Tag: semaglutide

Wegovy injections vs. pills: Doctors explain the differences
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Wegovy injections vs. pills: Doctors explain the differences

When it comes to GLP-1 pills vs. injections, doctors share which form may be best for you.

Updated: 3:01 PM PST Jan 15, 2026

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GLP-1 (glucagon-like peptide-1 receptor agonists) like Ozempic and Wegovy continue to make headlines as more research points to the benefits of taking these medications. Traditionally, patients administer these via injection, but now, one medication in particular is available to take in pill form. So, which works best: Wegovy injection vs. pill? And is the answer the same for all GLP-1s?First, GLP-1s are a class of drugs that mimic the GLP-1 hormone that’s naturally released in your GI tract when you eat, explains Mir Ali, M.D., medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. These medications help to moderate blood sugar levels, reduce feelings of hunger in the brain, and delay emptying in the stomach, making you feel fuller, longer. As a result, a side effect is weight loss. There are some buzzy GLP-1 medications that have become household names, like Wegovy and Ozempic, but there are also other options you may not have heard about.Ultimately, the best GLP-1 medication is one that you and your healthcare provider agree will best serve your needs. But learning more about the medication you intend to use can’t hurt. Here, find the major differences between GLP-1 injections and pills.There are a lot of medications that fall into the GLP-1 class, including injectable drugs and pills. Some popular ones include Ozempic, Rybelsus, and Wegovy.It’s worth noting that Wegovy (the main active ingredient of which is semaglutide) is the only GLP-1 pill that’s approved for weight loss by the U.S. Food and Drug Administration (FDA). While Rybelsus is sometimes used off-label for weight loss, it’s technically FDA-approved for blood sugar management in people with type 2 diabetes (the same goes for Ozempic). So, keep in mind that the information ahead speaks primarily to Wegovy.Wegovy injection vs. pill: How does each work? GLP-1 injectable medications are usually injected into the belly. “GLP-1 injections deliver the medication into the subcutaneous fat, where it is slowly absorbed,” explains Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “These drugs have a long half-life, about five to seven days, which is why they only need to be taken once a week.”After they’re injected, the medication steadily enters the bloodstream and activates the GLP-1 receptor, Dr. Buettner explains. Once it’s in your body, the medication signals to your brain to take in less food, says Martin Binks, Ph.D., professor and chair of the Department of Nutrition and Food Studies at George Mason University College of Public Health. “They also help delay stomach emptying, which ultimately improves satiety and reduces hunger,” he says. “The combined influences of these medicines regulate metabolism and appetite.”The GLP-1 pills work similarly, but these contain a higher dose of medication to compensate for absorption into the digestive tract, Dr. Binks says. (The injectable medications have lower doses of medication because they’re slowly released into the bloodstream and bypass the gastrointestinal tract, Dr. Ali explains.)These medications are taken by mouth once a day. They usually need to be taken on an empty stomach, and you can’t eat or take most other medications for up to an hour afterward, Dr. Buettner points out. “These requirements can be inconvenient for many patients,” he says.Which is most effective for weight loss?It depends. There have been a few clinical trials on the impact of GLP-1 injectable medications on weight loss with different results. However, People usually lose about 15% of their body weight while using semaglutide medications like Wegovy.Meanwhile, during clinical trials for the Wegovy oral route, people who took the pill lost about 16.6% of their body weight. (That’s compared to 3% weight loss achieved by people who used a placebo.)While Rybelsus isn’t FDA-approved for weight loss, people typically lose around eight pounds while taking this medication.Which works best?There are a few things to consider. “Both injectables and pill forms can be helpful,” says Dina Hagigeorges, PA.-C., a physician assistant who specializes in weight and wellness at Tufts Medicine Weight + Wellness – Stoneham. “Unfortunately, cost and insurance coverage are a huge deciding factor, as not all insurance plans cover these medications for people.” When paid for out of pocket, injectable GLP-1 medications are usually much more expensive than their oral counterparts.There’s a larger body of research to support injectable medications for weight loss, although the Wegovy pill shows promise, Dr. Ali says. “If someone can tolerate injections, it’s usually the better way to go—they’re taken less frequently,” he says. But these medications aren’t a good fit for people who are scared of needles, and they have to be refrigerated, Dr. Ali points out.“The pills are a good option for people who don’t like injections, and you can easily take them with you when you travel,” Dr. Ali says. “But they have to be taken daily, which is not for everyone.”Side effectsThe side effects are similar for both medications, Dr. Buettner says.These side effects may include:NauseaVomitingDiarrheaConstipationUpset Stomach “The most important thing is choosing a medication that you can use consistently and that aligns with your personal priorities—whether that’s maximum weight loss, convenience, avoiding injections, or simplifying your routine,” he says. “Many patients try one form first and later switch based on their experience.”So, talk to your healthcare provider and keep the line of conversation open. You may find one form of GLP-1 feels like a more natural fit over another.
GLP-1 (glucagon-like peptide-1 receptor agonists) like Ozempic and Wegovy continue to make headlines as more research points to the benefits of taking these medications. Traditionally, patients administer these via injection, but now, one medication in particular is available to take in pill form. So, which works best: Wegovy injection vs. pill? And is the answer the same for all GLP-1s?

First, GLP-1s are a class of drugs that mimic the GLP-1 hormone that’s naturally released in your GI tract when you eat, explains Mir Ali, M.D., medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. These medications help to moderate blood sugar levels, reduce feelings of hunger in the brain, and delay emptying in the stomach, making you feel fuller, longer. As a result, a side effect is weight loss.

There are some buzzy GLP-1 medications that have become household names, like Wegovy and Ozempic, but there are also other options you may not have heard about.

Ultimately, the best GLP-1 medication is one that you and your healthcare provider agree will best serve your needs. But learning more about the medication you intend to use can’t hurt. Here, find the major differences between GLP-1 injections and pills.

There are a lot of medications that fall into the GLP-1 class, including injectable drugs and pills. Some popular ones include Ozempic, Rybelsus, and Wegovy.

It’s worth noting that Wegovy (the main active ingredient of which is semaglutide) is the only GLP-1 pill that’s approved for weight loss by the U.S. Food and Drug Administration (FDA). While Rybelsus is sometimes used off-label for weight loss, it’s technically FDA-approved for blood sugar management in people with type 2 diabetes (the same goes for Ozempic). So, keep in mind that the information ahead speaks primarily to Wegovy.

Wegovy injection vs. pill: How does each work?

GLP-1 injectable medications are usually injected into the belly. “GLP-1 injections deliver the medication into the subcutaneous fat, where it is slowly absorbed,” explains Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. “These drugs have a long half-life, about five to seven days, which is why they only need to be taken once a week.”

After they’re injected, the medication steadily enters the bloodstream and activates the GLP-1 receptor, Dr. Buettner explains. Once it’s in your body, the medication signals to your brain to take in less food, says Martin Binks, Ph.D., professor and chair of the Department of Nutrition and Food Studies at George Mason University College of Public Health. “They also help delay stomach emptying, which ultimately improves satiety and reduces hunger,” he says. “The combined influences of these medicines regulate metabolism and appetite.”

The GLP-1 pills work similarly, but these contain a higher dose of medication to compensate for absorption into the digestive tract, Dr. Binks says. (The injectable medications have lower doses of medication because they’re slowly released into the bloodstream and bypass the gastrointestinal tract, Dr. Ali explains.)

These medications are taken by mouth once a day. They usually need to be taken on an empty stomach, and you can’t eat or take most other medications for up to an hour afterward, Dr. Buettner points out. “These requirements can be inconvenient for many patients,” he says.

Which is most effective for weight loss?

It depends. There have been a few clinical trials on the impact of GLP-1 injectable medications on weight loss with different results. However, People usually lose about 15% of their body weight while using semaglutide medications like Wegovy.

Meanwhile, during clinical trials for the Wegovy oral route, people who took the pill lost about 16.6% of their body weight. (That’s compared to 3% weight loss achieved by people who used a placebo.)

While Rybelsus isn’t FDA-approved for weight loss, people typically lose around eight pounds while taking this medication.

Which works best?

There are a few things to consider. “Both injectables and pill forms can be helpful,” says Dina Hagigeorges, PA.-C., a physician assistant who specializes in weight and wellness at Tufts Medicine Weight + Wellness – Stoneham. “Unfortunately, cost and insurance coverage are a huge deciding factor, as not all insurance plans cover these medications for people.” When paid for out of pocket, injectable GLP-1 medications are usually much more expensive than their oral counterparts.

There’s a larger body of research to support injectable medications for weight loss, although the Wegovy pill shows promise, Dr. Ali says. “If someone can tolerate injections, it’s usually the better way to go—they’re taken less frequently,” he says. But these medications aren’t a good fit for people who are scared of needles, and they have to be refrigerated, Dr. Ali points out.

“The pills are a good option for people who don’t like injections, and you can easily take them with you when you travel,” Dr. Ali says. “But they have to be taken daily, which is not for everyone.”

Side effects

The side effects are similar for both medications, Dr. Buettner says.

These side effects may include:

Nausea

Vomiting

Diarrhea

Constipation

Upset Stomach

“The most important thing is choosing a medication that you can use consistently and that aligns with your personal priorities—whether that’s maximum weight loss, convenience, avoiding injections, or simplifying your routine,” he says. “Many patients try one form first and later switch based on their experience.”

So, talk to your healthcare provider and keep the line of conversation open. You may find one form of GLP-1 feels like a more natural fit over another.
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January 15, 2026
FDA approves Wegovy pill for weight loss

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U.S. regulators on Monday gave the green light to a pill version of the blockbuster weight-loss drug Wegovy, the first daily oral medication to treat obesity.The U.S. Food and Drug Administration’s approval handed drugmaker Novo Nordisk an edge over rival Eli Lilly in the race to market an obesity pill. Lilly’s oral drug, orforglipron, is still under review.Both pills are GLP-1 drugs that work like widely used injectables to mimic a natural hormone that controls appetite and feelings of fullness.Video above: Doctor’s perspective on making GLP-1s more affordableIn recent years, Novo Nordisk’s injectable Wegovy and Lilly’s Zepbound have revolutionized obesity treatment globally and in the U.S., where 100 million people have the chronic disease.The Wegovy pills are expected to be available within weeks, company officials said. Availability of oral pills to treat obesity could expand the booming market for obesity treatments by broadening access and reducing costs, experts said.About 1 in 8 Americans have used injectable GLP-1 drugs, according to a survey from KFF, a nonprofit health policy research group. But many more have trouble affording the costly shots.“There’s an entire demographic that can benefit from the pills,” said Dr. Fatima Cody Stanford, a Massachusetts General Hospital obesity expert. “For me, it’s not just about who gets it across the finish line first. It’s about having these options available to patients.”The Novo Nordisk obesity pill contains 25 milligrams of semaglutide. That’s the same ingredient in injectables Wegovy and Ozempic and in Rybelsus, a lower-dose pill approved to treat diabetes in 2019.In a clinical trial, participants who took oral Wegovy lost 13.6% of their total body weight on average over about 15 months, compared with a 2.2% loss if they took a placebo, or dummy pill. That’s nearly the same as injectable Wegovy, with an average weight loss of about 15%.Chris Mertens, 35, a pediatric lung doctor in Menomonee Falls, Wisconsin, joined the Novo Nordisk trial in 2022 and lost about 40 pounds using the Wegovy pill. The daily medication worked to decrease his appetite and invasive thoughts of food, he said.“If there were days where I missed a meal, I almost didn’t realize it,” Mertens said.Participants in a clinical trial who took the highest dose of Lilly’s orforglipron lost 11.2% of their total body weight on average over nearly 17 months, compared with a 2.1% loss in those who took a placebo.Both pills resulted in less weight loss than the average achieved with Lilly’s Zepbound, or tirzepatide, which targets two gut hormones, GLP-1 and GIP, and led to a 21% average weight loss.All the GLP-1 drugs, oral or injectable, have similar side effects, including nausea and diarrhea.Both daily pills promise convenience, but the Wegovy pill must be taken with a sip of water in the morning on an empty stomach, with a 30-minute break before eating or drinking.That’s because Novo Nordisk had to design the pill in a way that prevented the drug from being broken down in the stomach before it could be absorbed by the bloodstream. The drugmaker added an ingredient that protects the medication for about 30 minutes in the gut and makes it easier to take effect.By contrast, Lilly’s orforglipron has no dosing restrictions. That drug is being considered under the FDA’s new priority voucher program aimed at cutting drug approval times. A decision is expected by spring.Producing pills is generally cheaper than making drugs delivered via injections, so the cost for the new oral medications could be lower. The Trump administration earlier this year said officials had worked with drugmakers to negotiate lower prices for the GLP-1 drugs, which can cost upwards of $1,000 a month.The company said the starting dose would be available for $149 per month from some providers. Additional information on cost will be available in January.It’s not clear whether daily pills or weekly injections will be preferred by patients. Although some patients dislike needles, others don’t seem to mind the weekly injections, obesity experts said. Mertens turned to injectable Zepbound when he regained weight after the end of the Wegovy pill clinical trial.He said he liked the discipline of the daily pill.“It was a little bit of an intentional routine and a reminder of today I’m taking this so that I know my choices are going to be affected for the day,” he said.Dr. Angela Fitch, an obesity expert and chief medical officer of knownwell, a health care company, said whatever the format, the biggest benefit will be in making weight-loss medications more widely accessible and affordable.“It’s all about the price,” she said. “Just give me a drug at $100 a month that is relatively effective.”

U.S. regulators on Monday gave the green light to a pill version of the blockbuster weight-loss drug Wegovy, the first daily oral medication to treat obesity.

The U.S. Food and Drug Administration’s approval handed drugmaker Novo Nordisk an edge over rival Eli Lilly in the race to market an obesity pill. Lilly’s oral drug, orforglipron, is still under review.

Both pills are GLP-1 drugs that work like widely used injectables to mimic a natural hormone that controls appetite and feelings of fullness.

Video above: Doctor’s perspective on making GLP-1s more affordable

In recent years, Novo Nordisk’s injectable Wegovy and Lilly’s Zepbound have revolutionized obesity treatment globally and in the U.S., where 100 million people have the chronic disease.

The Wegovy pills are expected to be available within weeks, company officials said. Availability of oral pills to treat obesity could expand the booming market for obesity treatments by broadening access and reducing costs, experts said.

About 1 in 8 Americans have used injectable GLP-1 drugs, according to a survey from KFF, a nonprofit health policy research group. But many more have trouble affording the costly shots.

“There’s an entire demographic that can benefit from the pills,” said Dr. Fatima Cody Stanford, a Massachusetts General Hospital obesity expert. “For me, it’s not just about who gets it across the finish line first. It’s about having these options available to patients.”

The Novo Nordisk obesity pill contains 25 milligrams of semaglutide. That’s the same ingredient in injectables Wegovy and Ozempic and in Rybelsus, a lower-dose pill approved to treat diabetes in 2019.

In a clinical trial, participants who took oral Wegovy lost 13.6% of their total body weight on average over about 15 months, compared with a 2.2% loss if they took a placebo, or dummy pill. That’s nearly the same as injectable Wegovy, with an average weight loss of about 15%.

Chris Mertens, 35, a pediatric lung doctor in Menomonee Falls, Wisconsin, joined the Novo Nordisk trial in 2022 and lost about 40 pounds using the Wegovy pill. The daily medication worked to decrease his appetite and invasive thoughts of food, he said.

“If there were days where I missed a meal, I almost didn’t realize it,” Mertens said.

Participants in a clinical trial who took the highest dose of Lilly’s orforglipron lost 11.2% of their total body weight on average over nearly 17 months, compared with a 2.1% loss in those who took a placebo.

Both pills resulted in less weight loss than the average achieved with Lilly’s Zepbound, or tirzepatide, which targets two gut hormones, GLP-1 and GIP, and led to a 21% average weight loss.

All the GLP-1 drugs, oral or injectable, have similar side effects, including nausea and diarrhea.

Both daily pills promise convenience, but the Wegovy pill must be taken with a sip of water in the morning on an empty stomach, with a 30-minute break before eating or drinking.

That’s because Novo Nordisk had to design the pill in a way that prevented the drug from being broken down in the stomach before it could be absorbed by the bloodstream. The drugmaker added an ingredient that protects the medication for about 30 minutes in the gut and makes it easier to take effect.

By contrast, Lilly’s orforglipron has no dosing restrictions. That drug is being considered under the FDA’s new priority voucher program aimed at cutting drug approval times. A decision is expected by spring.

Producing pills is generally cheaper than making drugs delivered via injections, so the cost for the new oral medications could be lower. The Trump administration earlier this year said officials had worked with drugmakers to negotiate lower prices for the GLP-1 drugs, which can cost upwards of $1,000 a month.

The company said the starting dose would be available for $149 per month from some providers. Additional information on cost will be available in January.

It’s not clear whether daily pills or weekly injections will be preferred by patients. Although some patients dislike needles, others don’t seem to mind the weekly injections, obesity experts said. Mertens turned to injectable Zepbound when he regained weight after the end of the Wegovy pill clinical trial.

He said he liked the discipline of the daily pill.

“It was a little bit of an intentional routine and a reminder of today I’m taking this so that I know my choices are going to be affected for the day,” he said.

Dr. Angela Fitch, an obesity expert and chief medical officer of knownwell, a health care company, said whatever the format, the biggest benefit will be in making weight-loss medications more widely accessible and affordable.

“It’s all about the price,” she said. “Just give me a drug at $100 a month that is relatively effective.”

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December 23, 2025
Semaglutide fails to slow progression of Alzheimer’s in highly anticipated trials, Novo Nordisk says

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An oral version of semaglutide, the active ingredient in blockbuster drugs Ozempic and Wegovy, failed to slow the progression of Alzheimer’s disease in closely watched trials, Novo Nordisk said Monday.In two Phase 3 trials of more than 3,800 adults receiving standard care for Alzheimer’s, the company evaluated whether an older pill form of semaglutide worked better than a placebo. The drug was shown to be safe and led to improvements in Alzheimer’s-related biomarkers, the company said, but the treatment did not delay disease progression.Novo had long treated Alzheimer’s as a long-shot bet for the popular GLP-1 drugs. Use of these drugs for diabetes and weight loss has exploded in recent years, and they have shown benefits for a wide range of additional health conditions, such as protecting the heart and kidneys, reducing sleep apnea and potentially helping with addiction.Smaller trials and animal studies had suggested GLP-1s might help slow cognitive decline or reduce neuro-inflammation but larger trials like Novo’s were needed to confirm whether patients saw actual benefits.”Based on the significant unmet need in Alzheimer’s disease as well as a number of indicative data points, we felt we had a responsibility to explore semaglutide’s potential, despite a low likelihood of success,” said Martin Holst Lange, chief scientific officer and executive vice president of Research and Development at Novo Nordisk said in a statement on Monday that thanked trial participants.A one-year extension of the trials will be discontinued, Novo said. Results from the trials have not yet been peer-reviewed or published but will be presented at upcoming scientific conferences.Novo has been facing increased competition in the weight loss market and recently announced lowered prices for some cash-paying patients using Ozempic and Wegovy. Novo shares fell Monday after the Alzheimer’s trial announcement.

CNN —

An oral version of semaglutide, the active ingredient in blockbuster drugs Ozempic and Wegovy, failed to slow the progression of Alzheimer’s disease in closely watched trials, Novo Nordisk said Monday.

In two Phase 3 trials of more than 3,800 adults receiving standard care for Alzheimer’s, the company evaluated whether an older pill form of semaglutide worked better than a placebo. The drug was shown to be safe and led to improvements in Alzheimer’s-related biomarkers, the company said, but the treatment did not delay disease progression.

Novo had long treated Alzheimer’s as a long-shot bet for the popular GLP-1 drugs. Use of these drugs for diabetes and weight loss has exploded in recent years, and they have shown benefits for a wide range of additional health conditions, such as protecting the heart and kidneys, reducing sleep apnea and potentially helping with addiction.

Smaller trials and animal studies had suggested GLP-1s might help slow cognitive decline or reduce neuro-inflammation but larger trials like Novo’s were needed to confirm whether patients saw actual benefits.

“Based on the significant unmet need in Alzheimer’s disease as well as a number of indicative data points, we felt we had a responsibility to explore semaglutide’s potential, despite a low likelihood of success,” said Martin Holst Lange, chief scientific officer and executive vice president of Research and Development at Novo Nordisk said in a statement on Monday that thanked trial participants.

A one-year extension of the trials will be discontinued, Novo said. Results from the trials have not yet been peer-reviewed or published but will be presented at upcoming scientific conferences.

Novo has been facing increased competition in the weight loss market and recently announced lowered prices for some cash-paying patients using Ozempic and Wegovy. Novo shares fell Monday after the Alzheimer’s trial announcement.

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November 24, 2025
Don’t Look Now, But Ozempic Might Help You Quit Smoking, Too

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Semaglutide, the active ingredient in popular weight loss drugs Wegovy and Ozempic, may help people quit smoking, too. New research published Monday has found evidence that semaglutide can prevent or treat people’s nicotine dependence. More study will be needed to confirm this potential benefit, however.

Semaglutide and other newer GLP-1 drugs have proven to be substantially more effective at helping people lose weight than diet and exercise alone. But scientists at Case Western Reserve University, led by researcher Rong Xu, have been studying the possible effects of semaglutide and similar drugs that might extend beyond treating weight loss and type 2 diabetes. Earlier this month, for instance, they published a study finding that GLP-1 drugs may be able to reduce the overall risk of obesity-related cancer in people with diabetes. Their new research, published in the Annals of Internal Medicine, looked at the connection between semaglutide use and nicotine use disorder.

The researchers analyzed the health records of over 200,000 diabetes patients after they were newly prescribed one of several antidiabetes medications, including nearly 6,000 people who were prescribed semaglutide. They found that semaglutide users were noticeably less likely to be diagnosed with tobacco use disorder or to be given treatments for it (i.e., drugs or counseling) over the following year. This pattern held true when the researchers only looked at people with or without obesity as well.

“While there are effective medications to support people if they wish to stop smoking, not everyone responds to them,” said Xu, a biomedical informatics professor at Case Western, in a statement from the university. “As a result of the high relapse rates, alternative medications to help people stop smoking are needed.”

The team’s findings alone cannot prove that semaglutide and similar drugs can help treat tobacco addiction. But anecdotes and some studies (including one by the same scientists published in May) have increasingly suggested that GLP-1 drugs can temper harmful cravings caused by other vices such as alcohol and even gambling. As a result, scientists elsewhere have begun to test out semaglutide for alcohol use disorder in clinical trials (with early promising results so far)—a trend that should be followed with nicotine as well, the authors say. “These findings suggest the need for clinical trials to evaluate semaglutide’s potential for [tobacco use disorder] treatment,” they wrote in their paper.

From potentially preventing cancer to possibly keeping our brains sharper as we reach our later years, is there anything that semaglutide can’t do?

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Ed Cara

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July 30, 2024
Next Gen Weight Loss Drugs Are Coming for Ozempic’s Throne

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The future of weight loss is fast approaching. At a recent scientific conference, drug companies showed off a variety of next-generation drugs for both obesity and type 2 diabetes. Some of these treatments might help people lose even more weight than current forerunners like Novo Nordisk’s semaglutide—the active ingredient in popular drugs Ozempic and Wegovy—while others may come with fewer side effects or be easier to take.

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Semaglutide is a drug that mimics GLP-1, one of several hormones that help regulate our sense of hunger and blood sugar. In clinical trials, semaglutide has proven to be much more effective at treating obesity than diet and exercise alone. Previously only approved for type 2 diabetes as Ozempic, semaglutide was approved for obesity in 2021 under the name Wegovy. However, it’s already started to be overshadowed by the arrival of Eli Lilly’s tirzepatide, which combines GLP-1 with another incretin hormone called GIP. Tirzepatide was approved by the Food and Drug Administration in 2021 for type 2 diabetes under the brand name Mounjaro; in November 2023, it was approved to treat obesity as Zepbound.

Newer treatments in the works are poised to compete with and possibly surpass both of these drugs. The American Diabetes Association held its annual conference over the past weekend, and the emergence of these future medications was a big aspect of the event. Companies presented preliminary data on over two dozen GLP-1 related drugs, all in various stages of development.

“We’ve heard about Ozempic and Mounjaro and so on, but now we’re seeing lots and lots of different drug candidates in the pipeline, from very early-stage preclinical all the way through late-stage clinical,” Marlon Pragnell, ADA’s vice president of research and science, told NBC News. “It’s very exciting to see so much right now.”

Altimmune’s pemvidutide, for instance, combines GLP-1 with glucagon, another hormone key to keeping our blood sugar level stable. In Phase II trial data presented this weekend, pemvidutide was found to help people lose over 15% of their baseline weight within 48 weeks, a bit ahead of the pace seen with semaglutide (15% weight loss over 68 weeks). A dual GLP-1/GIP candidate developed by scientists in China, called HRS9531 for now, was found to cause up to 16% weight loss within 24 weeks. Eli Lilly also presented new data on its second-generation drug retatrutide, which combines GLP-1, GIP, and glucagon, finding it improved insulin’s ability to control blood sugar in people with type 2 diabetes. In previous research, retatrutide was found to cause up to 24% weight loss, the highest mark seen yet with these drugs.

It’s not certain that these or other GLP-1 drugs in development will truly outmatch semaglutide and tirzepatide in terms of weight loss, but they may still have other benefits over them. Pemvidutide was found to cause less lean body mass loss, for instance, possibly due to the addition of glucagon (exercise naturally raises glucagon levels, so the drug could be mimicking some of the positive effects of exercise). Some experts are skeptical that lean body mass loss is a major concern with these drugs. However, it may be important to prevent this in individuals who are more vulnerable to muscle or bone loss, such as older adults.

It will take years for these newer drugs to reach the public, assuming they continue to succeed in larger trials. Their arrival may not only help people who don’t respond to existing treatments, though, but could also drive down the overall high costs of these medications (without insurance coverage, which is often denied, a month’s supply of semaglutide can reach over $1,000 per month).

“Over the past few years, we have seen the substantial impact of new research working to solve the dual health crisis we are facing, obesity and diabetes,” said Robert Gabbay, chief scientific and medical officer for the ADA, in a statement from the ADA. “The studies we are seeing presented at this year’s annual meeting show great promise to fuel new solutions and treatment options for patients across the globe living with type 2 diabetes and obesity.”

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Ed Cara

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June 25, 2024
Weight Loss Drug Users Are Giving Up Their Vices

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Image: Hollie Adams (Reuters)

It’s not only food CEOs who need to worry about their bottom lines thanks to in-demand weight loss drugs like Ozempic. Big Tobacco and Alcohol have reason to fret, too.

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A new report from Morgan Stanley finds that people using GLP-1 drugs — among them Ozempic, Wegovy, Mounjaro, and Zepbound — reduce their consumption of tobacco and alcohol while taking the medications. GLP-1s are a class of diabetes and weight loss drugs that have recently caught fire (and blown up sales numbers) for their ability to suppress a user’s appetite.

The investment bank also surveyed about 300 GLP-1 users about their consumption habits while taking the medication. Analysts at the bank have previously cautioned that the growing use of GLP-1s will put some longterm pressure on fast food sales, as users have reported spending less money at restaurants. But their survey also finds that users are reducing their intake of tobacco and alcohol.

Could weight loss drugs help users smoke or drink less?

While 40% of survey respondents said they smoked cigarettes at least weekly before starting a GLP-1 treatment, that number fell to 24% after they started the treatment. Meanwhile, weekly e-cigarette usage dropped from 30% of respondents to 16% after they started taking a GLP-1.

Morgan Stanley found similar results when it asked respondents about their use of alcohol. About 56-62% of alcohol consumers on GLP-1s reported drinking less alcohol since starting the medications, with about 14-18% cutting their alcohol consumption entirely.

The analysts noted they were “cautious about drawing conclusions” from their survey about the impact of GLP-1 drugs on addictive behaviors. But there has been anecdotal evidence from patients and health care providers that suggests GLP-1s can help users curb their addictions to alcohol and tobacco. While research hasn’t yet proven a causal link between the two, clinical trials are currently underway to better understand the effects of GLP-1’s on alcohol and tobacco consumption.

In addition, Morgan Stanley anticipates the GLP-1 frenzy isn’t slowing anytime soon. global market for GLP-1 drugs will reach $105 billion by 2030. It also projects these drugs will be adopted by about 31.5 million people in the U.S. (or about 9% of the nation’s population) by 2035.

This article originally appeared on Quartz.

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Bruce Gil, Quartz

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April 23, 2024
Ozempic, Prince Andrew, And More: This Week In Breaking News March 30, 2024

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Read more…

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March 30, 2024
Worst Side Effects Ozempic Users Don’t Want You To Know About

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While diarrhea is listed as a common side effect, none of the literature tells you that you will experience horrific visions of future wars, famines, and natural disasters every time you have a bowel movement—and worst of all, no one will believe you.

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March 27, 2024
Ozempic overdose? Poison control experts explain why thousands OD'd this year

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Some of those taking Ozempic or Wegovy are learning that too much of a good thing is never good.

Semaglutide, the medication prescribed under the brand names Ozempic, for treating Type 2 diabetes, and Wegovy, for weight management, works by mimicking the hormone GLP-1, which is released by the gut after eating. The hormone has several effects in the body, such as stimulating insulin production, slowing gastric emptying and lowering blood sugar.

It has been hailed for its weight-loss benefits, most conspicuously among celebrities. Oprah Winfrey recently said she uses weight-loss medication and lauded “the fact that there’s a medically approved prescription for managing weight and staying healthier, in my lifetime.” She said it felt “like a gift.”

But between Jan. 1 and Nov. 30 this year, at least 2,941 Americans reported overdose exposures to semaglutide, according to a recent report from America’s Poison Centers, a national nonprofit representing 55 poison centers in the United States.

California accounted for about 350 of the reports, or around 12%, according to Raymond Ho, the managing director of the California Poison Control System. Ho said the number roughly corresponds to the proportion of California’s population to the rest of the country.

The nationwide number of semaglutide overdoses this year is more than double the 1,447 reported in 2022, which was more than double the 607 semaglutide overdoses reported in 2021.

There were only 364 reported semaglutide overdoses in 2020 and 196 in 2019, less than 10% of the number that occurred so far this year.

America’s Poison Centers released the data with a disclaimer that the figures likely represent an undercount in the number of cases involving semaglutide, as the center only included those voluntarily reported to poison control centers.

“It is an alarming trend from a poison center perspective,” Ho said. “We get the usual dosing error calls, and all of a sudden there’s an explosion of people calling much more regularly about this.”

The use of semaglutide and other GLP-1 imitators has surged in popularity over the last year as a quick and effective way to manage weight loss. More than 4 million prescriptions for semaglutide were issued in the United States in 2020, according to federal data, and usage of the drug has continued to grow since then.

Dr. Stephen Petrou, an emergency medicine physician and toxicology fellow with California Poison Control, said there were multiple factors contributing to the increase in overdoses.

“Not only is there rising social popularity” of the drug, Petrou said, “but there’s also wider FDA indications for use.”

Semaglutide was patented by the Danish pharmaceutical company Novo Nordisk in 2012 and has been available in the United States since the FDA approved it in 2017. The drug was originally released as Ozempic for Type 2 diabetics to manage blood sugar levels. Moderate weight loss was found to be a common side effect of the drug, and the FDA approved a different formulation of semaglutide, called Wegovy, for that purpose in 2021.

Ho and Petrou said the different formulations of semaglutide could help explain why it has led to so many more overdoses than other drugs of its class. Both are administered via weekly injections, with Wegovy in single-use pens and Ozempic in needles that can vary in dosage. Standard dosages range from 0.25 mg to 2.4 mg for weekly injections, depending on the prescription.

“Someone who is unable to get Wegovy can resort to using Ozempic instead, because it is the same medication, but they may start to [adjust] their dose” upward, Petrou said. “That’s when they might encounter problems.”

Ho and Petrou said the vast majority of semaglutide overdose reports are accidental, either due to patients not waiting a week between doses or by misunderstanding dosing instructions. Unlike the GLP-1 hormone, which is rapidly metabolized by the body, semaglutide and similar medications have much longer half-lives, meaning the medication can build up inside the body if not enough time elapses between doses.

Furthermore, semaglutide can also be taken orally as a daily pill — sold under the name Rybelsus — but overdoses are rarely reported.

“We’re not seeing cases of mis-administration or toxicity or overdose with that medication,” Petrou said.

Ho and Petrou explained the signs of semaglutide overdose can resemble those of hypoglycemia, also known as low blood sugar. Symptoms can begin with increased heart rate, sweating, dizziness and irritability. More serious cases can cause confusion, delirium and coma.

“If they have hypoglycemia, the good majority of them will have to be admitted to the hospital and monitored and watched closely, because of how long these drugs last,” Ho said.

Ho encourages everyone who is prescribed semaglutide to thoroughly read the medication’s label and follow the dosing instructions listed.

“We always say this: The dose makes the poison,” Ho said.

Anyone who needs emergency poison assistance or has other poisoning-related inquiries can call the national Poison Helpline at (800) 222-1222 or visit the Poison Help website.

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Jeremy Childs

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December 20, 2023
Things To Never Say To Someone Taking Ozempic

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Though it is not FDA-approved for weight loss, Ozempic, an injectable drug used to treat diabetes, has helped users shit and puke away the pounds. These are things that you should never say to someone taking Ozempic.

“Oh nice! I’m on crack, myself.”

“Oh nice! I’m on crack, myself.”

Ozempic users don’t want to think of themselves as taking a harmful drug.

“Don’t worry. No matter what you decide, you’ll always be fat to me.”

“Don’t worry. No matter what you decide, you’ll always be fat to me.”

This is actually incredibly heartwarming.

“Have you tried loving your body for what it is instead?”

“Have you tried loving your body for what it is instead?”

Sure, why don’t they go ahead and do something that hasn’t ever been achieved by any human in history?

“That commercial makes me want to fucking kill myself.”

“That commercial makes me want to fucking kill myself.”

Aren’t we at a point where every commercial is supposed to do that?

“I was the guy who came up with the idea of counting down to the Olsen twins’ 18th birthday.”

“I was the guy who came up with the idea of counting down to the Olsen twins’ 18th birthday.”

You just shouldn’t say this to anyone.

“I guess I’ll have to stop playing the tuba to accompany your steps while you’re walking down the street.”

“I guess I’ll have to stop playing the tuba to accompany your steps while you’re walking down the street.”

You could’ve gone with a smaller brass instrument to be kind.

“Aren’t you hungry?”

“Aren’t you hungry?”

You fool, you just made them gain all the weight back with that one question.

“Want to watch me eat a steak while you sit there, nauseous?

“Want to watch me eat a steak while you sit there, nauseous?

What? It would be rude not to offer!

“And will that fix your personality as well or is that going to stay the same?”

“And will that fix your personality as well or is that going to stay the same?”

They may become more of an asshole after they lose the weight.

“You still look old, though.”

“You still look old, though.”

Ozempic for aging hasn’t finished clinical trials.

“I injected Ozempic into my foot once, and it immediately shriveled up and fell off.”

“I injected Ozempic into my foot once, and it immediately shriveled up and fell off.”

Don’t give them any ideas.

“I’ve never taken Ozempic, and I look great.”

“I’ve never taken Ozempic, and I look great.”

Don’t force an Ozempic user or anyone else to feed into your totally baseless belief in your attractiveness, you hideous slug.

“Well, if you don’t have the appetite to eat the French onion beef casserole I slaved over all day, then you can get the hell out of this house, just like your whore of a brother!”

“Well, if you don’t have the appetite to eat the French onion beef casserole I slaved over all day, then you can get the hell out of this house, just like your whore of a brother!”

Struggling with obesity is already tough enough without being reminded of how sexually loose their brother is.

“Ozempic should be reserved for people with diabetes or a nice hat.”

“Ozempic should be reserved for people with diabetes or a nice hat.”

Gate-keeping other people’s medication? Not a good look.

“Doughboy wants to lose weight, huh? Pillsbury doughboy wants to lose weight? Hey, everyone, Pillsbury doughboy wants to lose weight! Jump up and down and show the people how fat you are. That’s right, jiggle for us, doughboy. You make me sick.”

“Doughboy wants to lose weight, huh? Pillsbury doughboy wants to lose weight? Hey, everyone, Pillsbury doughboy wants to lose weight! Jump up and down and show the people how fat you are. That’s right, jiggle for us, doughboy. You make me sick.”

There are better ways to let someone you care about know you’re concerned for their health and well-being.

“Having a corporeal form is overrated.”

“Having a corporeal form is overrated.”

Although it’s definitely more ideal to be nothing more than a floating, weightless orb of light, some people can’t avoid having a body of flesh to inhabit.

“I’m not really sexually interested in you unless you’re over 750 pounds soaking wet.”

“I’m not really sexually interested in you unless you’re over 750 pounds soaking wet.”

If you really loved them, you would follow them on this weight-loss journey, no matter your own preferences.

You’ve Made It This Far…

You’ve Made It This Far…

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June 2, 2023
Did Scientists Accidentally Invent an Anti-addiction Drug?

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This article was featured in One Story to Read Today, a newsletter in which our editors recommend a single must-read from The Atlantic, Monday through Friday. Sign up for it here.

All her life, Victoria Rutledge thought of herself as someone with an addictive personality. Her first addiction was alcohol. After she got sober in her early 30s, she replaced drinking with food and shopping, which she thought about constantly. She would spend $500 on organic groceries, only to have them go bad in her fridge. “I couldn’t stop from going to that extreme,” she told me. When she ran errands at Target, she would impulsively throw extra things—candles, makeup, skin-care products—into her cart.

Earlier this year, she began taking semaglutide, also known as Wegovy, after being prescribed the drug for weight loss. (Colloquially, it is often referred to as Ozempic, though that is technically just the brand name for semaglutide that is marketed for diabetes treatment.) Her food thoughts quieted down. She lost weight. But most surprisingly, she walked out of Target one day and realized her cart contained only the four things she came to buy. “I’ve never done that before,” she said. The desire to shop had slipped away. The desire to drink, extinguished once, did not rush in as a replacement either. For the first time—perhaps the first time in her whole life—all of her cravings and impulses were gone. It was like a switch had flipped in her brain.

As semaglutide has skyrocketed in popularity, patients have been sharing curious effects that go beyond just appetite suppression. They have reported losing interest in a whole range of addictive and compulsive behaviors: drinking, smoking, shopping, biting nails, picking at skin. Not everyone on the drug experiences these positive effects, to be clear, but enough that addiction researchers are paying attention. And the spate of anecdotes might really be onto something. For years now, scientists have been testing whether drugs similar to semaglutide can curb the use of alcohol, cocaine, nicotine, and opioids in lab animals—to promising results.

Semaglutide and its chemical relatives seem to work, at least in animals, against an unusually broad array of addictive drugs, says Christian Hendershot, a psychiatrist at the University of North Carolina at Chapel Hill School of Medicine. Treatments available today tend to be specific: methadone for opioids, bupropion for smoking. But semaglutide could one day be more widely useful, as this class of drug may alter the brain’s fundamental reward circuitry. The science is still far from settled, though researchers are keen to find out more. At UNC, in fact, Hendershot is now running clinical trials to see whether semaglutide can help people quit drinking alcohol and smoking. This drug that so powerfully suppresses the desire to eat could end up suppressing the desire for a whole lot more.

The history of semaglutide is one of welcome surprises. Originally developed for diabetes, semaglutide prompts the pancreas to release insulin by mimicking a hormone called GLP-1, or glucagon-like peptide 1. First-generation GLP-1 analogs—exenatide and liraglutide—have been on the market to treat diabetes for more than a decade. And almost immediately, doctors noticed that patients on these drugs also lost weight, an unintended but usually not unwelcome side effect. Semaglutide has been heralded as a potentially even more potent GLP-1 analog.

Experts now believe GLP-1 analogs affect more than just the pancreas. The exact mechanism in weight loss is still unclear, but the drugs likely work in multiple ways to suppress hunger, including but not limited to slowing food’s passage through the stomach and preventing ups and downs in blood sugar. Most intriguing, it also seems to reach and act directly on the brain.

GLP-1 analogs appear to actually bind to receptors on neurons in several parts of the brain, says Scott Kanoski, a neurobiologist at the University of Southern California. When Kanoski and his colleagues blocked these receptors in rodents, the first-generation drugs exenatide and liraglutide became less effective at reducing food intake—as if this had eliminated a key mode of action. The impulse to eat is just one kind of impulse, though. That these drugs work on the level of the brain—as well as the gut—suggests that they can suppress the urge for other things too.

In particular, GLP-1 analogs affect dopamine pathways in the brain, a.k.a. the reward circuitry. This pathway evolved to help us survive; simplistically, food and sex trigger a dopamine hit in the brain. We feel good, and we do it again. In people with addiction, this process in the brain shifts as a consequence or cause of their addiction, or perhaps even both. They have, for example, fewer dopamine receptors in part of the brain’s reward pathway, so the same reward may bring less pleasure.

In lab animals, addiction researchers have amassed a body of evidence that GLP-1 analogs alter the reward pathway: mice on a version of exenatide get less of a dopamine hit from alcohol; rats on the same GLP-1 drug sought out less cocaine; same for rats and oxycodone. African vervet monkeys predisposed to drinking alcohol drank less on liraglutide and exenatide. Most of the published research has been conducted with these two first-generation GLP-1 drugs, but researchers told me to expect many studies with semaglutide, with positive results, to be published soon.

In humans, the science is much more scant. A couple of studies of exenatide in people with cocaine-use disorder were too short or small to be conclusive. Another study of the same drug in people with alcohol-use disorder found that their brain’s reward centers no longer lit up as much when shown pictures of alcohol while they were in an fMRI machine. The patients in the study as a whole, however, did not drink less on the drug, though the subset who also had obesity did. Experts say that semaglutide, if it works at all for addiction, might end up more effective in some people than others. “I don’t expect this to work for everybody,” says Anders Fink-Jensen, a psychiatrist at the University of Copenhagen who conducted the alcohol study. (Fink-Jensen has received funding from Novo Nordisk, the maker of Ozempic and Wegovy, for separate research into using GLP-1 analogs to treat weight gain from schizophrenia medication.) Bigger and longer trials with semaglutide could prove or disprove the drug’s effectiveness in addiction—and identify whom it is best for.

Semaglutide does not dull all pleasure, people taking the drug for weight loss told me. They could still enjoy a few bites of food or revel in finding the perfect dress; they just no longer went overboard. Anhedonia, or a general diminished ability to experience pleasure, also hasn’t shown up in cohorts of people who take the drug for diabetes, says Elisabet Jerlhag Holm, an addiction researcher at the University of Gothenburg. Instead, those I talked with said their mind simply no longer raced in obsessive loops. “It was a huge relief,” says Kimberly Smith, who used to struggle to eat in moderation. For patients like her, the drug tamed behaviors that had reached a level of unhealthiness.

The types of behaviors in which patients have reported unexpected changes include both the addictive, such as smoking or drinking, and the compulsive, such as skin picking or nail biting. (Unlike addiction, compulsion concerns behaviors that aren’t meant to be pleasurable.) And although there is a body of animal research into GLP-1 analogues and addiction, there is virtually none on nonfood compulsions. Still, addictions and compulsions are likely governed by overlapping reward pathways in the brain, and semaglutide might have an effect on both. Two months into taking the drug, Mary Maher woke up one day to realize that the skin on her back—which she had picked compulsively for years—had healed. She used to bleed so much from the picking that she avoided wearing white. Maher hadn’t even noticed she had stopped picking what must have been weeks before. “I couldn’t believe it,” she told me. The urge had simply melted away.

The long-term impacts of semaglutide, especially on the brain, remain unknown. In diabetes and obesity, semaglutide is supposed to be a lifelong medication, and its most dramatic effects are quickly reversed when people go off. “The weight comes back; the suppression of appetite goes away,” says Janice Jin Hwang, an obesity doctor at UNC School of Medicine. The same could be true in at least certain forms of addiction too. Doctors have noted a curious link between addiction and another obesity treatment: Patients who undergo bariatric surgery sometimes experience “addiction transfer,” where their impulsive behaviors move from food to alcohol or drugs. Bariatric surgery works, in part, by increasing natural levels of GLP-1, but whether the same transfer can happen with GLP-1 drugs still needs to be studied in longer trials. Semaglutide is a relatively new drug, approved for diabetes since 2017. Understanding the upshot of taking it for decades is, well, decades into the future.

Maher told me she hopes to stay on the drug forever. “It’s incredibly validating,” she said, to realize her struggles have been a matter of biology, not willpower. Before getting on semaglutide, she had spent 30 years trying to lose weight by counting calories and exercising. She ran 15 half marathons. She did lose weight, but she could never keep it off. On semaglutide, the obsessions about food that plagued her even when she was skinny are gone. Not only has she stopped picking her skin; she’s also stopped biting her nails. Her mind is quieter now, more peaceful. “This has changed my thought processes in a way that has just improved my life so much,” she said. She would like to keep it that way.

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Sarah Zhang

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May 19, 2023
Dieters Who Use Scarce Diabetes Drug Ozempic Could Face Side Effects

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By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Feb. 1, 2023 (HealthDay News) — Mila Clarke started taking Ozempic in 2020 to help manage her diabetes, but was pleasantly surprised to find herself soon shedding pounds.

“I was like, this is really weird because I’m not having to try very hard to do this,” said Clarke, who has been diagnosed with both type 1 and type 2 diabetes and chronicles her diabetes journey on her Hangry Woman blog. “And as I kept going on, I kept noticing that the weight was falling off.”

Then the side effects started — most worryingly, a racing and palpitating heartbeat.

“I could be laying down in bed and my heart rate, like resting heart rate, would be 120 beats per minute,” the sort of rate associated with exercise, Clarke said in an interview with HealthDay Now. “It was really having an effect on my heart rate, and that was really terrifying.”

First approved to treat diabetes under the brand name Ozempic, the drug semaglutide received federal approval in June 2021 to also be prescribed as a weight-loss medication — with the brand name Wegovy.

People interested in dropping pounds — either for their health or for vanity’s sake — flooded the market for semaglutide, making it difficult to impossible for people with diabetes to fill prescriptions needed to manage their condition.

But semaglutide comes with some troubling side effects that people might not have considered in their search for the perfect body, experts say.

These can range from nausea and vomiting to premature aging of the face, as well as heart problems.

The drug is a synthetic form of a naturally occurring gut hormone, Dr. Holly Lofton, an obesity medicine specialist with NYU Langone Health in New York City, told HealthDay Now.

“It goes to different areas of the brain and blocks hunger signals, it goes to your stomach and slows down the rate your stomach empties, and it hormonally helps your body be more sensitive to the insulin that you produce, thus helping your fat cells shrink,” Lofton explained.

Because of the way it works, semaglutide’s most commonly reported side effects involve the gastrointestinal system, Lofton said.

Those were the first that Clarke experienced.

Scary side effects, like a racing heartbeat

“You start out on a very low dose to have your body get used to it,” Clarke said. “You can get a lot of nausea, diarrhea, you can feel dizzy.”

When Clarke advanced to the therapeutic dose of semaglutide, she developed heart palpitations and tachycardia (racing heartbeat).

“It got to a point where it was like I could feel my heart beating out of my chest,” Clarke said. “It would wake me up in the middle of the night, and I was kind of panicking because I was like, this doesn’t feel right. It feels very scary.”

Clarke didn’t mention it, but other people who take semaglutide appear to develop what’s becoming known as “Ozempic face,” in which rapid weight loss causes a person’s face to look gaunt, saggy and prematurely aged.

“When you lose weight so acutely and quickly, you see more of a global facial wasting,” Dr. Paul Jarrod Frank, a New York City dermatologist, told NBC’s TODAY show.

“It’s not just a wrinkle we’re seeing in one area or a heaviness around the eyes,” Frank continued. “We’re seeing it in the temples, the jaw line, around the mouth, under the eyes.”

Despite her side effects, Clarke stuck with Ozempic for about a year because the drug was very effective in controlling her diabetes and helping her lose weight.

Clarke dropped about 10 pounds within a month. By the time she decided to stop taking Ozempic a year later, she’d lost 35 pounds.

“It was really tempting to continue it because it’s such an easy medication to take,” Clarke said. “It’s once weekly, it’s an injection, it does not hurt that badly at all, barely feels like a pinch.”

“I just felt like, I kind of want to continue this because I’m seeing really good results on it. But then for the flip side, it was like, even though I’m seeing these great results, I feel awful all the time,” Clarke added. “I don’t feel good, I don’t have any energy, I feel sick and nauseous. And that’s not quality of life.”

Clarke was worried that she’d regain the weight she lost after she stopped taking Ozempic, but that wasn’t what happened.

“I actually ended up maintaining my weight for a little while and then even losing a little bit more. So total, I lost about 50 pounds,” Clarke said.

As demand exceeds supply, some with diabetes go without

Clarke has described the semaglutide shortages as “really frustrating” on her blog, particularly for people who need the drug to manage their diabetes.

Wegovy contains a higher dose of semaglutide, because that’s the dose needed to treat obesity as approved by the U.S. Food and Drug Administration.

Ever since Wegovy arrived on the market, manufacturer Novo Nordisk has struggled to meet demand, prompting off-label prescription of Ozempic for weight loss.

“There are people who are using it for weight loss for health purposes, and I think that is amazing,” Clarke said. “Especially with my own experience, I know how helpful it can be.”

But social media has spurred demand by promoting semaglutide as a miracle weight-loss drug, Lofton said.

Wegovy is meant to help people with weight problems so bad that the extra pounds are harming their health, but semaglutide is instead being used to help people achieve the “perfect body.”

Clarke noted an “Ozempic challenge” circulating on TikTok.

“It’s people who are at a pretty normal weight,” Clarke said of the TikTok videos. “Maybe they have like 10 pounds that they want to lose because of some reason. From what I’ve seen, it’s usually vanity purposes.”

“And so they’re using Ozempic, and I think that has a really big impact on people with diabetes because we’re not able to get the drug at this point,” Clarke said. “There are so many shortages, and there’s a lack of production for Ozempic with this increased demand because people are seeing that it works for weight loss very well.”

Lofton said that both uses of the drug are legitimate, and what’s really needed is for Novo Nordisk to resolve its production bottleneck and for insurers to cover semaglutide treatment.

Novo Nordisk has promised to resolve the semaglutide shortages within the first few months of 2023, Lofton said.

“We have about 40 million people with obesity/overweight, and we have about 11 million people in the U.S. with diabetes,” Lofton said.

“If the companies can’t meet the demand — which I’m glad the demand is great and people know about these drugs — then we really need to reevaluate how these pharmaceutical companies are allowing us, as well as insurance companies are allowing us, to have access to these much-needed drugs for multiple conditions,” Lofton said.

More information

The U.S. Food and Drug Administration has more on shortages of Wegovy and Ozempic.

SOURCES: Mila Clarke, blogger and activist; Holly Lofton, MD, obesity medicine specialist, NYU Langone Health, New York City

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February 1, 2023
Weight-Loss Drug, Approved for Adults, Shows Promise in Kids

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Nov. 10, 2022 — The prospect of being involved in a research program that might help her lose weight intrigued Emmalea Zummo. At 15, the self-assured, energetic teenager from Jeanette, PA, weighed 250 pounds – enough to be considered obese. The trial she learned about through her endocrinologist was for a drug called semaglutide.

Before joining the study, Emmalea had exhausted a reservoir of strategies.

“She had been doing a variety of exercise programs, was involved in countless sports and activities to stay active, as some of her early doctors said that would work,” Davina Zummo, Emmalea’s mother, says. “She counted calories, did a gluten-free diet, limited what she ate, when she ate, and how much.”

Emmalea cut out all snacks, junk food, and sweets, but nothing made a difference, Zummo says: “She felt defeated.”

The FDA last year approved semaglutide, which was developed initially as a treatment for type 2 diabetes, for weight loss in adults. But researchers wanted to know if the drug, which targets areas of the brain that regulate appetite, also could help adolescents lose weight. Emmalea was curious, too.

Although often teenagers can be judgmental of each other, Emmalea’s friends “were happy for me, constantly motivating and supportive,” she says.

Today, Emmalea, now nearly 18, says the medication helped her lose 75 pounds, giving a boost to the lifestyle and diet coaching she received throughout the 68-week study.

Parents of teens like Emmalea who struggle with obesity hear the same refrain: If their kids slash the sugar, eat healthy snacks instead of junk foods, and exercise regularly, the results will follow.

But for many overweight youths — as with adults — shedding pounds often proves frustrating. Gains come and go, despite good intentions.

Could medication help?

A new study in the New England Journal of Medicine shows that semaglutide can indeed lead to small but meaningful losses of excess bodyweight. Whether that’s enough to tip the scales, as it were, toward overall better health is unclear, but the findings have specialists in child health optimistic.

“There is a real need for safe and effective medications to treat obesity,” says Silva Arslanian, MD, a pediatric endocrinologist at the University of Pittsburgh School of Medicine and a co-author of the new study.

“Typically, we make lifestyle recommendations: Eat more vegetables; don’t eat fried food; don’t drink soda,” Arslanian says. Unfortunately, she says, we live in a world where “it can be very hard to make those changes.”

Many experts agree that medication should be part of the conversation.

“It’s exciting to see this treatment becoming available. And the study results suggest few side effects, so the drug was safe and tolerable,” says Amanda Staiano, PhD, a researcher at the Pennington Biomedical Research Center at Louisiana State University in Baton Rouge. “Although not approved yet by the FDA, semaglitude and other new medications are transforming obesity treatment for adolescents. It’s going to be an exciting time for treating obesity.”

Staiano stresses, however, that lifestyle and behavioral counseling are key for the success of any obesity treatment, including drugs like semaglutide.

Daniel Weghuber, MD, a pediatrician at Paracelsus Medical University in Salzburg, Austria, says that although obesity is “not an issue of lack of willpower, this drug seems to enable people who are living with obesity to adhere to the recommendations that they have been following for years and years but were not able to achieve the goal. I think that this is important. It enables people to achieve their goals.”

In the new study, 201 obese or overweight boys and girls between the ages of 12 and 18 received either once-weekly injections of semaglutide or sham shots. They also all received lifestyle interventions — counseling on healthy nutrition and physical activity — throughout the nearly 16-month study.

By the end of the study, 75% of the adolescents who received semaglutide had lost and kept off at least 5% of their excess body weight, compared to 17% of those who got the sham injections. On average, those treated with the drug lost 33.7 pounds, compared to an average of just 5.3 pounds in the other group.

Weghuber said the research suggests the combination of lifestyle changes and obesity medications “will open up a new chapter” for treating adolescents with obesity.

More than 340 million children and adolescents worldwide aged 5-19 were overweight or obese in 2016. In the United States, obesity affected 22.2% of 12- to 19-year-olds from 2017 to 2020, according to the CDC.

Obesity is linked with decreased life expectancy and higher risk of developing serious health problems such as type 2 diabetes, heart disease, nonalcoholic fatty liver disease, sleep apnea, and certain cancers. Teenagers with obesity are also more likely to have depression, anxiety, poor self-esteem, and other psychological issues.

While obesity in children has long been a public health concern, the problem has worsened during the COVID-19 pandemic, Melissa Ruiz, MD, with the Pediatric Diagnostic Center in Ventura, CA, says. Some of her patients who had been “chubby” pre-pandemic had weight gains of 20-30 pounds at post-pandemic clinic visits, she estimates.

Ruiz and other experts say parents should discard the notion that obesity is something children – or adults — are doing to themselves, or that they are failing their children by not keeping their weight in check.

“There are genetic components that figure into obesity, and we have to acknowledge that,” Ruiz says.

Parents should seek help from their child’s pediatrician. “If the pediatrician cannot help you, ask, ‘Where can I go?’ Say, ‘I understand that you might not be trained in this yet’ and ask for a reference for someone who can help,” Ruiz says.

But medication should not be considered an all-in remedy, according to one expert.

“Medication is a last resort, only after behavioral interventions fail and after exploring the range of behavioral strategies to weight loss, including changing dietary patterns such as timing and meal plan,” says Lydia Bazzano, MD, PhD, a nutrition researcher at the Tulane University School of Public Health and Tropical Medicine in New Orleans.

Medication and even surgery have a place, but only if patients have exhausted all the dietary and lifestyle options, Bazzano says. “You don’t want the adolescent to have a lifetime of medication. Medication should only be used to kickstart the child to the point he should be — and then maintain that weight,” she says.

Adolescent obesity is a very difficult subject to navigate, Bazzano adds. “You have to engage the entire family, and not just the child. It has to be at the level of the whole family, and that can be very challenging. If the entire family engages together, there can be a modest weight loss.”

And Bazzano says she’s not impressed with the weight loss seen in the latest study. A 5% drop in body weight is helpful, she says, but “that’s not enough of a decrease to say the child is out of the risky range.”

Staiano thinks experts need more information about semaglutide before they should start prescribing it to kids.

“We need to see long-term outcomes from chronic medication use and whether weight rebounds when adolescents stop using the medication,” she says.

“How long should the medication be prescribed? For the rest of their lives? How do we support patients who are able to lose such a significant amount of weight? How do we ensure these treatments — behavioral counseling, medications, and weight loss surgery — are accessible and financially within reach of families?”

Emmalea, who stopped taking semaglutide about a year ago, has maintained her weight thanks to concentrating on a well-balanced diet and exercise. While she says she’s pleased with her progress and “feels comfortable in my own skin,” she doesn’t consider her current weight of 171 pounds to be the end zone. “I’d like to be somewhere between 145-150,” says the 5’4” high school senior.

Still, she says, “I don’t strictly monitor myself because thinking of food in a negative way is not healthy and can actually lead to worsening a food disorder.”

When she embarked on the study, she wasn’t sure it would be effective for her. But because of her interest in medicine and research, she says, she wanted to be involved: “I thought that if it didn’t help me, at least it might others.”

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November 10, 2022