Weight loss drugs: The science and side effects behind Ozempic and Wegovy

Ozempic and Wegovy are model names for the drug semaglutide. Many international locations have accredited Wegovy for weight loss in people who find themselves obese or obese and Ozempic for individuals with sort 2 diabetes.

How do these medication work?

Medicine akin to semaglutide mimic the actions of a hormone referred to as glucagon-like peptide-1, or GLP-1. These so-called GLP-1 analogues have a number of results, together with slowing abdomen emptying, performing on the brain to cut back urge for food and boosting the discharge of insulin, which helps to control blood sugar ranges.

For greater than a decade, GLP-1 analogues have been used to assist individuals with sort 2 diabetes management their blood sugar and a few customers skilled modest weight reduction. “These medication increase a system that already exists throughout the human physique, whose function it’s to suppress urge for food following meal ingestion,” says Simon Cork at Imperial School London.

Why are they making headlines now?

GLP-1 analogues have began to be prescribed for weight reduction in individuals with out sort 2 diabetes. They’ve additionally develop into accessible in formulations which can be stronger and simpler to make use of.

Initially GLP-1 analogues had been accredited to be used at a decrease dose and wanted to be given by twice-daily injections. Within the newest formulations they’re once-weekly injections, with Wegovy’s full dose being 2.4 milligrams for weight reduction and Ozempic being used at a maximum dose of 2 milligrams for sort 2 diabetes.

How extensively accessible are they?

In 2021, Wegovy was accredited for weight reduction in a number of international locations, including the US and Canada. Reward from some superstar customers introduced it widespread publicity.

Manufacturing problems meant its producer, Novo Nordisk, had bother assembly world demand, so some docs began prescribing Ozempic, which had been accredited for individuals with sort 2 diabetes in sure international locations a number of years earlier. This led to shortages for individuals who required it for diabetes management.

Within the UK, Wegovy was accredited in 2021, however solely got the nod from England’s medical guidelines body the National Institute for Health and Care Excellence in March 2023, when it mentioned the drug needs to be given by weight reduction clinics throughout the nation’s nationwide well being service. Wegovy is predicted to develop into accessible within the UK this 12 months, whereas Ozempic has been accessible for sort 2 diabetes since 2019.

In June 2023, the UK government announced the introduction of a two-year pilot that gives people with obesity access to new drugs, akin to Wegovy, exterior of a hospital setting.

How efficient are they?

Very. It’s a cliche however weight problems docs are speaking a few paradigm shift within the area of weight problems administration. Beforehand, a lack of about 5 per cent of physique weight can be thought-about a superb end result for any weight reduction intervention exterior of abdomen surgical procedure and is taken into account a benchmark in weight problems drug trials.

Wegovy results in a few 15 per cent reduction in body weight over a year, when mixed with exercise and consuming healthily.

The truth is, some individuals appear to really feel that the GLP-1 analogues have prompted them to develop into too gaunt, as mirrored within the rise of the search phrases “Ozempic face” and “Ozempic butt”. “Ozempic doesn’t do something particular to the pores and skin,” says Alexander Miras at Ulster College, UK. It’s the weight reduction that causes these obvious negative effects, with comparable outcomes typically additionally occurring after weight reduction surgical procedure, he says.

Do the medication have any negative effects?

Uncomfortable side effects will be delicate, akin to nausea, constipation and diarrhoea, which are likely to happen as individuals get used to the drug. Extra worrying negative effects embody irritation of the pancreas, though that is comparatively uncommon.

How about hair loss?

Hair loss has been reported by some semaglutide customers. That is additionally typically seen after vital weight reduction from different causes, akin to abdomen surgical procedure, says Miras.

Hair loss following weight reduction surgical procedure is regarded as as a result of physiological stress on the physique inflicting an elevated variety of hair follicles to enter their “resting” section, which ends up in the hairs falling out a number of months later. It stops when the load loss stabilises, nonetheless, the hair doesn’t at all times develop again, says Miras.

Do these medication trigger suicidal ideas?

GLP-1 analogues – akin to Ozempic and Wegovy – are being investigated by the European Medicines Company (EMA) after current reviews that they could trigger ideas of suicide or self-harm. This was after Iceland’s well being regulator acquired three such reviews relating to semaglutide and one other drug referred to as liraglutide, which is an earlier GLP-1 analogue.

The EMA says it’s analysing about 150 reports of possible cases of self-injury and suicidal thoughts. This doesn’t imply the medicines prompted these results, nonetheless, solely that folks reported these experiences after beginning to take them. “Extra work is required to find out if a causal hyperlink exists,” says Michael Schwartz on the College of Washington in Seattle.

A spokesperson at Novo Nordisk, the producer of liraglutide and the semaglutide medication Ozempic and Wegovy, advised New Scientist: “GLP-1 receptor agonists have been used to deal with sort 2 diabetes for greater than 15 years and for remedy of weight problems for eight years. The protection information collected from massive medical trial programmes and put up advertising and marketing surveillance haven’t demonstrated a causal affiliation between semaglutide or liraglutide and suicidal and self-harming ideas.”

Want a listening ear? UK Samaritans: 116123; US 988 Suicide & Crisis Lifeline: 988; hotlines in other countries.

Do these medication assist with addictions?

Maybe. There have been many anecdotal reports of individuals taking these medicines for diabetes or weight management who lose their urge to drink alcohol or see waning of different habits that could possibly be described as “behavioural addictions”, akin to compulsive purchasing.

That is supported by research in animals that discovered the GLP-1 analogues decrease consumption of alcohol and addictive medication. A small trial in individuals has hinted at an analogous impact from a GLP-1 analogue referred to as exenatide, which reduced heavy drinking, but only in people who were obese.

The reason could possibly be related with the best way the medication act on the mind to cut back meals cravings, however the precise mechanism is unclear. We’re solely at first of understanding how these therapies may assist individuals with alcohol and drug additions, says Daniel Drucker at Sinai Well being in Toronto, Canada. “The medical trial information just isn’t but in to substantiate the anecdotes.”

What occurs to a consumer’s weight long-term?

The longest trial of Wegovy lasted two years and located that folks’s weight broadly plateaued in the second year.

In most international locations, Wegovy has been accredited for 2 years’ use, but when individuals cease taking the drug, they typically regain the misplaced weight – two-thirds of it after one year, according to one trial.

“The load loss is simply sustained for so long as the drug is taken as a result of as quickly as you cease the drug, all of these physiological processes which can be making an attempt to get your physique weight again up kick in once more,” says Cork.

This implies that after two years of use, there can be demand from shoppers for docs to proceed prescribing the drug “off label”. “I believe there’ll be a giant push to attempt to change these pointers,” says Cork.

Ozempic will be prescribed long-term for sort 2 diabetes as a result of the situation is normally life-long.