Weight loss drugs: The science and side effects behind Ozempic and Wegovy

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Ozempic will help individuals to shortly drop pounds however can also have critical uncomfortable side effects

AP Photograph/David J. Phillip/Alamy

Ozempic and Wegovy are model names for the drug semaglutide. Many international locations have accredited Wegovy for weight reduction in people who find themselves overweight or obese and Ozempic for individuals with sort 2 diabetes.

How do these medication work?

Medication akin to semaglutide mimic the actions of a hormone known as glucagon-like peptide-1, or GLP-1. These so-called GLP-1 analogues have a number of results, together with slowing abdomen emptying, appearing on the mind to cut back urge for food and boosting the discharge of insulin, which helps to manage blood sugar ranges.

For greater than a decade, GLP-1 analogues have been used to assist individuals with sort 2 diabetes management their blood sugar and a few customers skilled modest weight reduction. “These medication increase a system that already exists throughout the human physique, whose function it’s to suppress urge for food following meal ingestion,” says Simon Cork at Imperial Faculty London.

Why are they making headlines now?

GLP-1 analogues have began to be prescribed for weight reduction in individuals with out sort 2 diabetes. They’ve additionally turn into accessible in formulations which might be stronger and simpler to make use of.

Initially GLP-1 analogues have been accredited to be used at a decrease dose and wanted to be given by twice-daily injections. Within the newest formulations they’re once-weekly injections, with Wegovy’s full dose being 2.4 milligrams for weight reduction and Ozempic getting used at a most dose of two milligrams for sort 2 diabetes.

How broadly accessible are they?

In 2021, Wegovy was accredited for weight reduction in a number of international locations, together with the US and Canada. Reward from some superstar customers introduced it widespread publicity.

Manufacturing issues meant its producer, Novo Nordisk, had bother assembly world demand, so some medical doctors began prescribing Ozempic, which had been accredited for individuals with sort 2 diabetes in sure international locations a number of years earlier. This led to shortages for individuals who required it for diabetes management.

Within the UK, Wegovy was accredited in 2021, however solely bought the nod from England’s medical tips physique the Nationwide Institute for Well being and Care Excellence in March 2023, when it mentioned the drug ought to be given by weight reduction clinics throughout the nation’s nationwide well being service. Wegovy is predicted to turn into accessible within the UK this 12 months, whereas Ozempic has been accessible for sort 2 diabetes since 2019.

In June 2023, the UK authorities introduced the introduction of a two-year pilot that provides individuals with weight problems entry to new medication, akin to Wegovy, exterior of a hospital setting.

How efficient are they?

Very. It’s a cliche however weight problems medical doctors are speaking a few paradigm shift within the discipline of weight problems administration. Beforehand, a lack of about 5 per cent of physique weight could be thought-about a very good end result for any weight reduction intervention exterior of abdomen surgical procedure and is taken into account a benchmark in weight problems drug trials.

Wegovy results in a few 15 per cent discount in physique weight over a 12 months, when mixed with train and consuming healthily.

Actually, some individuals appear to really feel that the GLP-1 analogues have induced them to turn into too gaunt, as mirrored within the rise of the search phrases “Ozempic face” and “Ozempic butt”. “Ozempic doesn’t do something particular to the pores and skin,” says Alexander Miras at Ulster College, UK. It’s the weight reduction that causes these obvious uncomfortable side effects, with related outcomes typically additionally occurring after weight reduction surgical procedure, he says.

Do the medication have any uncomfortable side effects?

Uncomfortable side effects might be delicate, akin to nausea, constipation and diarrhoea, which are likely to happen as individuals get used to the drug. Extra worrying uncomfortable side effects embody irritation of the pancreas, though that is comparatively uncommon.

How about hair loss?

Hair loss has been reported by some semaglutide customers. That is additionally typically seen after vital weight reduction from different causes, akin to abdomen surgical procedure, says Miras.

Hair loss following weight reduction surgical procedure is considered attributable to physiological stress on the physique inflicting an elevated variety of hair follicles to enter their “resting” part, which ends up in the hairs falling out a couple of months later. It stops when the burden loss stabilises, nonetheless, the hair doesn’t all the time develop again, says Miras.

Do these medication trigger suicidal ideas?

GLP-1 analogues – akin to Ozempic and Wegovy – are being investigated by the European Medicines Company (EMA) after latest stories that they could trigger ideas of suicide or self-harm. This was after Iceland’s well being regulator obtained three such stories relating to semaglutide and one other drug known as liraglutide, which is an earlier GLP-1 analogue.

The EMA says it’s analysing about 150 stories of attainable circumstances of self-injury and suicidal ideas. This doesn’t imply the medicines induced these results, nonetheless, solely that folks reported these experiences after beginning to take them. “Extra work is required to find out if a causal hyperlink exists,” says Michael Schwartz on the College of Washington in Seattle.

A spokesperson at Novo Nordisk, the producer of liraglutide and the semaglutide medication Ozempic and Wegovy, informed New Scientist: “GLP-1 receptor agonists have been used to deal with sort 2 diabetes for greater than 15 years and for therapy of weight problems for eight years. The protection knowledge collected from massive medical trial programmes and put up advertising and marketing surveillance haven’t demonstrated a causal affiliation between semaglutide or liraglutide and suicidal and self-harming ideas.”

Want a listening ear? UK Samaritans: 116123; US 988 Suicide & Disaster Lifeline: 988; hotlines in different international locations.

Do these medication assist with addictions?

Maybe. There have been many anecdotal stories of individuals taking these medicines for diabetes or weight management who lose their urge to drink alcohol or see waning of different habits that may very well be described as “behavioural addictions”, akin to compulsive purchasing.

That is supported by analysis in animals that discovered the GLP-1 analogues decrease consumption of alcohol and addictive medication. A small trial in individuals has hinted at the same impact from a GLP-1 analogue known as exenatide, which decreased heavy ingesting, however solely in individuals who have been overweight.

The reason may very well be related with the way in which the medication act on the mind to cut back meals cravings, however the actual mechanism is unclear. We’re solely at first of understanding how these remedies might assist individuals with alcohol and drug additions, says Daniel Drucker at Sinai Well being in Toronto, Canada. “The medical trial knowledge isn’t but in to substantiate the anecdotes.”

What occurs to a person’s weight long-term?

The longest trial of Wegovy lasted two years and located that folks’s weight broadly plateaued within the second 12 months.

In most international locations, Wegovy has been accredited for 2 years’ use, but when individuals cease taking the drug, they often regain the misplaced weight – two-thirds of it after one 12 months, based on one trial.

“The burden loss is simply sustained for so long as the drug is taken as a result of as quickly as you cease the drug, all of these physiological processes which might be attempting to get your physique weight again up kick in once more,” says Cork.

This means that after two years of use, there will likely be demand from customers for medical doctors to proceed prescribing the drug “off label”. “I feel there’ll be a giant push to attempt to change these tips,” says Cork.

Ozempic might be prescribed long-term for sort 2 diabetes as a result of the situation is often life-long.


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