Alec Mais, Summer Intern, Seton Hall Law School 2024 (Anticipated)
Recently, Ozempic and Wegovy have been all over the news for their weight loss effects. They are both brand names for semaglutide but are prescribed under different names with slightly different doses and indications. Ozempic is approved by the FDA for people with type 2 diabetes and Wegovy is approved for people who are obese or those who are overweight and have health problems associated with their weight. With these new drugs the question remains what the risks and benefits are. The most obvious benefit of these medications is weight loss, which can be 15- 20% of a person’s body weight. These medications work by suppressing a person’s appetite. However, there are health risks associated with these drugs that are not adequately advised of and one still needs to eat healthy and exercise.
What are known side effects and risks?
- Serious side effects include thyroid tumors, pancreatitis, changes in vision, hypoglycemia, gallbladder inflammation, kidney failure and cancer. Pancreatitis, gallbladder inflammation, kidney failure and cancer can all lead to hospitalization.
- Common side effects are nausea, abdominal pain, constipation, and diarrhea. These constant gastrointestinal symptoms can lead to stress, anxiety, and depression which is known as the “gut-brain connection.”
- Other side effects include fatigue, indigestion, dizziness, bloating, gas, damage to the eye’s retina, and suicidal ideations. People with diabetes may suffer from retinopathy because of the medications.
- Reports of malnutrition and people suffering from “Wegovy or Ozempic face”, which is fat loss in their face which causes them to look older exist.
- People who stop taking Wegovy and Ozempic often gain weight back relatively quickly after stopping the medication. You may need to keep taking the medication forever to maintain weight loss.
- The drugs are expensive and insurance companies do not cover them for weight loss (although they do cover them for diabetes). Without insurance coverage these medications can cost $15,000-$20,000 a year.
Can I take these medications while pregnant?
There are concerns amongst physicians about using these medications while pregnant. It is not recommended you take these medications while pregnant and they should be discontinued two months before becoming pregnant. Given that nearly half of the pregnancies in the United States are unplanned, the time period before a pregnancy is detected may be particularly concerning while taking these medications. Animal studies have shown that these medications are associated with miscarriage and birth defects, but it is unclear what effect these medications have on humans as it is unclear whether these pregnancy complications are caused by the medication or the weight loss, as weight gain is an important goal of a healthy pregnancy. The FDA’s Wegovy pregnancy warning is slightly more stringent than its Ozempic warning. Wegovy users are advised to stop the drug as soon as a pregnancy is detected. Ozempic users may continue “only if the potential benefit justifies the potential risk to the fetus,”. Before starting these drugs, women should have a negative pregnancy test.
Can I get these medications from other places besides my doctor and pharmacy?
With rising demand for semaglutide, people have circumvented their doctors turning to buying semaglutide from compounding pharmacies, online, or other countries which creates risks of impurity or adulteration. Some compounding pharmacies that make semaglutide mix it with vitamins which limited research has shown may contribute to weight loss. Some compounding pharmacies are distributing a different active ingredient, semaglutide sodium, which is sometimes sold as a research chemical and does not meet FDA standards. Additionally, medications bought from other countries, like Canada or Mexico, may not meet FDA standards. Semaglutide sold on websites for “research use” requires no prescription or oversight. Finally, online telehealth providers who prescribe semaglutide are often midlevel providers rather than physicians and these providers may not know your full medical history.
Can these medications lead to eating disorders?
There is also concern amongst medical experts that prescribing these medications without a medical need could lead to people developing eating disorders because people who lose a significant amount of weight often become fixated on body size and food intake which can cause them to develop an eating disorder. Specifically, there’s a concern when the effects of the medication plateau or someone is no longer using the drug.
Ozempic and Wegovy have a place in the treatment of diabetes and obesity, but these drugs carry risks of rare but serious side effects. They should not be used without physician oversight and only for people unable to control their weight with diet and exercise.