How Wegovy and Ozempic Have Changed the Face of Weight Loss
Incredibly, less than 10% of obese patients who try to lose weight through traditional diet and exercise can maintain that weight loss over the long term. Despite the billions of dollars spent on diet and exercise programs, some of which may offer questionable value, we don’t seem to have made any progress toward solving the obesity epidemic in the United States. With 2/3 of adults in the US overweight and approaching 40% obese, it’s no wonder that “miracle” drugs (known as Semaglutide or GLP-1 receptor agonists) have become so popular to the point of nationwide and even worldwide shortages.
What Are These Drugs?
Glucagon-like peptide-1 receptor agonists or GLP-1 RAs mimic the hormone naturally produced in the body that stimulates insulin secretion. As such, these injectable GLP-1 drugs have been used for blood sugar control for years. Beyond the blood sugar benefits, GLP-1s suppress hunger signals when taken in greater concentrations, people report feeling less hungry, and the weight seems to melt away. For many, 20% body weight loss is not out of the realm of possibility. This means that a normal BMI is often within reach for some overweight patients. Obese patients can benefit as well, though they are less likely to reach a BMI that would be considered normal.
You may have seen a drug known as Ozempic advertised on TV for several years. Approved by the FDA in 2017 for diabetes management, patients and physicians quickly noticed that not only was it effective in treating type two diabetes, but the drug also showed consistent and rapid weight loss benefits. The same company, Novo Nordisk, then applied to the FDA for the same drug, but at a higher dosage and a different indication – to treat obesity. This was approved by the FDA in 2021. Known as Wegovy, this drug has proven so popular that patients worldwide are scrambling to find it. Online influencers and celebrities alike have used these therapies for significant weight loss, and many have openly discussed their stories.
It’s important to remember that many people rely on Ozempic for diabetes management and Wegovy to fight morbid obesity. Therefore, the current drug shortages have caused a very concerning situation. And demand is pushed higher by patients getting these drugs from their physicians off-label. While this is a legal way of prescribing drugs, there are rightful concerns for those who can no longer access potentially life-saving medication.
In the case of Wegovy, indicated for certain obese patients, the drug is not for those needing to lose a relatively small amount of weight, but that’s exactly what’s happening.
Are There Any Other Options?
The short answer is yes; Eli Lilly markets a drug known as Mounjaro for diabetes, and approval is in the pipeline for a weight loss application. Much like Semaglutides, this drug is also in short supply because it has shown excellent results for weight loss and is being prescribed off-label.
Is This Sustainable? And Safe?
From preliminary data on these weight loss and diabetes drugs, there seem to be some risks, as would be the case with any medical intervention. The risks don’t seem disproportionate to the benefits, however, so most eligible patients will likely qualify. Of course, you should speak to your primary care physician or weight loss specialist to understand whether these drugs suit you.
Sustainability is a different story. Patients who take these drugs only receive the benefit as long as they are on the medication. If these drugs are discontinued, most patients will regain some or all their weight over time. To avoid this, patients must use this time to implement fundamental and long-term changes to their diet and exercise. This means eating healthier, more wholesome foods and upping their exercise. All too often, we see patients binge on unhealthy foods, thinking that the medication will be there to save them. Unfortunately, that is only a recipe for longer-term failure.
We also want to caution high-BMI patients because these drugs likely will not have a strong enough effect on their weight to eliminate comorbidities. Bariatric surgery remains the best option for many patients needing a long-term solution to morbid obesity. However, there is reason to believe these drugs could be useful in reducing their weight to a degree where surgery is less risky. Patients may also benefit from these weight loss medications after their bariatric procedure if they are experiencing some weight gain or their weight loss has slowed. While we always suggest improving diet and exercise habits as the first defense against weight regains, we understand that some patients need help to get back on track.
Of course, this is all a moot point right now. But as manufacturers ramp up production and doctors, hopefully, prescribe these medications more judiciously, we expect them to be once again available on the marketplace.
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