So why are so many non-diabetics taking a drug designed for the autoimmune condition? Anyone who reads the health headlines will have noticed that, over the past few months, a drug that goes by the name semaglutide – Ozempic or Wegovy to use its various brand names – has been garnering a lot of column inches. In many ways, it isn’t a new story; the US Food and Drug Administration approved the use of Ozempic for treating diabetes in 2017. So why all the attention?

Well, unlike previous diabetes medication – namely Metformin – which affected a limited degree of weight loss in some patients, those who were prescribed Ozempic appeared to trim down significantly as a side-effect of the drug. And, when treating Type II diabetes, losing weight, especially that which accumulates around the waist, is a first line course of action. Ergo, anything to make that battle easier, particularly for those suffering from insulin resistance which can make weight loss substantially more challenging, had to be a good thing. While every case is individual, a 10 per cent reduction in body weight for patients on semaglutide appears to be typical.

Of course, not everyone living with obesity is diabetic. However, there are innumerable other ways in which the condition can cause adverse health effects; again, any help that can be proffered is, surely, worth some exploration. Duly, then, Wegovy – a new version of the drug which is specifically aimed at those living with obesity and which contains a higher dosage of active ingredient semaglutide – was approved in the UK in 2021 by the Medicines and Health Products Regulation Agency. And whilst it is not yet available on the NHS, patients can currently access the drug via select private medical practices. However, the wait will not be long for those without deep pockets: in March, NICE recommended the use of Wegovy on the NHS to adults with a BMI of over 35, or for those between 30-34.9 kg/m2, with one weight-related comorbidity.

It has, of course, caught on. Its use is already rife in hyper body conscious Hollywood. Elon Musk credits his trimmer physique to the drug, as does Jeremy Clarkson, while British writer David Aaronovitch has also tried it. Writing in The Times, Aaronovitch explains, ‘I hate writing this, because I sound like a PR agent, but from quite early on magic was worked. I’ve thought a lot about how to describe this, and every time I’ve tried I’ve failed. The nearest I can get is to say that I have felt a strange combination of being at all times mildly bloated and pleasantly full, as though someone has put a football where my stomach ought to be. Since I started on the semaglutide I have never, not for one second, felt hungry. I don’t have to try not to eat, or exercise any willpower. I can go without food quite happily for 16 to 18 hours.’

So how does it work? Taken in the form of a weekly injection or a pill, the drug is an insulin regulator for the pre-diabetic which lowers the blood sugar, slows down the stomach from emptying and promotes the feeling of satiety. Talking to The New York Times, Dr. Janice Jin Hwang, chief of the division of endocrinology and metabolism at the University of North Carolina School of Medicine, says that for patients on the medication, ‘foods that used to be really exciting to them are no longer exciting’.

Weight loss is not, however, the only side effect of the semaglutide. It is also been proven to reduce instances of cardiovascular disease in those with diabetes. However, on the negative side, it can cause nausea, dehydration and other gastric problems such as constipation. It is, therefore, recommended that patients start off on a low dose to see what their bodies can – or cannot – tolerate.

Predictably, it’s hugely popular, with the hashtag #MyOzempicJourney going viral on TikTok, and #Ozempic garnering some 74m views on the same platform. But it is also appropriate to exercise caution and ask questions. Is this a drug one wants to be on forever (patients who come off it tend to regain at least some of the weight they lost)? And what are the long-term effects?

Dr. Zhaoping Li, chief of clinical nutrition at the David Geffen School of Medicine at UCLA, talking to Variety, warns, ‘Obesity is an epidemic. The issue is that this is one of the tools in our box, it is not the end-all. The longest study done on these injections was conducted over less than two years. A lot of questions have not been answered.’

By Nancy Alsop
June 2023