Apr 17 / Devon Da Costa

Riding the Wave of Weight-Loss Drugs (Ozempic): What is the knock-on effect?

We first wrote about the diabetes drug, Ozempic, and its uses for weight loss in December 2023 - Here are our follow-up perspectives.

The knock-on effect of Ozempic?

We first wrote about the diabetes drug, Ozempic, and its uses for weight loss in December 2023. In our first article discussing the glucagon-like peptide (GLP-1) drug, we found that although it was originally developed for diabetes management it is popularly used as a weight loss intervention (1–3). Clinically known as Semaglutide, the drug stimulates insulin production, which helps balance blood glucose level and reduce appetite. This reduction in appetite results in reduced calorie consumption and eventually weight loss (4,5). In recent months Ozempic has remained in the news, with a few interesting bulletins, hence our need for further debate.

Previously, we discussed various scientific studies that showed the drug was effective in achieving weight loss, but once taken off the drug, a large number of participants gained back all the weight lost (1,3). Putting patients back on square one and back at their doctor’s office requesting additional prescriptions. The increasing use of Ozempic has resulted in a drug shortage all over the world (6). This shortage means no weight loss drug for overweight patients, but also none for diabetic patients. It’s important to remember that the original purpose of Ozempic was to manage diabetes, a potentially fatal lifestyle disease with the long-term symptoms such as blindness, amputation, and heart failure (7). Should patients wanting to lose weight, often for aesthetic reasons, be given access to a drug that could otherwise help manage chronic disease?

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Despite the current shortage, the high prices (mentioned in our previous article, at R1200 – R1500 a syringe), it’s remains popular in the public eye. When searching the latest news, celebrities such as Oprah, 50cent, Kylie Jenner and many others have publicly discussed using Ozempic (8). Oprah in particular hosted an ABC special discussing the use of Ozempic with doctors and specialists. The episode highlighted the importance of finding effective treatments for obesity, which Ozempic is proving to be. Although the FDA has not cleared the drug for weight-loss, doctors are eligible to make the decision to prescribe the drug for weight loss. Despite its efficacy, more and more reports are reporting its unsustainability long term. Article report patients’ battling to maintain weight loss, experiencing increased hunger, and regaining weight once off the drug. Which supports the scientific research conducted on the drug (1,3). Due to the high prices, and current shortage, more and more patients are having to go off the drug. Hence the question: would it not be better to find sustainable treatment for weight loss that can be maintained?

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Overlooking sustainability, safety is our next concern. An additional side effect of the drug shortage is the illegal purchase of the drug on the black market (6). A recent position statement from the South African Health Products Regulatory Authority (SAPHRA) warned that Ozempic is not cleared as a weight loss treatment in South Africa, and rather only for the use of diabetes (9). They also make mention that no generic options are available, and that people should caution buying the drug from anyone other than their registered practitioner. Despite these warnings, reports have surfaced of people buying the drug online, at beauty parlours and fitness centres. This can lead to dangerous side effects as the ingredients of the drugs on the black market may contain toxic ingredients (9). Buying medications online or from uncredible sources places people on chronic medication at an additional risk, due to the likelihood of medications responding negatively with one another. People should practice extreme caution when buying any sort of prescription drug “over the counter” from uncredible sources.  

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If considering using Ozempic, there are many points to consider… is it worth the wait for the shortage to end, and what about the diabetic patients who are missing out on treatment? What happens when your prescriptions end, and what are the potential side effects of buying it on the black market? Knowing that the effects of the drug are not maintained once administration ends, can you maintain it for the rest of your life?  Avoid running just yet… and continue with low impact exercise. Rather get in a gentle swim as a means of active recovery as opposed to just couch surfing. 

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  1. Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug 1;24(8):1553–64.
  2. Smits MM, Van Raalte DH. Safety of Semaglutide. Vol. 12, Frontiers in Endocrinology. Frontiers Media S.A.; 2021.
  3. Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity. JAMA. 2021 Apr 13;325(14):1414.
  4. Jones C. Rolling Stone. 2023. Weight Watchers Is Pivoting to Ozempic. Influencers Aren’t Following.
  5. Kunene Z. News24. 2023. Ozempic: A hashtag and a helpful effect collide, draining global stocks of a diabetes drug.
  6. Aoife WPRai. BBC News. 2023. Weight loss injection hype fuels online black market.
  7. Diabetes Australia. Diabetes - long-term effects. 2013.
  8. HeraldNet. Oprah Hosts ABC Special on Impact of Ozempic, WeGovy, Mounjaro Weight Loss Medications. 2023.
  9. SAHPRA. Public Urged To Use Registered Ozempic Products. 2023.
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