Semaglutide

Semaglutide is the active ingredient in certain drugs taken as pills or injections, to treat diabetes (primarilySteven Novella (June 28, 2023). "Does Intermittent Fasting Work?". Science-Based Medicine. "There are medications available, such as Ozempic. These are primarily for diabetes, but are shifting to treatments for obesity itself. However, these medications are expensive and have to be taken indefinitely, with a risk of rebound if they are stopped. Medical interventions therefore have a role to play, but they are not for everyone."), obesity, or not yet looking like a Tim Burton character. For diabetes, it's prescribed under the brand names Ozempic (injection) or Rybelsus (pills), and for weight loss as Wegovy (injection).(January 10, 2024). "Medications Containing Semaglutide Marketed for Type 2 Diabetes or Weight Loss". Food and Drug Administration. According to the manufacturer (Novo Nordisk), these all come "with different indications, dosages, prescribing information, titration schedules, and delivery forms … The products are not interchangeable". As of 2023, no generic versions had been approved by the FDA.(July 19, 2023). "Ozempic for weight loss: Does it work, and what do experts recommend?". UC Davis Health.
Semaglutide is a glucagon-like peptide-1 (GLP-1) agonist, meaning it mimics the GLP-1 hormone usually released by one's intestines in response to eating food. This helps type 2 diabetics when it reduces blood sugar. It helps for weight loss because it suppresses appetite and slows stomach digestion.(July 3, 2023). "GLP-1 Agonists". Cleveland Clinic.Lisa Catanese (February 5, 2024). "GLP-1 diabetes and weight-loss drug side effects: "Ozempic face" and more". Harvard Health Publishing. Randomized controlled trials (RCTs) suggest the drug also reduces risk of death from cardiovascular disease in either group.(August 30, 2024). "New Science Suggests Semaglutide Improves CV Outcomes Beyond Weight Loss". American College of Cardiology.
The drug is not meant as a "miracle drug" for these conditions, being more of an assistant to other treatment strategies. Nonetheless, the expensive drug is touted by Hollywood and social media as an easy weight loss method.Matt Donnelly (September 21, 2022). "Hollywood's Secret New Weight Loss Drug, Revealed: The Hype and Hazards of Ozempic". Variety. Many people instead find the common side effects like diarrhea, nausea and vomiting too difficult to bear, and cease treatment before achieving "clinically meaningful weight loss". According to the studies of one research lab, semaglutide reduced risk for forty-two health conditions but increased risk for nineteen others.Ziyad Al-Aly (January 22, 2025). "Ozempic and similar weight loss drugs may lower risk of 42 health conditions, but also pose risks". The Conversation.
The drug's use as a weight loss assistant has caused shortages, including for diabetic people whose condition is typically more urgent to treat although obesity can also be life-threatening,Stephen Fairclough (September 6, 2023). "Ozempic shortage hits diabetes patient after weight loss use". BBC News. and the pharma companies themselves may have contributed to the drug's scarcity via advertising campaigns.Sydney Lupkin (July 10, 2024). "Ozempic's popularity leads to shortages for people with Type 2 diabetes". Health Shots (NPR). The demand has resulted in Novo Nordisk being, at times, the highest-valued company in the entire European Union.Euan Healy (September 4, 2023). "Weight-loss drug maker Novo Nordisk becomes Europe’s most valuable company". The Financial Times. The Danish company's controlling shareholder, the Novo Nordisk Foundation, states its intent to reinvest profits into "philanthropy, in the form of research, grants, education and even sometimes investments", e.g. stem cell research.Hannah Kuchler (December 26, 2023). "How anti-obesity drugs built the world’s largest charitable foundation". The Financial Times.James Waldron (October 6, 2023). "Flush with Wegovy cash, Novo Nordisk's owner widens investment strategy beyond biotech". Fierce Biotech.
==Problems==
Gastrointestinal issues like nausea, vomiting, and diarrhea have been reported as common side effects since some of the earliest RCTs with semaglutide as a weight loss treatment, combined with exercise and dietary coaching; said trials have found the drug effective for weight loss when combined with those.Harriet Hall (April 6, 2021). "A New Medication to Combat Obesity". Science-Based Medicine. So-called "Ozempic face", that being sagging skin on the face, can also happen. It's attributed to the drug (for which it earned a place in Internet meme canon"Ozempic Face". KnowYourMeme.), though it can actually occur as a result of any quick weight loss. It is suggested that makeup would be a cheaper option for Corpse Bride cosplayers.
Not to FUD the drug — but it's clearly a commitment.
===Shortages, fakes, and "alternative" forms===
Although approved for weight loss in cases of obesity and sometimes overweight when additional health problems related to excess weight occur, the semaglutide has also been sought after by people who want to lose weight for "cosmetic" purposes, which has helped to fuel shortages. The shortages have also led people in both categories to seek out "compounded" alternatives which may not be up to standard and could in some cases contain different active ingredients such as "salt formulations" of semaglutide, semaglutide sodium and semaglutide acetate. In the United States, these compounded versions are regulated at the state level rather than by the US Food and Drug Administration (FDA).Anna Claire Vollers (July 8, 2024). "‘Compounded’ weight-loss drugs are a growing problem for state regulators". Stateline (States Newsroom). The FDA says:
As of 2024, the FDA was investigating allegations of counterfeit semaglutide sold online. Some reports suggest the drug has been incorporated by online scammers promising big discounts, especially if paid in cryptocurrency — just like your real doctor asks for!(June 16, 2024). "Consumer Health Digest, Issue #24-24". Quackwatch.Abhishek Karnik (June 12, 2024). "How Ozempic Scams Put People’s Finances and Health at Risk". McAfee. Penis enlargement suddenly has some competition in the spam market.
==Eating disorders==
A cohort study concluded semaglutide's use for binge eating disorder (in which somebody has excessive urges to eat) warranted investigation, which makes intuitive sense given it suppresses appetite. Though, non-pharmaceutical strategies exist and may be pursued first.Casey Kuhn (September 25, 2023). "Patients say drugs like Ozempic help with ‘food noise.’ Here’s what that means". PBS NewsHour.
Some (non-)food for thought, quoted in part:
(There can be "feedback loop" situations between body shame and overeating, and so it's hard to entirely rule out such an option to break a vicious cycle, but there may be better ones.)
==See also==
*Fad diet
*Food woo
==External links==
*See entries for "Semaglutide Injection" and "Semaglutide" at MedlinePlus.
==References==
Category:Chemicals
Category:Drugs
Category:Medicine