WATCH: We look into #Ozempic, a viral "weight-loss injection"

While experts say semaglutide (Ozempic) has triggered a turn in evidence-based obesity management, it’s a real medication that must be prescribed by a doctor — not an over-the-counter weight loss hack.

Emma Jones 7 minute read June 15, 2022

Whenever TikTok starts heralding the effects of a proclaimed wonder-drug, we at Healthing start looking really closely. As it turns out, while this new medication isn’t exactly a magic pill for obesity management, experts say it represents a new chapter in treating a much-maligned chronic illness.

Semaglutide, marketed under the brand name Ozempic, is a medication originally marketed to help manage blood sugar levels in patients with type 2 diabetes. Its effects —  dampening food-cravings and delaying stomach emptying (decreasing hunger) — are also recognized to help individuals diagnosed with obesity. This is where TikTokers jumped on board, excitedly sharing the news of a new option for weight loss.

The drug became so popular that in Australia — where it is approved to help with management of type 2 diabetes — a shortage of the medication prompted health officials to ask that it be prioritized for patients with diabetes.

Experts say that this medication is promising and poses a new therapeutic tool for those looking to manage obesity or type 2 diabetes. That being said, it’s a real medication that must be prescribed by a doctor to manage specific diagnoses, not an over-the-counter weight-loss hack.

Semaglutide (Ozempic) “triggered a turn in evidence-based obesity management”

The conversation around living with obesity has changed in recent years. Instead of framing the issues as a behaviour or a choice — which has been linked to harmful effects on mental and physical health — researchers and advocates are instead recognizing obesity as a complex diagnosis that involves genetic, hormonal and psychosocial factors.

For Ian Patton, PhD, Director of Advocacy and Public Engagement at Obesity Canada, the research around semaglutide marks a step in the right direction for treating obesity faithfully as a chronic illness, which Obesity Canada has recognized since 2020.

“[Obesity] is a complex chronic disease … that means there’s going to be different approaches to management,” Patton says. “But [when] semaglutide got approved for obesity management, and you started seeing the research that was coming out around it, it kind of triggered a turn in evidence-based obesity management.”

Previously, says Patton, the main medical intervention for those living with obesity was bariatric surgery, which wasn’t an option for many and was difficult to scale to meet demand. Other medications available worked for some patients but weren’t as effective as surgery. And with a diagnosis that has as many contributing factors as obesity, choices are needed. Patton says he’s looking forwards to seeing the new treatments that are expected to come thanks to the breakthrough that semaglutide represents.

Specific treatments for obesity are needed — not off-label medications

Dr. Tom Elliott, the medical director for B.C. Diabetes, tells Healthing that he’s not aware of any semaglutide shortages in B.C. or across Canada. This is a good thing, he explains, because it has “revolutionized” the ability to respond to type 2 diabetes through weight management and glycemic control. However, doctors are wary of the pressure that prescribing semaglutide for off-label purposes may put on supply levels.

In Canada, semaglutide for treatment of type 2 diabetes and semaglutide for treatment of obesity are provided under different names and varying doses. Produced by Novo Nordisk, these medications are approved by Health Canada under three brand names, all of which must be prescribed by a doctor: Ozempic and Rybelsus, which are approved to be part of a treatment plan for management of type 2 diabetes, and Wegovy, for weight management in adults who a.) have a BMI classified as obese or b.) have a BMI classified as overweight with at least one other weight-related diagnosis such as sleep apnea, hypertension or type 2 diabetes.

Wegovy is expected to be available on the Canadian market this fall, although it is currently unclear if the shortages seen in other areas of the world will impact its release. That being said, health governing bodies are able to approve the use of these medications for off-label use, so a patient diagnosed with obesity may be prescribed Ozempic.

Dr. Akshay Jain, MD, Clinical and Research Endocrinologist, explains that it is important regional health bodies continue to recognize the need for obesity treatments and develop responses specifically to support these patients.

“Given that well over a third of Canadian adults are living with overweight/obesity, I am hoping that [Wegovy] will be commercially available in Canada soon,” Jain communicates over email. “Provincial health authorities will not realize the burden of obesity/overweight if diabetes medications are being prescribed to treat obesity.
“On paper, it will just seem that the number of patients with diabetes is going up and that will take away from the focus that we need to put on the growing rates of obesity.”

Ozempic and Wegovy part of a larger treatment plan

Semaglutide is classified as a “GLP-1 receptor agonist,” which mimics the hormone GLP-1. In the body, GLP-1 helps increase the release of insulin and lowers glucagon, which is an important tool for keeping blood sugar levels in check. It also helps the stomach slow down on how quickly it empties, which can help patients feel fuller longer.

The medication isn’t perfect, Elliott explains — about one in 10 to 15 people will find that it causes nausea and vomiting and won’t be able to continue with the treatment plan. It is also expensive: in B.C., it amounts to about $7 dollars a day, which can be too pricey for some patients who are on the medication long term. There are coupons and reductions available, explains Elliott, but it requires the proper paperwork to be completed by a specialist.

Those who take Ozempic, however, often see a weight loss of five to 10 per cent of their body mass. One study, published in the New England Journal of Medicine, saw patients on semaglutide injections lose an average of 14.9 per cent of their body weight over 68 weeks.

Patients who are using semaglutide say they aren’t as focused on food

“Before getting obesity treatment, I called it my food brain, I was completely consumed with food, it dominated my day,” explains Patton. “Which was something I knew was weird, because I was different than anyone else that I was around. … Once I started getting obesity treatment, semaglutide being part of that, I finally feel normal. I don’t have that insane food drive.”

Staci Rice, a TikToker from Georgia, U.S., has been sharing her experience with semaglutide since she started with it at the beginning of May, says it helps manage her appetite so she’s not constantly looking for a snack. (Rice did not disclose if she has been diagnosed with obesity.) Outside of some side effects like bloating and constipation, she says her overall experience with the medication is positive.

“I eat a whole lot of snacks and they’re all sugar. I have an 11-year-old so I’m constantly in the snacks or getting anything I can get my hands on,” she explained to Healthing. “Since I started this, I don’t really get hungry anymore … [fast food] is not something that I even crave.”

Rice says she sometimes forgets to eat to the point where she starts to feel dizzy and light-headed, so she has to remember to stop to have a healthy snack (Rice says she now favours fruit smoothies), but it has changed her focus away from battling the constant desire to eat sugary, greasy foods.

Giving herself weekly injections was also difficult at first, but now Rice says she hardly feels it. While she is working closely with a weight-management specialist, Rice doesn’t plan to be on the medication long-term. Instead, Rice says she is hoping to taper off the medication once she reaches a healthy weight and then will try to maintain her new eating habits on her own.

While the medication represents a turning point for obesity management, it is important to note that it is not a magic pill. Obesity is a complex, chronic diagnosis that requires lifelong management, similar to hypertension or diabetes, says Patton. But having the tools and the support to manage this condition opens a pathway to a healthier future.

 

Emma Jones is a multimedia editor with Healthing. You can reach her at emjones@postmedia.com or on Instagram and Twitter @jonesyjourn.

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