UNITED STATES – April 12, 2023 – New diabetic and weight-loss drugs may be the answer to the obesity epidemic in the United States. Ozempic, (with the active ingredient semiglutide), made by Novo Nordisk, was originally developed to treat diabetes by controlling blood sugar. The Food and Drug Administration (FDA) approved Ozempic for treating diabetes in 2017. However, rapid weight loss after taking the medicine dramatically increased its popularity. In 2021, the FDA approved Wegovy, a similar drug made by the same company with a higher dose of the active ingredient, to treat obesity. Qualifying patients must be obese, with a Body Mass Index (BMI) at 30 or greater, or overweight, with a BMI greater than or equal to 27. They also must have at least one weight-related medical problem. Another medicine, Mounjaro (with the active ingredient tirzepatide), made by Eli Lilly, is a new medicine to help control diabetes. It may be approved for weight loss later this year. More than 4 in 10 Americans are considered obese, putting them at risk for the development of related health problems like high blood pressure, arthritis, diabetes, heart disease, and some cancers. Studies have shown that obese patients can lose about 15% of their body weight taking Wegovy and up to 20% with Mounjaro.
Each of the 3 drugs are appetite suppressors. They work by binding with the GLP-1 (glucagon-like peptide-1) receptors located in the beta cells of the pancreas to stimulate insulin production which in turn lowers blood sugar that is abnormally high in diabetes. The drug also binds to these receptors in the appetite control center within the brain, in the hypothalamus, to suppress hunger. Ozempic has been proven effective in treating high blood sugar associated with diabetes and it can also lessen the risk of cardiovascular disease in diabetics. Most people will have to take the drugs their entire life or they will gain their weight back. These medicines are administered with a weekly shot. They should be used in combination with exercise and eating well.
Common side-effects are nausea, diarrhea, vomiting and constipation. Other known side effects include dehydration, fatigue and headaches. Long-term complications are small but include a higher risk of thyroid cancer, acute pancreatitis, gallbladder disease, low blood sugar, damage to kidneys, injury to the retina, and suicidal thoughts.
The weight loss drugs will have to be taken indefinitely, so these medicines become a costly expense. Each drug cost about $1 thousand a month. The annual cost can be more than $12 thousand. Most insurers do not cover the cost of these medicines for weight loss. The pharmaceutical companies are heavily lobbying commercial insurers and government-funded Medicare to cover the cost.
The medicines are so popular that they have been worldwide shortages for the past 6 months. The diabetes medicine Ozempic has been frequently prescribed off-label for weight loss. Pharmaceutical companies have succeeded in influencing the prescription habits of doctors by persuading them to prescribe the new weight-loss medicines. The companies paid almost $15 million for educating and training doctors in 2021.
Many muscular athletes and healthy people may have an elevated BMI. For people who may be obese but do not have any associated medical issues, Dr Kimberly Dennis, a psychiatrist that specializes in addictions and eating disorders, said that the drugs “stand to do a lot more harm to a lot more people than good.”
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Contact: Dr. Dick Needleman, Health reporter, 103.3 AshevilleFM, healthyasheville@ashevillefm.org