What’s the problem with Ozempic?

A well-written article in The Atlantic highlights problematic thinking around the current weight loss drug Ozempic. We are firmly in the panacea stage. That is to say there is a perception of all upside, no downside. Semaglutide (Ozempic) is a hormone that mainly works by slowing down your stomach emptying and acting in your brain to make you feel full. Most patients tell me they simply don’t feel like eating, leading to a significant decrease in calories consumed and therefore weight loss. Ozempic is extremely effective. People lose an average of more than 30 pounds within months. When used for appropriate reasons, this can improve metabolic factors including sugar control, blood pressure, cholesterol, and physical function. So what’s the problem??

Ozempic is hormone therapy. In Canada, it is approved for treatment of type 2 diabetes and obesity, though most insurance companies only reimburse for the diabetes indication. Yet, Ozempic is being used by many people, notably wealthy Americans with large social media followings, who suffer from neither. They just want to lose weight for vanity. As with any diet-craze, little thought goes into this, other than ‘how can I get my hands on a steady supply?’ What they don’t appreciate is what we don’t yet know about the long-term side effects.

For example, when people stop taking Ozempic, they regain weight quickly. Not surprising, since they go into withdrawal of the active hormone within days. We also don’t have long-term data from any studies to tell us about the ideal maintenance dose or whether this treatment needs to be indefinite. At present, I tell my patients exactly that. In their cases, though, accepting an unknown risk for the known benefit of better control of type 2 diabetes or obesity with end-organ damage, is often worth the trade-off. Outside of this setting, subjecting your body to a hormone treatment, untested for the reason you’re using it, with no long-term data, is a very risky proposition.

It bears repeating that the mainstay of achieving weight loss is by diet, exercise, sleep, and stress management. This continues to be the case for those on medications to aid the process. It’s about working on creating a healthier lifestyle every day. There is no quick fix, even with Ozempic. And please, if you are considering medical management of your weight, find a doctor who can help guide the decision-making and not simply act as a prescription pad.