Welcome back to the Doctor Rich Channel. You’ve probably heard about the diabetes drug Ozempic® — which is also a very effective weight loss medication. But are diabetics now at an increased risk of cardiovascular disease because fitness models and celebrities are gobbling up all of the Ozempic for weight loss?
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So what’s the deal?
Ozempic is a diabetes drug that was FDA-approved in 2017. It’s produced by Novo Nordisk® and is a unique design for a diabetic drug in that it’s a GLP-1 analog. What does that mean? Diabetes is a condition of excess blood sugar. There are two hormones made in the pancreas that the body produces to help balance the blood sugar. Insulin lowers it, and glucagon increases it. And simply put, Ozempic fools the body into not releasing the glucagon — and therefore not letting the blood sugar rise. That’s one effect.
The other effect is it actually delays gastric emptying. It delays the food moving through the body, through the stomach, and the intestines. And so less food moves through, you get full for longer — and you just simply eat less food. Researchers found that it was actually extremely helpful for weight loss as well! In fact, in a large study that compared all the drugs for weight loss, Ozempic was the most effective. So Novo Nordisk made a separate product at a higher dose called Wegovy™ — which is specifically used (and only FDA-approved) for weight loss in obese patients or overweight patients with one other risk factor. Since it was so effective for weight loss, there was a rush on it by patients to get it and doctors to prescribe it. And now diabetics who actually need it because it reduces their risk of cardiovascular disease and controls their condition can’t get access because so many other patients are getting it just for weight loss.
And keep in mind, Ozempic is approved for diabetes and diabetics with obesity — it’s not FDA-approved for weight loss by itself.
So what are the five things you need to know about Ozempic?
1. The weight loss is not permanent.
Any weight loss medication needs to be combined with a change in lifestyle and diet that’s sustainable. It’s basically a boost to get you on the right path — but the second you stop the drug (if you haven’t made any other lifestyle and dietary changes), the weight will come right back. Also, keep in mind that even the weight loss drug Wegovy is not FDA-approved for normal weight patients. In fact, normal weight patients that go on and off really any weight loss drug have an increased risk of a cardiovascular event.
2. Is it expensive?
Well, a month’s supply of the weekly injection of Ozempic costs around $1,000.00 (without insurance). Insurance companies won’t cover the cost of the drug Ozempic for off-label use of weight loss. And most insurance companies won’t cover the Wegovy (which is FDA-approved) for weight loss. However, many insurance companies WILL cover Ozempic for the on-label use of the treatment of type 2 diabetes.
Now, patients deserve low-cost access to necessary medications — and many patients and doctors have turned to compelling pharmacies to get the generic version of Ozempic, semaglutide, at a much lower cost. This can be a powerful option for patients and prescribers, but keep in mind the benefits and the side effects may be different
3. So I’m afraid of needles. What can I do?
There’s another drug (an oral medication called Rybelsus™) that was FDA-approved in 2019. Although not FDA-approved for weight loss (approved for diabetes), it is also very effective at weight loss.
4. How does it work?
Primarily as an appetite suppressant. It also prevents glucagon from being released, and so it prevents more sugar from going to the bloodstream. It also prevents food transit, and it slows that down gastric transit — so the glucose appears in the bloodstream at a slower rate.
5. What are the side effects?
The common side effects are nausea, vomiting, heartburn, diarrhea, and dizziness. Rare, severe side effects can include pancreatitis and thyroid cancer. So these are things that in animal studies are certainly very rare, but (with any medication) you really have to talk about the benefits and the risks with your doctor.