If you have a TikTok, follow celebrity news, or engage with mainstream media, you’ve probably been wondering: What is Ozempic, and why is everyone talking about it?
Ozempic is an injectable diabetes drug that has recently gone viral for helping people lose weight, as it uses the hormone GLP-1 which increases insulin sensitivity and suppresses appetite. You might also know it as its generic, semaglutide, which is also sold under brand name Wegovy.
Wegovy, which was first available in the US, specifically aimed at shedding pounds, is due to go on sale in the UK in Boots with a prescription, the Mail on Sunday reports. The drug’s manufacturer, Danish pharmaceutical giant Novo Nordisk, said the drug will go on the market “as soon as possible.”
Now, The Times reports that overweight Britons will be told to download weight-loss apps to get quicker access to slimming jabs. According to the newspaper, The National Institute for Health and Care Excellence (Nice) has approved four online platforms — Liva, Oviva, Roczen and Second Nature — to offer the medication along with support to increase healthy eating and exercise.
Some of the platforms can prescribe the drugs semaglutide and liraglutide directly. Others collect and share data with an NHS team to support prescribing, and all provide a wraparound service involving diet and exercise. Semaglutide, which is used under the name Wegovy to treat obesity, is not yet available in the UK thanks to global shortages.
However, Nice has approved the drug to treat people with a body mass index (BMI) of at least 35 and at least one weight-related health problem, such as diabetes or high blood pressure. A lower BMI threshold applies in some cases.
The price of the slimming drug is not yet known but current users of Ozempic pay around £180 for a month’s supply.
This new class of medication has become a controversial topic over the past year, and in February, model Remi Bader opened up about her experience taking Ozempic, Chelsea Handler confessed she had used it but was unaware at the time, and The New York Times, NPR, the Today show, and more have reported on the phenomenon that is “Ozempic face.”
“When I first learned of the Ozempic trend, I felt sick to my stomach.”
Now critics are questioning the ethics of normalising Ozempic for weight loss when it’s intended for the treatment of type 2 diabetes—especially since the drug has faced shortages so severe that many who need it can’t access it. But the demand for and interest in Ozempic hasn’t slowed, especially as tabloids, most notably celebrity gossip Instagram @deuxmoi, allege that celebrities are continually turning to the drug as a makeshift diet aid. Ozempic is also trending for noncelebrities: At the time of writing, Ozempic and Wegovy have a combined total of over 1.5 billion views on TikTok.
Not everyone who takes Ozempic does so as part of a get-thin-quick scheme, however. Ozempic is prescribed for type 2 diabetes, and Wegovy was created and FDA-approved specifically for the treatment of obesity. These drugs have also been found to help people with prediabetes, polycystic ovary syndrome (PCOS), reducing insulin resistance, and other related conditions. Therefore, Ozempic and similar drugs should not be reduced to some sort of weight-loss hack; these are real medicines that benefit people with chronic conditions.
“The real story is that highly effective, safe medicines for weight loss are finally here, and we can finally treat the obesity epidemic with tools that work,” Spencer Nadolsky, DO, an obesity and lipid specialist physician and medical director of Sequence, tells Glamour. “There is a lot of stigma and bias against those with obesity: Why would anyone object to someone having an improved quality of life and the prevention of future illness just because they used a medicine to lose the weight? We should be happy for them.”
That said, Dr. Nadolsky isn’t surprised by some critics’ frustration over the phenomenon. “I understand the anger when those who are healthy and don’t have obesity are getting the high-demand medicine just for their small amount of vanity weight, which is something I don’t recommend.”
These innovations in obesity treatment shouldn’t make anyone feel that they “need” to lose weight. Glamour has addressed this: Body types are not trends that go in and out of style, and research has found that diet culture does much more harm to one’s health than good. If someone has a condition that Ozempic or Wegovy can medically treat, however, they deserve to fully understand what these medications are and how they work.
Yet, taking these medications also doesn't come without their own risks, as Ozempic has been linked to thyroid cancer. Ahead, doctors break down everything you need to know about taking Ozempic and Wegovy for the treatment of chronic conditions—as well as who qualifies, what’s causing the shortage, side effects, and more.
What is Ozempic?
Ozempic is actually a brand-name for semaglutide, which is FDA-approved for the treatment of type 2 diabetes. Semaglutide is also available under the brand name Wegovy, which is approved for obesity, and in pill form as Rybelsus, which is intended for type 2 diabetes.
Semaglutide mimics a hormone the body produces that releases insulin and reduces appetite after eating food. “But semaglutide has a much longer half-life than our natural hormone, meaning it lasts longer in our system,” Dr. Nadolsky explains. Translation? It makes you feel full for longer.
By nature of being a woman, I’ve had my body commented on throughout my life.
“Medications that enhance the activity of the hormone cause you to feel satisfied—less hungry—more often, which typically leads to decreased food intake,” says Jessica Cutler, MD, a weight-loss surgeon at the Maryland Bariatric Center at Mercy in Baltimore. That is how the drug causes people to lose weight: via appetite control in the brain.
Semaglutide has more straightforward health benefits too. “These medicines help lower blood sugars—only if they are elevated, not when they are normal—by helping our pancreas release more insulin, which lowers blood sugars, and decreasing glucagon, a hormone that increases blood sugars, along with slowing down our gastric emptying, which slows down our GI tract,” Dr. Nadolsky says. Ozempic and Wegovy are taken via a once-weekly injection in either the thigh or stomach.
Who is qualified to take Ozempic?
According to Heather Martin, DO, family physician and medical director of the primacy care program at K Health, most prescribers have very strict criteria when it comes to prescribing these drugs.
“Patients must have a BMI over 30, or a BMI over 27 with one weight-associated condition like hypertension or type 2 diabetes, and must have been unable to lose and keep off weight with lifestyle changes alone like diet and exercise,” she says. “We also do a full intake which includes blood tests to ensure you’re a good fit.”
Dr David Eccleston, a private Birmingham GP specialising in fat loss, told The Independent: “No medical professional in the UK is allowed to actively promote Ozempic as a treatment for obesity because it is outside the product licence.”
A Boots spokesman said: “Wegovy is a prescription-only weight-loss medicine that can help to regulate appetite and reduce cravings.
“It can be an effective medicine to achieve sustained weight loss when used alongside a reduced calorie diet, increased physical activity and healthy lifestyle choices.”
What’s causing the Ozempic shortage?
“Unfortunately, manufacturers sometimes make mistakes and sometimes can’t keep up with demand,” Dr. Nadolsky says. Dr. Cutler agrees: “We have seen a lot of supply-chain issues which have limited the availability of these medications. I wish we lived in a world where every person who could benefit from a medication would have the choice to take it."
How many GLP-1 medications are there, and how do they differ from one another?
There are at least eight GLP-1 medications that are FDA-approved, including Trulicity, Bydureon, Byetta, Ozempic, Victoza, Saxenda, Rybelsus, Wegovy, and Mounjaro.
"Mounjaro is a new medication which also works to enhance the activity of GLP-1, but also another molecule known as GIP,” Dr. Cutler explains. GIP also stimulates the release of insulin. “Put together, augmentation of both these molecules seems to produce a very strong effect on appetite suppression," she says. Mounjaro has also been given an FDA “fast track” approval process, meaning it’s likely to be approved for obesity in 2023.
Losing weight isn’t necessarily good, and putting it on isn’t bad. Our healthcare system needs to do better to understand and communicate these complexities.
What are Ozempic and similar medications supposed to treat?
“The FDA has approved Ozempic, Victoza, Rybelsus, and Mounjaro for the treatment of type 2 diabetes, and they are effective medications for this condition,” Dr. Cutler says. “However as more people started to use them, their benefits in appetite suppression and weight loss became more evident, to the extent that some of them have been rebranded and submitted to the FDA again as medications for weight loss, like Wegovy and Saxenda.”
That said, these medications have been also found to help other conditions related to insulin resistance, such as prediabetes, fatty liver, and PCOS, Dr. Cutler says (Metformin, another diabetes medication, is also used to treat PCOS). “Indirectly, conditions like high blood pressure, high cholesterol, sleep apnea, and others may improve with weight loss that comes along with these medications.”
What are the possible risks and/or side effects?
One of the more concerning risks from taking Ozempic is that it could cause thyroid cancer. According to the official Ozempic safety information sheet, in studies with rodents, Ozempic and medications like Ozempic, Ozempic caused thyroid tumours and thyroid cancer.
“It is not known if Ozempic will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people,” the sheet says, adding that you should tell your health care provider if you get a lump or swelling in your neck.
As the chances of humans developing thyroid cancer from taking the medicine is currently unknown, medical professionals are calling it safe to use.
“The new class of GLP-1 receptor agonists are safe,” says Dr. Martin. “Like most medications, however, they do have some side effects that some patients may experience, including bloating, nausea, vomiting, diarrhea, or constipation. When we prescribe these medications to our patients, our strategy is to slowly increase the dosage of the medication as tolerated to minimise side effects. Sometimes we even decrease dosage or pause on increasing the dosage if the side effects become unbearable.”
There are other more serious risks that can arise. “Other potential effects of losing weight quickly could include forming gallstones and associated problems like pancreatitis; loose skin; or vitamin deficiency if a person is not making sure to get enough nutrition in their diet,” says Dr. Cutler. While there is a small risk of gallstones and gallbladder disease associated with the medication, that risk is also common for quick weight loss. Dr. Nadolsky says, “As a result, it’s debated how much is from the medicine itself.”
Such is also the case for what has been dubbed Ozempic face, the rapid ageing in the face as a result of extreme weight loss. "This is likely seen more so in those who didn’t struggle with obesity or type 2 diabetes who are taking [these medications] for small amounts of vanity weight loss, something I do not recommend,” says Dr. Nadolsky. “It’s not from the medicine itself, but the weight lost from the medicine.” Essentially, if you don’t have a lot of weight to lose to begin with, you will start to lose it from places like your face.
What’s some advice for someone starting Ozempic?
“The medicines affect everyone differently. Some people have a very small response at first, while others may experience more severe nausea,” says Dr. Nadolsky. “Most people tolerate GLP-1 medications pretty well. I always recommend to keep the dose low and only go up as tolerated each month according to the label. My general rule of thumb is that patients should be on the lowest dose that’s effective.”
Therefore, if a patient is already losing weight at a healthy rate, they don’t need the maximum dose. Adds Dr. Nadolsky, “If you're experiencing moderate to severe side effects, it’s likely not a good idea to increase your medication dose. You absolutely want to get in enough protein, electrolytes, and vitamins and minerals. So, if you can’t eat actual food, you’ll need to supplement with shakes. Many patients notice large, heavy meals do not sit well.”
Dr. Cutler also advises speaking with a dietician, nutritionist, or other nutrition professional. “Some of these medications can suppress appetite to the point where a person has to remind themselves to eat—so if they are not being careful about getting in enough protein and vitamins, they may end up losing weight, but become unhealthy for different reasons.”
Danielle Sinay is the associate beauty editor at Glamour. Follow her on Instagram @daniellesinay.
This story originally appeared on Glamour US.
