You’d have to be living under a rock to not have heard about the newest weight loss drugs praised in TikTok testimonials and celebrity endorsements. It seems everyone is raving about Ozempic and Wegovy, injectable drugs that help shed unwanted pounds. In a world that idolises slimness, people are scrambling for prescriptions. Exercise is outdated, and healthcare regulatory agencies don’t seem to be urging caution.
As the injectable weight loss juggernaut rages across the United States, Europe and now the Middle East, some physicians are raising concerns. They know modern medicine has a dark history when it comes to weight loss drugs and surgical procedures that promise thinness, but end up harming. Remember Fen-Phen, the 30,000 people with damaged heart valves, and the US$13 billion in lawsuits? Are these new drugs another ‘get thin quick’ scheme that will backfire on our future health? In promoting these drugs, what kind of message are we sending to women about weight and weight loss, and is that the kind of conversation we should be having?
The active ingredient in both Ozempic and Wegovy is semaglutide, a glucagon-like peptide 1 (GLP-1). It mimics the GLP-1 hormone that the intestines produce after we eat a meal that tells the brain, ‘I’m full and finished eating.’ It controls appetite by inducing a sense of satiety, while stimulating the pancreas to secrete insulin and blocking the liver from releasing glucose (sugar). This slows down the emptying of the stomach, making a person feel full longer, reducing cravings, emotional eating, overall calorie intake, and blood sugar spikes after a meal. Crucially, keeping post-meal blood sugar more stable is why Ozempic was developed for diabetes patients — not for weight loss.
While Ozempic is being prescribed for weight loss, it is not FDA (Food and Drug Administration of America) approved for that purpose, only for diabetes treatment. Surprisingly, the FDA does allow drugs to be prescribed for ‘off-label’ uses for which they were never approved or researched, if physicians find they work for certain conditions. That’s how people are getting Ozempic prescriptions to lose weight.
In comparison, Wegovy has been FDA-approved for the treatment of overweight and obesity, and contains a higher dose of semaglutide than Ozempic. It’s approved for patients with obesity or overweight with a body mass index (BMI) of at least 27 and one weight-related health condition such as high blood pressure, high cholesterol or heart disease. People with a BMI of 30 or higher have no other requirements. Both Ozempic and Wegovy are prescribed as weekly self-injections.
For all the talk about these drugs, the results from the trials and other research don’t seem worthy of the high praise coming from the Hollywood crowd. In the first of two trials where 74 per cent of participants were women with an average body weight of 105kg and average BMI of 38, those taking Wegovy lost an average of 12.4 percent of their body weight in 68 weeks. That means it took a woman weighing 105kg one year and four months to lose 13kg. If she was 5’6with a healthy target weight of 63.5kg, she would still be over 90kg with 27kg more to go. It seems diet and exercise would be a healthier and faster approach.
A second trial with type 2 diabetes patients where 51 per cent were women with an average body weight of 100kg and averageBMI of 36, those on Wegovy lost an average of 6.2 per cent of their body weight in 68 weeks. Other research shows a weight loss range of five to 15 per cent over 68 weeks using a semaglutide injectable drug. Even at 15 per cent, that’s only 13.5kg off a 100kg person in 16months. For a drug that costs US$1,400 per month if your insurance doesn’t cover it, it would seem patients should get a better result for their investment and without all the risk.
Because these drugs act through gastric, hormonal and blood pathways, side effects involving gut health, blood sugar and digestion are a concern. Some of these include nausea, diarrhoea, constipation, abdominal distention or pain, indigestion, belching, gas, vomiting, acid reflux, heartburn, gastroenteritis and low blood sugar. Interfering with blood sugar can create a host of problems, and so many digestive side effects indicate negative changes in the gut microbiome. This involves the bulk of the immune system and our ability to absorb the nutrients from the foods we eat.Even worse, semaglutide has been linked to kidney damage and thyroid tumors. This is why the FDA requires these drugs to carry a black box warning, the strictest warnings required by the FDA for drugs that pose serious risks such as significant injury or death.
In return for these risks and relatively low weight loss over along period of time, further analysis of the trial data shows that a large percentage of semaglutide weight loss comes from lean mass, meaning muscle, not fat. In the first trial, lean mass accounted for 39 per cent of total weight loss, and in the second trial with diabetic participants it was 40 per cent. This is important because lean mass, like the muscle acquired through exercise, is what helps the body burn more fat, even at rest.
In spite of what we already know about the risks of injectable weight loss drugs and the long-term unknowns, more healthcare agencies are hopping on the ‘get thin quick’ bandwagon, pushing for these drugs to be made available to a broader population. Citing a link between obesity and cancer, the Moffitt Cancer Center in Florida, USA is lobbying to get these drugs approved by Medicare with the NAACP joining in. The FDA has already approved semaglutide injections for children as young as 12 with the support of the American Academy of Pediatrics.
Much of this stems from the U.S. government lowering there commended healthy weight guidelines in 1998. Under the lower weight and BMI standards, 29 million Americans became ‘overweight’ overnight and eligible for all the new medical weight loss interventions of the time. It’s no coincidence that bariatric surgery was about to takeoff as the newest weight loss sensation, along with all the risks, false expectations, and complications that came with it.
For decades, lobbyists in the medical establishment have been trying to get overweight and obesity classified as a disease, even going so far as to use non-medical terms such as chronic overweight management to make it sound more official. If weight struggles can be classified as a disease then more drugs can be developed and marketed to that population. It would open up an enormous new revenue stream for drug companies where insurance providers could hardly refuse to cover such drugs. After all, it’s for a ‘disease’.
Whether it’s selling women another ‘get thin quick’ scheme or telling them they have a weight disease, it’s not helping them take more control over their lives. Taking a drug to do your weight loss for you or because you have a ‘disease’ is disempowering. It teaches women that they’re victims of their weight, and there is nothing else they can do about it. It engenders lack of discipline because if the drug is doing the weight loss for you, why exercise or eat healthy?
Both prevent women from taking responsibility for their lives.It’s difficult to admit we created certain aspects of our lives as they exist today, including our body weight, but without that admission, we don’t have the power to change anything.
At the same time, simply taking a pill to lose weight doesn’t address the underlying emotional or addiction issues that drive unwanted weight gain for many women. That’s why once a diet is over or the shots stop, the weight comes right back, often with a little extrato boot. Without the proper psycho-emotional work, women must take these shots for the rest of their lives to maintain the weight loss. How is that empowering women or helping them lead independent lives?
This is why taking personal responsibility for our lives and the power to change are two sides of the same coin. By admitting we made something happen, we immediately acquire the power to unmake it and create something new. That’s a prescription for empowerment, and it doesn’t come with side effects.
