If you’ve seen a celebrity thin down in recent years, you may have wondered what exactly they changed in their daily routine.
While most have attested to changes in their diet and lifestyle, there are whispers that a certain diabetes drug ‘semaglutide’, commonly known by the brand name ‘Ozempic’ is the catalyst.
The drug is literally flying off shelves as people seek out the medication, based off the online buzz. As a result, Australia is currently experiencing a shortage of this vital diabetes drug, raising ethical concerns about taking it on top of concern about it being widely prescribed off-label.
It has many people asking the question, what is Ozempic and does it actually work?
What is Ozempic?
Ozempic is the brand name for a drug called semaglutide, which also goes by the brand names Wegovy and Rybelsus.
Semaglutide is a ‘Glucagon-like peptide-1 (GLP-1) receptor antagonist’. This means that it activates the receptor to produce a biological response.
In this case, semaglutide copies the effects that the GLP-1 hormone should have on the body, making the pancreas secrete insulin and reduce blood glucose levels.
Another impact of semaglutide is delayed gastric emptying, meaning that people who take this drug feel fuller for longer. The consequence is that people who start taking it generally feel less cravings or urge to eat when it is unnecessary—resulting weight loss.
What was semaglutide originally created to do?
Semaglutide was originally created to assist with the management of diabetes. According to Diabetes Australia the drug creates a stronger signal than the body naturally produces to generate more insulin.
This can help people suffering with diabetes manage their blood glucose and also can reduce the impact of the disease on vital organs, such as the heart and brain.
According to Diabetes Australia, semaglutide is a once-weekly injection into the fat layer in the stomach, thigh or upper arm.
It does not need to be taken with food and a forgotten dose can be taken within five days. Usually, the doctor will start the patient on a smaller dose of the medication and work up to the required level.
Why is it so popular now?
While semaglutide was originally developed to manage Type 2 diabetes, doctors soon noticed that people on the drug found it easier to lose weight.
People are calling it the ‘Hollywood Injection’, alleging that it is how the celebrity elite have been slimming down.
The New York Post has reported on speculation that semaglutide was used in Kim Kardashian’s extreme weight loss to fit into Marilyn Monroe’s ‘Happy Birthday, Mr. President’ gown for the Met Gala. Kardashian has not responded to the TikTok rumours.
The same article included a tweet from Tesla founder Elon Musk explaining that his own weight loss was the result of ‘fasting’ and taking semaglutide.
Why is semaglutide being prescribed off-label in Australia? Is it legal?
Semaglutide is approved by Australia’s Therapeutic Goods Administration (TGA) for diabetes management only, however it is being prescribed off-label for weight loss reasons in Australia. The TGA does not recommend this.
According to the TGA website, semaglutide “is only approved by the TGA for lowering blood sugar in adults with type 2 diabetes.” The agency says it cannot stop doctors from prescribing the medicine off-label.
“Off-label prescribing is a regular occurrence in the Australian healthcare system, particularly for uncommon diseases and conditions or underrepresented patient groups,” it writes.
“The TGA does not have the power to regulate the clinical decisions of health professionals and is unable to prevent doctors from using their clinical judgement to prescribe [semaglutide] for other health conditions.”
Why is there an semaglutide shortage in Australia?
The pharmaceutical company at the helm of Ozempic, Novo Nordisk, has told the TGA that the drug will not be available in Australia until the end of March 2023.
For months there has been a major shortage of semaglutide medications as more and more Australians accessed the drug for weight loss purposes. People with diabetes have reported struggling to access this all-important medication because of the demand.
The RACGP says that social media influencers “touting the drug as a ‘miracle’ weight loss treatment” are largely to blame for the shortage.
What are the side effects of semaglutide?
While semaglutide has had a lot of positive promotion on social media, it has some major downsides too, namely that delayed gastric emptying can create a back-up of food in the digestive tract.
This can cause nausea and vomiting when people taking the drug ingest more than the body can handle. When the gastric emptying is delayed too much it can also cause constipation, abdominal pain and diarrhea.
While the other more serious side effects are less common, the Ozempic website includes a huge list of potential ones, including:
- Inflammation of the pancreas (pancreatitis): symptoms include severe stomach pain that will not go away
- Changes in vision
- Low blood sugar: symptoms include irritability, blurred vision, sweating, hunger, confusion, headache, shakiness and a fast heart beat
- Kidney problems (kidney failure): In people who have existing kidney problems
- Serious allergic reactions including swelling to the throat, face, lips and tongue
- Gallbladder problems: symptoms include pain in the upper stomach, fever and yellowing of the skin or clay-coloured stools
One of the most worrying side effects of semaglutide is possible thyroid tumours, including cancer.
The website advises to, “tell your health care provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath.”
This warning comes off the back to studies that found rodents on medicines like semaglutide caused thyroid tumours and cancer. According to the website, “It is not known if [semaglutide] will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people.”
As a result it is not advised to take semaglutide if you or anyone in your family has had this type of thyroid cancer or an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Who can’t take semaglutide?
Anyone with a family history or personal experience with MTC or MEN 2 should not use this medicine. Anyone with an allergy to semaglutide or other ingredients in the drug should also avoid it.
Patients should also disclose to their general practitioner if they’ve had kidney or pancreas problems, have a history of diabetic retinopathy, are pregnant or plan to be, or are breastfeeding.
We are talking about a serious drug here, so do remember that the only people you should be discussing new medications with is your doctor, not a wellness influencer.
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