by Dawn Pleasant Parker, American Women of the Aquitaine and Health Team Co-Chair
You can barely get through a day without hearing something about Ozempic® and similar drugs. Whether you’re on TikTok or other forms of social media, news about these medications seems to emerge constantly.
In the spirit of full disclosure, I am a Type 2 Diabetic who is currently taking a weekly dose of Ozempic®. I’ve also had limited experience with Mounjaro® due to the unavailability of Ozempic®. This subject is vast, and new information arises daily. Therefore, we’ll be publishing a series of articles to address any issues or concerns you may have or want us to include in future pieces. Please feel free to send us your experiences or burning questions about this topic.
I must also share that this is both an exciting and frustrating time for these drugs. I distinctly remember when I was first put on Ozempic®, I was so frustrated because I couldn’t obtain this life saving drug. I was furious, thinking that someone in Hollywood was buying it just to fit into a smaller dress size! There were massive shortages, and I was in a country that sold it over the counter, so anyone could come in and get it – even without a prescription! This raises questions about the worldwide impact this drug can have.
Personally, Ozempic® was a game changer for me. My blood sugar fluctuated wildly before, requiring regular insulin and leading to periods of hypoglycemia (low blood sugar) followed by peaks of hyperglycemia (high blood sugar). Ozempic® quickly stabilized my blood glucose levels, eliminating my need for regular insulin.
The worldwide impact cannot be minimized. According to the WHO, the global prevalence of diabetes has steadily increased over decades. As of 2019, an estimated 463 million adults aged 20–79 years were living with diabetes worldwide, the majority being Type 2 diabetics. Type 2 diabetes is closely linked to obesity and other lifestyle factors. The co-occurrence of Type 2 diabetes and obesity is a significant public health concern, as both conditions are associated with an increased risk of cardiovascular disease, stroke, kidney disease, and other chronic health problems.
How Do Drugs Like Ozempic® Work?
Ozempic® belongs to a class of medications called GLP-1 receptor agonists, named after a hormone in the human body they are designed to imitate. In 2017, the Food and Drug Administration (FDA) approved Ozempic® to treat Type 2 diabetes, but many have used the drug off-label to lose weight. In the last few years, other similar drugs have hit the market: Wegovy®, a drug approved for weight loss and reducing the risk of cardiovascular issues in some adults; Mounjaro®, approved for Type 2 diabetes; and Zepbound®, authorized for weight loss. All of these medications are weekly injections.
Both Wegovy® and Ozempic® contain semaglutide, which mimics the hormone GLP-1 to stimulate insulin production in the pancreas and slow down stomach emptying, making people feel fuller faster and longer. Mounjaro® and Zepbound® work similarly, but they use tirzepatide (rather than semaglutide) to simulate both GLP-1 and a second hormone, GIP.
These drugs work by:
- Stimulating insulin production: Helping regulate blood sugar levels by encouraging the pancreas to produce more insulin.
- Slowing stomach emptying: Helping users feel fuller for longer, reducing overall food intake.
- Targeting hunger signals in the brain: Reducing cravings, which can be particularly beneficial for weight loss.
Effectiveness and Results
These medications have been labeled as "game-changers" for many, though effectiveness can vary. An analysis of the longest and largest study on semaglutide, published this month, showed that participants who took the medication for four years shed an average of around 10% of their body weight and sustained that weight loss. A major trial on tirzepatide showed that people who took the highest dose lost an average of around 18% of their body weight after 72 weeks.
“They’re just a game-changer,” said Dr. Melanie Jay, director of the N.Y.U. Langone Comprehensive Program on Obesity.
However, these drugs don’t work for everyone. In clinical trials, a small fraction of participants did not lose significant weight or see meaningful improvements in blood sugar control. “We haven’t quite figured out yet who will respond well,” said Dr. Scott Hagan, an assistant professor of medicine at the University of Washington who studies obesity.
Side Effects
Common side effects, particularly in the early stages of treatment, include:
- Gastrointestinal issues: Nausea, vomiting, diarrhea, constipation, acid reflux.
- Other side effects: Fatigue, dizziness, headaches, and potential low blood sugar in diabetics.
- Long-term effects: Rapid weight loss may lead to muscle mass loss and, in rare cases, pancreatitis or gallbladder issues.
For What Other Uses are These Drugs Being Studied?
Dozens of clinical trials are currently underway to test whether these drugs could treat a range of conditions, including chronic kidney disease, Alzheimer’s, liver disease, sleep apnea and polycystic ovary syndrome (PCOS). These medications’ ability to induce weight loss might help with many of these conditions, but scientists speculate that the drugs have unique effects independent of weight loss, possibly by alleviating inflammation. They are also watching how these drugs impact the brain and whether inhibiting cravings could help with alcohol use disorder.
In March, the FDA approved Wegovy® to reduce the risk of heart attack, stroke and cardiovascular-related death in adults who have heart disease and are overweight or obese.
How Much Do These Medications Cost?
The list price of Ozempic® in the United States is currently around $968 for a one-month supply. The cost of Wegovy® is about $1,349; Mounjaro® is around $1,069 and Zepbound® is about $1,059. Patients do not typically pay the list price; many insurers cover the medications, although the extent of that coverage varies, and some have introduced new restrictions. Additionally, some patients can qualify for financial assistance. In the European Union, the average cost is between €40-80, even if you are not enrolled in the respective countries’ health plan.
Because these drugs can be expensive, some people have sought out compounded semaglutide and tirzepatide – unauthorized medications that the FDA has linked to adverse reactions. There is no generic version of semaglutide or tirzepatide.
How Long Do You Take These Drugs?
Drugs like Ozempic® are considered indefinite prescriptions, similar to blood pressure medications or statins. The drugs are only effective while they are being used; when patients stop, they will likely hit a weight loss plateau and regain weight.
Some patients balk at the idea of staying on these medications long-term. Dr. Jay Feldstein, a physician using Ozempic® since late 2023, said: “In the absence of carbohydrate cravings, I'm left instead with questions: Did I need this drug in the first place? Have we found a panacea, or are we opening a Pandora's box? I'm not the first, and won’t be the last, to ask. Answers may be years away.”
Conclusion
Drugs like Ozempic® represent a significant advancement in treating Type 2 diabetes and obesity. However, they come with challenges, including side effects, high costs and the need for long-term use. Ongoing research and patient experiences will continue to shape our understanding and use of these medications.
Sources:
- Ozempic® (semaglutide) approved in the US | Novo Nordisk Global
- How Much Weight Comes Back After You Stop Using a Weight-Loss Drug? | New York Times
- I'm a Doctor on Ozempic—It's Effective Under One Condition | Newsweek
- How long can I use Ozempic? | MyDr.com.
- How long does it take for Ozempic to work? | Drugs.com
- Ozempic: Uses, Dose, Side Effects, Instructions | Drugs.com
- The Wegovy Shortage Continues, Leaving Patients On the Weight Loss Drug in Limbo | The New York Times
- FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss | U.S. Food and Drug Administration
- Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial | Nature Medicine
- Senate Committee Investigates Ozempic and Wegovy Costs | New York Times
- Ozempic Is Hard to Find. Some Pharmacies Are Offering Unauthorized Alternatives | New York Times
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