approved Wegovy for weight loss in people with overweight or obesity and one other weight-related health condition, such as high cholesterol, type 2 diabetes, or high blood pressure.5FDA approves new drug treatment for chronic weight management, first since 2014. US Food & Drug Administration. June 4, 2021. Many doctors also safely prescribe the diabetes drug Ozempic off label for weight loss.

This is because the drugs enhance communication throughout the body’s digestive, endocrine, and nervous systems. Once administered, the drugs activate GLP-1 receptors in the pancreas. This prompts the pancreas to release more insulin, which brings blood glucose (blood sugar) levels back to normal ranges over time.6Shaefer CF, Kushner P, Aguilar R. User’s guide to mechanism of action and clinical use of GLP-1 receptor agonists. Postgraduate Medicine. 2015;127(8):818-826.

There’s also a secondary benefit at work here. While increasing insulin production, GLP-1 agonists also slow the emptying of the digestive tract. This makes people who are on Ozempic and Wegovy feel fuller longer, leading to weight loss.7Shah M, Vella A. Effects of GLP-1 on appetite and weight. Rev Endocr Metab Disord. 2014;15(3):181-187. In one September 2022 study, 175 patients taking semaglutide lost 5.9% of their body weight after 3 months and 10.9% after 6 months.8Ghusn W, De la Rosa A, Sacoto D, et al. Weight loss outcomes associated with semaglutide treatment for patients with overweight or obesity. JAMA Netw Open. 2022;5(9):e2231982.

This is a safe, and gradual amount of weight loss. But it isn’t just weight loss that’s occurring in isolation. People who are prescribed these drugs are losing weight while improving the hormonal and neurological underpinnings of health.

Clinical experience has shown us that there are some people who, despite diet, exercise, and other lifestyle modifications, cannot lose weight. This is not due to some personal failing or lack of willpower. It’s because of chronic dysregulation of hormones such as ghrelin9Alamri BN, Shin K, Chappe V, Anini Y. The role of ghrelin in the regulation of glucose homeostasis. Hormone Molecular Biology and Clinical Investigation. 2016;26(1). and insulin,10Kolb H, Stumvoll M, Kramer W, Kempf K, Martin S. Insulin translates unfavourable lifestyle into obesity. BMC Med. 2018;16(1):232. as well as those produced by the thyroid.11Laurberg P, Knudsen N, Andersen S, Carlé A, Pedersen IB, Karmisholt J. Thyroid function and obesity. Eur Thyroid J. 2012;1(3):159-167.

When we tackle these hormonal underpinnings of weight loss with drugs such as Ozempic and Wegovy, we’re improving metabolism from the ground up. That manifests outwardly as weight loss, which we see as improvement squared.

Words of caution about weight-loss

It’s critical to understand that different clinicians have different philosophies. At Anzara Health, we’re not just looking to get patients back into their skinny jeans. That’s because being skinny does not equate with being healthy.

Consider, for example, rates of non-alcoholic fatty liver disease (NAFLD) among people who are lean or who have a normal BMI. Across the globe, it’s estimated that anywhere between 9.6% and 27% of lean people or people with a normal BMI have NAFLD, a condition with proven risks for metabolic health, death from cardiovascular events, and overall mortality.12Kumar R, Mohan S. Non-alcoholic fatty liver disease in lean subjects: Characteristics and implications. Journal of Clinical and Translational Hepatology. 2017;XX(XX):1-8. Being skinny should not be construed with being healthy and this, unfortunately, is where many patients and even some healthcare providers are going wrong.

We have encountered some online weight-loss practices, staffed by healthcare providers who are not endocrinologists, offering these drugs in dosages that are incorrect. For example, Ozempic should follow a strict titration schedule where dosage changes over time.13Ozempic dosage. Updated March 28, 2022. Accessed October 19, 2022.

Furthermore, some are turning to compounded formulations of semaglutide.14Putka S. Demand rising for ‘bootlegged’ weight-loss drug. Medpage Today. July 8, 2022. Compounding is a process by which some pharmacies alter, combine, or mix certain ingredients to create drugs that are specific to individual patients. While these drugs may resemble the original versions, they are not FDA approved and may put patients and doctors at risk.15Compounding and the FDA: Questions and answers. US Food & Drug Administration. Updated June 29, 2022. Accessed October 19, 2022.

In fact, Novo Nordisk, the makers of Wegovy and Ozempic, has issued a letter to healthcare providers, warning them about prescribing compounded versions of the drugs.16Brett J, Radin M. Subject: Compounded semaglutide products. Novo Nordisk. September 2022.

“The compounded products do not have the same safety, quality, and effectiveness assurances as approved drugs, and may expose patients to potentially serious health risks,” the pharmaceutical company wrote.17Brett J, Radin M. Subject: Compounded semaglutide products. Novo Nordisk. September 2022.

What weight-loss patients should do

First, patients should not feel ashamed if they require these drugs for weight loss and for improving their overall health. These are legitimate, proven, and safe pharmaceuticals that target the hormonal underpinnings of health—factors that diet and exercise alone may not address.

If you are struggling to lose weight, work with a qualified endocrinologist to determine the source or sources of the issue. They will perform comprehensive lab work to assess your hormonal health, as well as review lifestyle factors that may be influencing your condition.

Know that weight loss and a healthy BMI are just two components of overall health. While it’s undeniable that many of us want to look better and feel better by shedding a few pounds, doing so without a comprehensive plan may not make you healthier. You’ll know you’ve found the right healthcare team if they’re also discussing diet, exercise, sleep, and other lifestyle factors, in addition to medications.

Finally, there is no reason anyone should have to feel badly about needing these drugs to improve their overall health. More than 40% of people with obesity indicate that they experience stigma associated with their weight.18Lee KM, Hunger JM, Tomiyama AJ. Weight stigma and health behaviors: Evidence from the Eating in America Study. Int J Obes. 2021;45(7):1499-1509. Let’s not add to it by perpetuating misinformation about these safe and effective drugs.

Are you struggling to lose weight despite diet and exercise? You may be contending with chronic hormonal dysregulation. Schedule your appointment with our best-in-class, board-certified endocrinologists to begin your journey to better health.



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