Is Ozempic the New Diet Drug?

The latest pharmaceutical “trend” that patients seek is called Ozempic, an injectable drug that’s FDA-approved to lower blood sugar and regulate insulin in patients with type 2 diabetes. 

Using this drug often leads to weight loss, which can significantly improve the health of diabetic patients.

This benefit has caught the attention of many celebrities, social media influencers and others seeking to quickly shed pounds with the click of a disposable injection pen. 

As high-profile people and the media share Ozempic-induced weight-loss stories and before-and-after photos, requests for this class of drugs (called incretin mimetics) have sky-rocketed. This sudden, increased demand, coupled with a national supply shortage, has made it challenging and even impossible for many patients with diabetes to get their hands on their life-saving medication.

While drug manufacturers work to meet public demand, doctors are busy addressing patient requests for what they think is the latest diet pill.

A relatively painless injection that can help you lose those last 10 pounds or fit into a dress for a big event might sound like a medical miracle. But, these drugs, like all others, have potential side effects and aren’t right or safe for everyone. 

What does Ozempic do?

The active ingredient in Ozempic is semaglutide, the same ingredient in the weight loss drug called Wegovy, which is FDA-approved at a higher dose to treat obese patients with life-threatening risk factors like high blood pressure and heart disease.

“Semaglutide delays gastric emptying and regulates satiety and appetite,” says Gianluca Iacobellis, M.D., Ph.D., an endocrinologist with the University of Miami Health System.

Semaglutide can also target and reduce fat itself, he says. 

“Excessive body weight, particularly visceral fat (located around the heart and liver and in the abdomen), is a major but modifiable risk factor for type 2 diabetes. Semaglutide has shown not only to induce a significant weight loss (up to 20% with high doses) but a visceral fat reduction that greatly benefits patients with type 2 diabetes and others.”

Dr. Iacobellis’ recent research at the University of Miami Health System found that the fat depot of the heart (called epicardial fat) also responds to semaglutide. 

“We found that people with type 2 diabetes treated with semaglutide have lower fat of the heart,” he says. “This is very important because the reduction of epicardial fat improves the heart performance of people with type 2 diabetes and reduces their risk of having a heart attack, atrial fibrillation or stroke.”

How do people feel while taking semaglutide?

“Changes in appetite are expected,” Dr. Iacobellis says. “The desired effects are a result of how semaglutide works on specific receptors in our brain that regulate satiety and appetite. Patients usually feel fuller with a smaller portion of food due to the central (brain) effects, but mainly due to the delayed gastrointestinal emptying induced by the medication.”

Side effects associated with the use of semaglutide:

• abdominal pain
• allergic reactions
• complications with diabetes-related retina disease (diabetic retinopathy)
• constipation
• dehydration
• diarrhea
• fatigue
• gallstones
• inflammation of the pancreas or pancreatitis
• low blood sugar
• nausea/vomiting

“The most common side effects for this drug are nausea, constipation and abdominal discomfort (greater with long-term use and higher doses),” Dr. Iacobellis says.

“The other side effects are rare. Some recent studies showed beneficial effects on diabetes retinopathy, although it is still a controversial topic.”

Is Ozempic for weight loss right for you?

Despite what pharmaceutical ads claim, you shouldn’t have to ask or tell your doctor which prescription drugs are right for you. If your healthcare provider thinks that your health, wellness, life expectancy and quality of life could improve with the use of a particular medication, they will let you know. 

Medical professional recommendations are based on your medical history, age and current condition, and a risk-benefit analysis considering a drug’s potential side effects and health outcomes. 

When prescribing a drug like semaglutide, your doctor will consider your BMI (body mass index), underlying health conditions (including diabetes, AFib, high blood pressure and heart disease) and any personal history of certain conditions, like pancreatitis. If your BMI indicates that you are overweight or obese and have risk factors other than diabetes, your doctor may recommend taking Wegovy. If you have type 2 diabetes and are overweight, your doctor may recommend taking Ozempic to help manage this condition and reduce your risk factors for premature death. 

“Many insurances do not cover Wegovy but do cover Ozempic. I wish these and other drugs could be more affordable,” Dr. Iacobellis says.

If you do not have any risk factors for stroke or cardiovascular disease, and you want to lose some weight, your provider can help determine the safest and most effective way for you to reach and maintain a healthy weight. Patients prescribed semaglutide are advised to increase their physical activity/exercise and reduce their daily caloric intake with a heart-healthy diet. These lifestyle changes not only support the effectiveness of weight loss medication, they also help patients at all fitness levels improve cardio-pulmonary and neurological health, increase energy and lower stress.

Obesity affects the quality of life of millions of people. 

Dr. Iacobellis

“I am in favor of weight loss interventions with science- and clinical-based evidence, in cases that are not contraindicated, of course.” 

He says semaglutide may be appropriate for overweight and obese patients who are considered otherwise healthy. 

Patients like these “are still at higher risk because they are obese or even just overweight with abdominal fat accumulation. Obesity itself is a major risk factor for diabetes and heart disease. Losing even 10 pounds can make a difference in both health and quality of life,” he says.

“As with any pharmacological treatment, including Ozempic, it must be prescribed and supervised by a doctor — without question.”

Dana Kantrowitz is a contributor for UHealth’s news service. 

Tags: blood sugar levels, diet and exercise, Dr. Gianluca Iacobellis, ozempic and wegovy, treat type 2 diabetes