Tropical Weight Loss
Photo: Nataliya Vaitkevich
But Ozempic is not a miracle. The drug works because Semaglutide simulates a hormone called GLP-1 that regulates blood sugar levels. If blood sugar rises, the hormone tells the body to produce more insulin, which lowers blood sugar levels in turn.
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Read More »“Everyone’s on it,” says Dr Daniel Ghiyam whose “medical spa” in Ventura county, California, offers skin tightening, body contouring, vaginal rejuvenation and, lately, injections of Semaglutide, the active ingredient in a new drug called Ozempic. To hear Ghiyam tell it, these injections are Hollywood’s worst-kept secret. “A lot of celebrities are on it,” he says. “Everyone’s who’s not talking about it is on the stuff.” Ozempic has become so popular in the last two years because it makes people lose weight fast. It’s so controversial because of the way it works: by triggering a chemical repugnance to food itself. After being injected with Ozempic, a user could try to imagine a moist slab of black forest gateau, or a calorically-dense, half-pound Baconator bacon cheeseburger from Wendy’s, and their body physically revolts, with spasms of nausea and waves of ill feeling. It’s the chemical realization of a behavioral psychologist’s wildest dream; A Clockwork Orange for junk food, an eating disorder in an injection. On TikTok, videos documenting Ozempic-assisted weight loss have racked up hundreds of millions of views. Elsewhere on the internet, speculation that Ozempic has catalyzed the drastic body transformations of celebrities runs wild. A number of musicians and actors told the Guardian that they personally knew high-profile people in their industries using Ozempic, although none would go on record. Ghiyam has joined in on the publicity push himself, with his own informational #OzempicWeightLoss TikToks reeling in hundreds of thousands of views. The world’s wealthiest individual, Elon Musk, has also praised the drug, publicly and unabashedly. Ozempic is also advertised regularly on TV: the ubiquitous commercials feature various characters who, having stabilized their blood sugar levels, are living healthy, active lives. “Oh!” they exclaim, turning to the camera, barely containing their excitement, as the soundtrack – set to the earwormy melody of Magic, the breakout 1974 single by Scottish soft-rockers Pilot – crescendos. Oh! Oh! Oh! Ozeeeeempic! But the ad mentions weight loss only as an afterthought. In the motormouth recitation of precautions and potential side effects that underscore pharmaceutical ads, the voiceover says off-handedly “You may lose weight!” to which a chipper character responds, “Oh!” That’s because Ozempic is not being marketed as a weight loss drug. It’s sold as a diabetes medication. It’s gained traction in the medical community for its ability to lower blood sugar, or rein in levels of glycated hemoglobin (also known as A1C), often transforming the lives of patients. One of its corollary effects however, is that it makes patients want to eat less. And so doctors are increasingly prescribing the drug off-label, purely for its effect helping people lose weight. Trish Wheeler is one of thousands of Ozempic users. For years, she had exercised and eaten right. She’d even been profiled in a fitness magazine. But as she got a little older, and her body transitioned into menopause, she found her usual habits were no longer doing the trick. “Dieting was not working,” Wheeler, 53, says, “and my joints were hurting enough that I couldn’t strenuously exercise anymore”. When the pandemic hit, the situation got even worse and, as Wheeler puts it, “the weight just piled on”. She managed to lose about 20lbs (9kg) before her doctor prescribed a new treatment: Ozempic. The treatment has seen drastic changes in Wheeler’s life: fatigue, dizziness and an elevated heart rate. She says her brain is “running really, really slowly these days”, which makes phone calls and Zooms a little challenging. But she’s lost weight: a reported 47lbs more (21kg) . “Whether due to age or health,” Wheeler says, “traditional methods for weight loss can become less effective, and so far this drug has done a miraculous job overcoming those obstacles”. But Ozempic is not a miracle. The drug works because Semaglutide simulates a hormone called GLP-1 that regulates blood sugar levels. If blood sugar rises, the hormone tells the body to produce more insulin, which lowers blood sugar levels in turn. This method of action has made GLP-1 a game changer in the management of type 2 diabetes, but the same hormone has also been shown to slow down the passage of food from the stomach to the small intestine, which can increase a feeling of satiety by making patients feel fuller faster. According to data from the Mayo Clinic, studies found that patients combining weekly Semaglutide injections with healthy lifestyle changes (eating a balanced diet, exercising regularly and so on) resulted in weight loss of about 33.7lbs (15kg) in a 68-week period. The drug’s popularity, combined with its promised results, has led to a massive run on supplies globally. The worry is that the off-label use of Ozempic for weight loss is creating shortages for people who rely on the drug in treating type 2 diabetes. Isabelle Kenyon is a founder and CEO of Calibrate, a telehealth weight loss startup that has more than 25,000 members, all of whom are using GLP-1s, including Semaglutide, for weight management. “That’s a bad headline,” she protests when I mention a potential Semaglutide shortage. “There is no chance,” she insists, “that the use of these medications, on or off-label, is impacting the availability of these medications for diabetes”. While Kenyon vehemently maintains that the increased usage isn’t resulting in shortages, or in diabetics being unable to access medicine, federal agencies don’t agree. They have been fretting about a Semaglutide scarcity for the past few months.
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Read More »In the spring, Ozempic’s manufacturer, the Danish pharmaceutical giant Novo Nordisk, reported difficulty keeping up with the skyrocketing demand. In Australia, recommendations were made to physicians, who were instructed to prioritize Ozempic’s use in the on-label treatment of type 2 diabetes. As Australian authorities noted, “The shortage is significantly affecting people using Ozempic for its approved use.” The US food and drug administration is sounding a similar alarm, noting that “intermittent supply disruptions” of certain quantities of Semaglutide injectables (the 0.25mg/0.5mg doses, and larger 2mg dose) are attributable to a “demand increase for the drug”. Online, some doctors say the drug is on back order through December. Novo Nordisk responded to the uptick in off-label prescribing by introducing a new, rebranded drug, called Wegovy: a chemically identical Semaglutide injection, offered at higher doses, targeted specifically for obesity and weight management. Now, Wegovy itself is in short supply. The FDA reports that the distribution of Wegovy, in various dosages, has been temporarily paused. Wegovy’s manufacturer stopped shipments of the two smaller, starter dose strengths until their manufacturing and supply chains are able to keep pace with demand. This pause comes at what is, arguably, an opportune time. Between the media hype, the TikTok trends, the targeted ads and the wall-to-wall blitz of TV commercials, GLP-1s seem to have exploded overnight. And while seemingly benign, the drug’s method of action – regulating blood sugar levels and promoting satiety – comes with some peculiar side effects.
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Read More »Such treatments may seem a little drastic. But as Calibrate’s CEO Isabelle Kenyon and chief medical officer Kim Boyd argue, they’re merited given the scale and severity of America’s obesity epidemic. More than 40% of Americans qualify as obese, which puts them at increased risk for heart disease, stroke and type 2 diabetes. In 2013, the American Medical Association officially voted to declare obesity a disease, which demands both treatment and prevention efforts. The decision came after decades of debate, regarding whether obesity was a proper disease, or merely a behavioral issue, or a “lifestyle choice”. Despite the official declaration, and resulting changes in treatment protocols, the idea that being overweight is somehow a moral failing lingers in the culture. Some insurers have also denied coverage for GLP-1s, maintaining that weight loss treatments are a form “vanity”. “Is obesity a medical condition that warrants treatment, or some sort of willpower issue?” Boyd asks, rhetorically. “We fundamentally believe that it is a medical issue that warrants treatment.” Desperate times may well call for desperate measures. But not everyone sees Ozempic (or Wegovy, or similar drugs) as some magical, miracle intervention into the obesity epidemic. But this miracle comes with its own costs, both medical and cultural. Among the less common side effects are hair loss, heartburn and swelling at the site of injection. Others are even more severe. Animal studies have linked Semaglutide to an increased risk for thyroid cancers, as well as pancreatitis and gallstones. (Some law firms already seem to be gearing up to file suits on the basis of these adverse effects.) The drug’s defenders would argue that such risks are acceptable, given the wide range of dangers associated with obesity: heart disease, stroke, sleep apnea, cancer, osteoarthritis and, of course, type 2 diabetes.
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