What Is Ozempic, and Why Is Everyone Talking About It?

Ozempic, a brand name for the drug semaglutide, has recently catapulted into the spotlight. Often dubbed the “skinny jab“, it’s garnered the attention of celebrities, influencers, and the general public alike.

Weight-loss treatments have always captured public interest, from thyroid extract in the 1890s, to amphetamines of the mid-20th century, to today’s semaglutide – we will touch on the psychology behind this later.

Originally designed to manage blood sugar levels in type 2 diabetes, its powerful weight-loss effects have captured widespread attention. Its sudden rise to fame and accessibility, however, have sparked concerns among the public and in the medical world.

Understanding Semaglutide: How Does Ozempic Work?

While Ozempic is an injectable formulation of semaglutide, belonging to a class of drugs called GLP-1 agonists, other variants exist.

• Rybelsus – an oral formulation used in diabetes management.
• Wegovy – an injectable that can be prescribed at higher doses, specifically licensed for weight management.

Semaglutide works by mimicking the action of GLP-1, a hormone* naturally produced in the body in response to eating food. This leads to several beneficial effects:

1. Boosts Insulin production which helps lower blood glucose (sugar) levels.
2. Slows digestion, allowing your body to absorb more glucose from the foods that you eat.
3. Suppresses appetite and promotes feelings of fullness.
4. Reduces glucagon levels, lowering blood glucose levels. Glucagon is a hormone* that increases blood sugar levels by triggering the release of stored glucose (glycogen) from the liver.

*Hormone = a chemical substance in the body that acts as a messenger, coordinating different functions in the body.

Who Can Take Semaglutide?

Despite its popularity, semaglutide isn’t available for everyone. The NICE guidelines, which are evidence-based recommendations for healthcare in England and Wales, limit prescriptions of semaglutide to specific scenarios:

1. For type 2 diabetes: (Ozempic, Rybelsus)
   • When triple therapy* is ineffective, not tolerated, or contraindicated.
   • Patients with a Body Mass Index (BMI) >35 or lower for certain ethnic groups, with medical or psychological complications of obesity.
   • Patients with a BMI <35 where insulin therapy is inappropriate, or weight loss would improve other obesity-related health issues.
   • On specialist advice for patients already on insulin.
2. For weight management: (Wegovy)
   • When prescribed by specialist weight management services.
   • When used alongside a reduced-calorie diet and increased physical activity.

*Triple therapy = 3 oral diabetic medications taken at the same time.

The Psychology of Quick Fixes

There are several reasons why we may seek “quick fix” weight loss drugs in our society.

Our use of social media has meant that we often look for instant gratification, in one such way being that we desire immediate results. Weight loss drugs that promise rapid weight loss appeal to those seeking a quick solution.

Stigma remains pervasive in many aspects of society, including in relation to weight and body image, too. The desire to conform to unrealistic societal body standards to avoid weight-related discrimination may drive people towards these drugs.

Losing weight can also be very difficult, especially if there is an underlying medical condition that makes it harder to do so, as your body needs to be in an energy deficit* over a sustained period of time. It can be difficult to maintain lifestyle changes such as an exercise regimen long-term, meaning that medications are often viewed as an easier alternative to the sustained effort required for lifestyle modifications to work.

Furthermore, if people have tried to lose weight in the past and have been unsuccessful, resulting frustration can push people towards a more “foolproof” method that works for everyone.

*Where your body uses up more energy than you consume through the foods that you eat.

The Dark Truth of Ozempic’s Popularity

Celebrity Influence and Body Image Pressures

The rapid rise of semaglutide in popular culture has led to a surge in people asking their doctors for prescriptions, something I witnessed first hand whilst working in General Practice.

With celebrities like Elon Musk and Sharon Osbourne opemly discuss On TikTok the hashtag #Ozempic has been viewed over 273 million times, and a quick search on Instagram reveals countless posts advertising its apparent miraculous effects on weight loss.

However, social media often glorifies rapid transformations without acknowledging the complex physical and mental toll of drastic weight loss. This may act to exacerbate body image issues, particularly among teenagers and young adults.

Increased Illegal Purchases

In the UK, it is illegal to sell semaglutide without a prescription. However, a growing number of individuals, unable to secure prescriptions from their general practitioners, are resorting to online pharmacies and illicit sellers. This trend is alarming, as these unregulated supply chains lack the rigorous quality controls found in legal distribution networks. Consequently, many so-called “Ozempic pens” acquired through these channels often contain alternative substances, such as insulin, which can be life-threatening if administered incorrectly. Moreover, significant discrepancies in dosing are common, posing additional risks to unsuspecting users.

The gravity of this situation has prompted the World Health Organisation to issue a medical alert on falsified semaglutides. This warning came in the wake of 3 falsified batches in Brazil, the UK and the US in 2023. In the UK alone, the Medicines and Healthcare products Regulatory Agency (MHRA) seized 369 potentially fake Ozempic pens between January and October 2023, highlighting the scale of this illicit trade.

An investigative report by the BBC shed light on the alarming accessibility of these illegal drugs too, with individuals being able to purchase them online or even from salons. Results of lab testing on semaglutide acquired from various illicit sellers showed inconsistencies in the samples though, and while most samples did contain semaglutide, a couple contained none at all. Nearly all fell short of the full dose that had been paid for.

Spotting counterfeit medications:

1. Is the price suspiciously low?
2. Is the seller licensed, and can you see their license?
3. Does the packaging of the drug match official images from the seller?
4. Are there any spelling errors on the packaging?
5. Is the packaging unsealed?

If yes to any of the above, then do not take the drug and seek advice from a healthcare professional.

Supply Shortages

The increased demand, especially due to the surge in off-label prescriptions, has contributed to supply issues within the NHS, potentially affecting patients who genuinely need the medication for diabetes management.

The imbalance between supply and demand can also subsequently create opportunities for criminals to exploit the situation.

Lack of Medical Oversight

Purchasing Ozempic illegally often means that crucial (and patient specific) medical assessments are bypassed, meaning potential side effects, contraindications and appropriate dosing can be overlooked, potentially carrying significant risks to health.

Side Effects and Safety Concerns

As with all medications, it’s use is not without risks. Common side effects include:

• Gastrointestinal issues: Nausea, vomiting, diarrhoea and constipation are most frequently reported.
• Gallbladder disorders: Namely gallstones and Cholecystitis (inflammation of the gallbladder).
• Hypoglycaemia: Especially when used in tandem with other diabetes medications, hence the need for medical supervision.
• Alopecia (hair loss).
• “Ozempic face“: A term coined by US Dermatologist and Cosmetologist Dr Frank, which describes the sagging of facial skin following rapid weight loss on Ozempic.

Ethical Implications

The Ozempic phenomenon raises several ethical and societal questions.

1. Equitable access: With limited supplies and high costs, who gets access to these potentially life-threatening medications? Increasing demand may divert resources from patients who need them.
2. Body image: use of this drug may reinforce unrealistic beauty standards, increasing pressure to achieve rapid weight loss, especially among vulnerable groups like young people heavily influenced by social media.
3. Long-term health implications: the long-term effects of GLP-1 agonists for weight loss in non-diabetic individuals largely remains unknown. We have seen a significant increase in patients on this medication presenting to emergency services with a variety of conditions, but until there is more research into the long-term effects, we won’t know if there is a correlation between them.

The Future of Weight Management

Recent research presented at the European Society of Cardiology Conference advocates that semaglutide acts as an overall “health promoter”, as participants in the Select trial died at a lower rate from all causes, including Covid-19 and cardiovascular disease, over a 3 year period. This suggests it could be used to treat a wide range of illnesses, including heart failure, arthritis, Alzheimer’s and cancer in the future.

However, while semaglutide shows promise in weight management, it is not a panacea*. Experts stress that these medications should be part of a comprehensive approach to weight loss, including:

• Lifestyle modifications (diet and exercise).
• Behavioural therapy.
• Addressing underlying psychological factors related to obesity.

*Panacea = a solution that will solve all problems, or cure all illnesses.

In Summary

While semaglutide offers promising results for weight management and diabetes control, its sudden popularity has led to misuse, supply issues, and ethical concerns.

As more research is conducted and long-term data accumulates, healthcare providers must keep working to ensure that there drugs are used safely, effectively, and equitably. Patients considering Ozempic or similar alternatives should always consult with a healthcare professional and obtain prescriptions directly from them, so that benefits, risks and appropriate usage can be considered on an individual basis. This way alternatives and adjuncts can be considered too, such as NHS weight-management programs, or specialist dietitian services.

A holistic approach to health, combining medical treatments with lifestyle changes and psychological support, should remain the gold standard for sustainable weight management and overall wellbeing.

I’d love to hear your thoughts! Leave a comment below.

• How do you think social media and celebrity endorsements influence our attitudes toward weight-loss treatments?
• Should weight-loss medications like Ozempic be prioritized for individuals with medical needs over cosmetic purposes? How should we balance supply and demand?
• Do you believe the long-term health risks of weight-loss drugs are worth the potential short-term benefits? What would convince you otherwise?