#Serious Risks

[xtruss]

Since gaining popularity online, the diabetes medication Ozempic (semaglutide) has been increasingly requested to manage weight. Now, there’s a shortage that’s affecting people who use the medication. Photograph By Imyskin, Getty Images

Ozempic is a Serious Drug with Serious Risks. Here’s What to Know.

The diabetes medication semaglutide has recently become a trendy weight loss treatment. But like every drug, there are downsides—and potentially serious side effects.

— By Allie Yang | August 1, 2023

Billionaire Elon Musk credited it for his dramatic weight loss. Celebrity sites allege that many more A-listers are using it to stay trim. And TikTok is full of influencers showing off their startling before-and-after shots showing off their weight loss after using it.

What is it? A medication called semaglutide, which is sold under different brand names, including Ozempic, approved in 2017 for treating type 2 diabetes, and Wegovy, approved just last year for weight loss.

The buzz about these drugs has created a shortage of both, according to the U.S. Food and Drug Administration, which is expected to last for several months—causing alarm among patients with diabetes who rely on Ozempic to help control their blood sugar. Experts caution that it’s important to understand these are not miracle drugs—and that there are risks to taking them outside of their intended use.

Here’s what you need to know about semaglutide, including how it works and the risks.

What’s The Science Behind The Drug?

Semaglutide helps lower blood sugar by mimicking a hormone that’s naturally secreted when food is consumed, says Ariana Chao, assistant professor at the University of Pennsylvania School of Nursing and medical director at the school’s Center for Weight and Eating Disorders. This medication, administered through injection, helps people feel full for longer, helps regulate appetite, and reduces hunger and cravings.

There is significant demand for the drug. In 2019, more than 11 percent of the population was diagnosed with diabetes, while more than four in ten adults classified as obese in 2020.

Patients with type 2 diabetes often have impairments in insulin, a hormone that helps break down food and convert it into fuel the body can use, Chao says. Semaglutide signals the pancreas to create more insulin and also lowers glucagon, which helps control blood sugar levels. This can result in weight loss but experts point out that Ozempic has not been approved for that purpose, though semaglutide at a higher dose (Wegovy) has been.

Wegovy is the first drug since 2014 to be approved for chronic weight management. The difference between the two drugs is that Wegovy is administered at a higher dose of semaglutide than Ozempic. Wegovy’s clinical trials showed more weight loss but only slightly greater improvements in glycemic control compared to Ozempic, Chao says.

The FDA sees Ozempic and Wegovy as two different medications for different uses. Chao says many insurance companies cover Ozempic for diabetes but don't cover Wegovy for obesity—a prime example of weight bias in health care. That's why some medical providers use the two doses somewhat interchangeably, as obesity and type 2 diabetes are inextricably linked–obesity is the leading risk factor for developing type 2 diabetes.

What Are The Risks?

Like every medication, there can be downsides.

The most common side effects are gastrointestinal issues, such as nausea, constipation, and diarrhea, Chao says—and more rarely, pancreatitis, gallbladder disease, and diabetic retinopathy.

Angela Godwin, nurse practitioner and clinical assistant professor at the NYU Rory Meyers College of Nursing, explains that recent reports of extreme vomiting and gastroparesis (delayed emptying of the stomach) are to be expected.

Gastroparesis “just means the food’s in your stomach longer, which then makes you feel fuller longer,” she explains.

Nausea is one of the biggest side effects of medications like Ozempic and Wegovy, and that can always lead to vomiting, Godwin says. In June, the American Society of Anesthesiologists recommended patients stop taking these medications before surgery to avoid aspiration and vomiting.

“Normally, in my experience, it's tolerable,” she says. “But then there are times when I ask [patients], ‘Well, what happened?’ And they [say] they ate too much and ate too quickly. And then yes, the body will vomit it up, because it just can't tolerate that much food anymore.”

These drugs have been extensively studied, but their relatively recent approval means researchers still don’t know what the effects of taking them long term might be.

Continuing research is helping us understand more about what happens when people stop taking these medications—which many may be forced to do amid current shortages. Research does suggest that stopping use of this medication could cause patients to regain weight, especially if they didn’t make any lifestyle changes.

“In almost all weight-loss studies, it really depends on your foundation,” says Stanford endocrinologist Sun Kim. “Your efforts at lifestyle will determine how much weight you lose. If you have your foundations like food, exercise, and sleep, you’re gonna do well.” If not, you might regain as much as 20 percent of the weight lost per year.

These medications can also be incredibly expensive, especially without insurance. Kim says an injection pen can run more than $1,000.

What Does It Mean To Use This Drug Off-label?

Using a drug off-label means using it in a way other than its intended and its FDA-approved purpose, which may not be safe or effective. Ozempic has been approved only for type 2 diabetics, and Wegovy has been approved only for patients with a BMI above 30, or 27 if they have a weight-related comorbidity like high blood pressure.

“There is no scientific evidence to show whether this medication will be effective or of benefit to those who do not fit the criteria from the FDA-approved label indications, such as people with a BMI lower than 27,” Chao says. “We also do not know the side effects or risks in these populations—there could be unknown drug reactions. These medications are not meant to be a quick fix.”

Even if you meet the criteria, experts warn against trying to obtain the medication without a prescription by traveling to countries that don't require them.

“When the medication’s not used under supervision of a health-care provider, then they can come into misuse,” Chao says. “There could be more serious adverse events that can happen.”

Godwin says recent reports of extreme vomiting and gastroparesis are a reminder that patients should schedule regular checkups with their doctor when taking these medications.

“I think it's so popular now that practitioners might be tempted to just prescribe more freely, and then maybe not monitor patients as frequently,” she says.

Patients should not increase their Ozempic dose without doctor approval—which is possible because there are multiple doses in one pen. “They could definitely have a lot of poor side effects, because they didn't titrate up to that level yet,” Godwin says. The same could be said for Wegovy, which comes in a pack of four one-dose pens.

Robert Gabbay, the American Diabetes Association’s chief scientific and medical officer, said the organization is “very much concerned” about the Ozempic shortage.

“The medication has been an important tool for people with diabetes,” he says. “Not only does it lower blood glucose and weight but it has been shown to decrease cardiovascular events—heart attacks—one of the leading causes of death for those living with diabetes.”

A Last Resort?

Still, Kim says that prescribing drugs like Ozempic and Wegovy to patients who are desperate for a new approach to weight loss can make her feel “like a superhero.” By the time patients come to her, they’ve often tried methods like Weight Watchers and following the advice of dieticians. In that case, she says, medications like Ozempic and Wegovy can be a great option.

“What I find is sometimes as they're becoming successful at losing weight, it really does feed into their lifestyle too, and then they're able to be more active,” Kim says. “It’s hard to lose weight. Seventy-five percent of the U.S. population is overweight or obese. I feel that we shouldn't be holding this back if this can help.”

Chao agrees that these medications are a good alternative for those who are unable to lose 5 percent of their body weight within about three months of making lifestyle changes. Still, she recommends trying those approaches before turning to medication.

Patients should “make sure that they're focusing on a healthy dietary pattern, reducing calories, as well as increasing physical activity,” she says. “It’s important they know that even if they are taking the medication, it's not an easy way out: They're still going to have to make lifestyle changes.”

[keferon]

OKAY OH MY GOD THIS FIC IS GREAT I HAVE ONLY READ THREE AND A HALF CHAPTERS AND IM ALREADY IN LOVE

I originally wanted to make both of these pieces in color but I’m gonna be honest I have no fucking idea how to draw Ricochet…he is described as black and red and…mmhhmmm does he have canonical (canonical for this fic I mean) design? Do I need to design him myself? Idk I’ll figure this out later

[bertoyana]

X-MEN APOCALYPSE (2016)

+bonus:

[spirkbitch]

tos spirk fic writers you know i love you

and i do hate to break it to you, but i really don’t think that these chairs

would allow for very much straddling to occur

[violent138]

Dick got extremely frustrated with Tim when Red Robin didn't take any time off after repeated concussions, and wound up changing all the passwords and messing with the spelling on Tim's reports and files, which freaked Tim out enough that he did go for a head CT and a decent nap.

Bruce, much later: "Why is my password not working?"

Dick, seeing a golden opportunity: "Password's the same as always. How many concussions are we up to now?"

Bruce:...

[raptorrobot]

i feel like i'm fighting for my fucking life here

[padfoot-lupin77]

Remus: I’m not joking guys I’m fucking serious

James and Peter: *Le gasp*

Sirius: *grins*

Remus: oh fuck the lot of you that’s not what I meant and you know it

Sirius: is it not true though? *winks*

Remus: *sighs* I suppose it is

Peter: Pay up James

James: couldn’t you guys have waited until after Christmas? I would have won the bet then

[lloydfrontera]

the webcomic can have one (1) funny "earnest moment interrupted by comedy" joke. as a treat. but also because it is so in character for them ajkshdjkas

yes they will say the most earnest shit to each other and then immediately try to cringe out of their own bodies. they are best friends but they would rather jump out of a window before admitting it. they are incredibly devoted and grateful to one another but you could not water board that out of either of them.

the only thing that can get either of them to admit how much they care for each other is if the other is in life threatening danger and not a second before aakjshdks

[gunsatthaphan]

lv 100 // lv 1

[oldbookist]

i think most people who casually know enjolras don’t think “oh that guy is definitely going to die a tragic martyr for revolution” he’s just that charming but kind of quiet guy who always has a newspaper under his arm and drinks a lot of coffee

[three-dee-ess]

Hey I saw your post about the puffy battery and my 3DS has that (it’s starting to crack the case). I knew it was affecting the battery life but I didn’t know that it was dangerous. How would you go about repairing/replacing this?

ok this is going on my FAQ after this. possibly in my pinned post.

Contact your local *non emergency* number and ask them how to dispose of a puffy lithium ion battery. Follow their instructions.

To remove the battery from the case (which is the best thing to do in that situation) follow the instructions linked in my pinned post "for physical 3DS issues" (https://www.ifixit.com/Device/Nintendo_Handheld_Console)

Be as careful as possible to NOT puncture the battery.

for getting a replacement, just look at the number on your 3DS's battery and type that into amazon. Should be plenty of results, all around $10~$20 USD and they should work perfectly fine. check the reviews if you are worried.

Again, if you have any battery that is bending or breaking the case, is is a legitimate explosion hazard. That battery can explode into a fiery ball of toxic gas. It is in your best interest to dispose of it as soon as possible.

this also goes for batteries inside of ANY electronic device. Switch batteries, macbook batteries, phone batteries, electric bike batteries are also examples of lithium ion batteries that get a lot of usage and often can get overcharged.

resource links:

[endless-nightshift]

Heaven officials blessing version of this. They fill me with joy <3

[natelia-aldelliz]

They exchanged their dog tags because they're cuties

Ghost isn't sure if he prefers Johnny Riley or Simon MacTavish, though, he'd probably doodle both and draw little hearts around it as he's pondering the question

Price : okay, you've been sighing and staring at nothing more than usual, what's up

Ghost : if you had a boyfriend, or girlfriend, or whatever, and they're probably thinking about getting married, would they take your name or would you take theirs ?

Price :

Ghost : cause i have this friend, and it's happening to him right now and he's getting a little overwhelmed so he asked me but i don't know so i'm asking you

Price : *sigh* right, a friend, so you should probably tell him to ask his boyfriend about what he thinks, first off, and to consider just putting a hyphen between both names, and also chilling the fuck out because you just pulled your heads out of your arses and started dating two weeks ago

Ghost :

Price : *tired dad stare*

Ghost : so, what sounds better, Riley-MacTavish or MacTavish-Riley ?

[corezy]

Call me cynical all you want, I don’t trust one single doctor on planet earth. Just saw some in a comments section complaining about patients who come in with an idea of what condition they’re experiencing and I just can’t stand it as someone who was told “looks like someone’s been doing some googling” the last time I went in with obvious serotonin syndrome.

[compassionatereminders]

And I'm NOT saying hard drugs like cocaine are harmless, I'm saying that all drugs are risky and potentially dangerous, even the legal ones and the "spiritual" ones and the ones you and all your friends have been taking for ages. I am just saying that your bottle of vodka or your pack of cigarettes isn't morally superior to the "dangerous" drugs you avoid

[colinfeatherington]

man I just keep thinking about it. why did colin have to ice her out after the wedding… I just feel so bad for penelope laying alone in that martial bed night after night after he seemingly forgave her for being whistledown and they get married and have such a beautiful dance and she thinks this is it, it’s resolved but he couldn’t accept her continuing to be whistledown so instead they live this silent strange life together for weeks and go to family functions together but not and they live these parallel lives instead of a life as a couple. I’m not saying colin doesn’t have a right to be upset or process his emotions but the method and timing and time it took… it’s hard to accept rn