It’s darn near impossible to go anywhere these days and not hear about Ozempic. It’s in our face everywhere thanks to large marketing budgets of big pharma. 

But is this new drug a medical breakthrough or just another fad that will just make big pharma even wealthier?

What is Ozempic and how does it work?

Ozempic was originally developed as a treatment for type 2 diabetes; it is delivered as an injection into the skin. Ozempic is a sema-glutide or a GLP-1 receptor agonist. Sema-glutides mimic hormones necessary for glucose regulation that are naturally produced in your body when you eat. Ozempic lowers blood glucose levels by stimulating insulin production and inhibiting glucagon secretion. This in part contributes to slowing down how quickly your stomach empties as your food digests.These drugs work by replicating the hormone (GLP-1 agonist) our body produces after we eat which will lowers blood sugar and creates a feeling of satiety or fullness. 

Ozempic can cause temporary weight loss by:

  • Delaying gastric emptying – Ozempic increases the time that your food passes through the digestive system. Because your food takes more time to digest, you feel fuller for longer. This increases the time between meals and snacking periods, causing some to eat less frequently.
  • Mimicking hormones that simulate fullness – Ozempic mimics hormones that signal fullness, causing you to feel fuller than you normally would when you eat. This may cause you to eat less food than you normally would.
  • Causing nausea, explosive diarrhea and vomiting – These adverse side effects of Ozempic can lower appetite and ability to eat.

Why is Ozempic prescribed for weight loss?

Ozempic was originally designed as a treatment for type 2 diabetes in order to improve blood glucose levels. Many of the few studies conducted show that Ozempic can cause 5-15% total body weight loss. Because of medical weight stigma, doctors have now begun to prescribe Ozemoic for weight loss even if someone does not have diabetes. 

Some doctors are prescribing Ozempic when their patient complains that they haven’t been able to lose weight successfully by other methods. Doctors suggest that Ozempic for weight-loss should be prescribed in individuals that with a BMI of 27 or greater. Doctors argue that the benefits of the drug outweigh the risks of chronic disease.

Some (not all!) doctors though are advising people not to take the drug if they are not diabetic. They state that the drug used for off-label purposes poses great risk for individuals who take the drug as a quick weight-loss solution. For these people, they say that the health “benefits” do not outweigh the potential risks.

Unfortunately and because these drugs are so lucrative for doctors to prescribe, these drugs aren’t exclusively prescribed for weight loss and diabetes treatment and prevention. Because of the hype and promise of quick weight loss, lots of folks are getting this new drug even though they don’t fit the critieria as outlined by doctors. Folks in Hollywood (I won’t name any names) have been very public about their struggles with this new drug. 

Why is Ozempic so trendy?

According to Aaron Flores, a registered dietitian nutritionist in Calabasas, California. “It’s a reflection of how deep the fear of weight gain and existing in a large body truly is in our society,” he said. “The message being sent is very clear; being in a large body is bad and you should do anything possible to change it.”

The way this medication has become trendy and in demand also speaks to the deep disparity that exists in health care, Flores said. (Ozempic retails for about $900 a month if your insurance doesn’t cover it.)

The popularity of the drug has led to a national shortage making obtaining it difficult for diabetics who use Ozempic to manage their blood sugar and reduce their risk of heart problems and other complications.

“But if you have the financial privilege to go outside of your insurance coverage, you can find someone to prescribe this drug to you, no problem,” Flores said. “Large groups of people who take this for its intended purpose are going to be denied access to this intervention, only because others with more privilege and more money can circumvent the system.”

It’s important to note that Ozempic isn’t the first drug that has been used as an aid for weight-loss and praised for being a “miracle”. You may have heard about Fen-Phen and Ephedra, past drugs prescribed by Doctors to assist in weight-loss efforts but later taken off the market. Similar to Ozempic, these drugs were prescribed shortly after development with little research only to later reveal serious irreversible side effects, including heart valve complications and death. In this way, Ozempic is not a new story as we’ve seen this before.

Four Things to Consider about Weight Loss Medications

1.Any Weight Loss is Likely to Be Temporary: You may lose weight while you’re taking it  (short term), but as soon as you STOP taking it, you are likely to regain most or all the weight back (and possibly more). New emerging research has already shown rapid regain after stopping the medication and after one year, two-thirds of folks had regained the weight they had lost. 

 

2.  The Side Effects are No Joke: Common side effects include nausea, diarrhea, vomiting, constipation, stomach pain, headache, fatigue, upset stomach, dizziness, bloating, belching, gas, intestinal infection, and heartburn. The reduction of food intake associated with the drug can cause malnourishment regardless of one’s size. There have also been reported cases of more serious side effects including:  pancreatitis (with higher risk for those prescribed without diabetes), Development of thyroid cancer, and suicidal ideation or behavior. 

More recently, the FDA issued a black label warning on Ozempic which rarely takes place. Black label warnings are the highest safety-related warning that medications can have assigned by the Food and Drug Administration. These warnings are intended to bring the consumer’s attention to the major risks of the drug. Some scientists claim that, like many other medications, these side effects subside after the body has adjusted to the dosage. However, there have been no long-term studies to support or refute any evidence of long-term side effects associated with Ozempic and many individuals have had to stop using the off-label drug due to side effects.

3. These Weight Loss Medications Can Fuel Eating Disorders

Because of weight stigma, and the belief that larger bodies should be smaller to be “healthy,” these systems will only cause an increase in disordered eating and eating disorders. Any medication that essentially masks our ability to hear physical hunger and satiety is a set up to create conditions whereby eating disorders thrive. It does not promote trust with the body, it promotes control and deprivation. In addition to deprivation, dietary restriction is the fuel of all eating disorders. Add to this, stigma and fear of weight regain and you 100% in eating disorder territory. 

4. These Weight Loss Medications are Very Expensive

In the US, the cost of the medication is an estimated $900-1,300 a month, if it is not covered by your insurance. Even with insurance, it’s costly about $250/month. If your insurance doesn’t cover it (especially if you do not have type 2 diabetes), it will cost you about about $16,000 you have to pay per year for the rest of your life—as soon as you stop, you will just gain all the weight back. A conservative 20-year plan will set you back about $312,000. Big pharma profits yet again.

What happens when you stop taking Ozempic?

Many people report having an insatiable feeling of hunger after stopping the medication because of the prolonged period of undernourishment (aka starvation) caused by the effects of the drug. And, in all cases of stopping the medication, weight gain happens and people go back to their original weight, often gaining more due to being undernourished/starved. Shocker!

For individuals who have struggled with binge eating disorder and/or have taken this drug to stop binge eating, stopping Ozempic causes the behaviors to return in full force, often increasing the frequency of binge eating behaviors.

Additionally, taking Ozempic for purposes other than diabetes control can alter your body’s natural hunger signals, and put you at risk for developing disordered eating behaviors or a more serious eating disorder. 

Ozempic has its place in the medical world, and this medication might be life-changing for those with diabetes. However, when Ozempic is taken for reasons other than its intended use, it may cause a lot of harm to the body physically and mentally.

As a registered dietitian who specializes in eating disorders, I believe that this drug is dangerous to take off-label due to its lack of long term research and the harm that it can cause to those in eating disorder/disordered eating recovery. This is not however an attack on individuals who choose to take Ozempic. The reasons that would lead to someone taking Ozempic are often complex and what matters most is that you be as informed as possible before taking a medication like this.

These drugs are likely to be the latest in a long history of misguided attempts to find the effortless solution to a problem that doesn’t exist. Remember fen-phen in the 1990s? 

Bodies are diverse and there have always been fat bodies. 

But that hasn’t stopped companies from preying and profiting off body shame. Unfortunately, many of the previous drugs that have been marketed for weight loss were later pulled due to safety concerns.

The problem isn’t with an individual wanting to take Ozempic. The real problem is drug companies profiting off the collective fear of fatness and the belief that fatness needs to be eradicated in the name of health. 

I remind my clients that to heal our relationship with food and our bodies, we need to shift our way of thinking about bodies and about fatness. Your body and your weight is not the problem. The real problem is the internalization of anti fatness and over valuation of a thin ideal; all of which are promoted by these drug companies making millions of dollars.

Are you feeling triggered by Ozempic? Do you have questions related to Ozempic or other nutrition concerns?

I get that it can be so hard to want to heal your relationship with food and your body, AND to be bombarded with these types of weight loss drugs all the time is infuriating. And, yet it can feel so seductive too. Wanting to take it to ‘drop the weight fast’ and yet all the while knowing it’s harmful. 

If you find yourself straddling both sides and want support, reach out to book a free call with me here

 

Much love, light and dark chocolate,

 

Karen Louise MA, RDN… your anti-diet dietitian since 2005!

 

Article inspired and adapted by 1) https://www.bravespacenutrition.com/blog/dietitian-exposes-the-truth-about-ozempic-weight-loss-drug

2) https://www.eatingdisordertherapyla.com/four-things-you-should-know-before-jumping-on-the-ozempic-bandwagon/

3) https://www.huffpost.com/entry/conversations-about-ozempic-can-be-triggering-for-people-with-eating-disorders_l_64120b44e4b0cfde25c28551

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Karen Louise Scheuner, MA, RDN

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