There are side effects, and the weight comes back once you stop using the drug. This medicine is meant for those who are obese with uncontrolled diabetes despite taking medicines and who can’t lose weight the traditional way, say top diabetologists.
Seldom do drugs and healthcare become talking points at the Oscars. But presenter Jimmy Kimmel sparked up some amusement for viewers after joking about the rumoured widespread use of the diabetes drug, Ozempic, as a weight loss formula by Hollywood A-listers. During his opening monologue, Kimmel spoke about the use of the injectable prescription drug to lose weight, wondering aloud: “Everybody looks so great. When I look around this room, I can’t help but wonder ‘Is Ozempic right for me?’”
The fact that the reference was made, even in good humour, on the cosmetic appeal of the drug overtaking its health benefits, means that a serious conversation needs to happen about its supervised use. Simply because the side effects are not pretty. “Though not available in India yet, GLP receptor agonist drugs are good for weight loss and consequently diabetes and related problems. But these should be used according to indication because side effects are problematic. Initially, there is nausea and vomitting and very rarely, there is pancreatic inflammation,” says Dr Anoop Misra, Chairman, Fortis CDOC Hospital for Diabetes and Allied Sciences.
WHAT IS OZEMPIC?
It is nothing but the new weight-loss medicine Semaglutide. Sold under brand names like Ozempic and Wegovy, the diabetes medicine at higher doses has shown remarkable results. It has also been found to reduce the risk of cardiovascular events in patients with Type 2 diabetes. “With obesity becoming an increasing health burden for India – it is estimated that 9.5 per cent of all men and 13.9 per cent of all women will be obese by 2040 – it comes as close to a magic bullet as any drug can. The drug has shown to help study participants lose around 15 per cent of their body weight, with some losing even up to 20 per cent, which is unheard of with any other intervention except for bariatric surgery. There are other weight loss drugs available in the market but none as effective. The medicine can help people lose weight, especially in those with a history of obesity and related diseases in the family. It should be prescribed to those who might not see a lot of impact with dieting or cannot exercise because of joint pains due to their weight,” says Dr Misra.
“This drug becomes effective in typical Type 2 diabetics as their weight drives blood glucose. So, there is long-term sugar control. It is indeed more effective than any drug in the recent past,” says Dr Ambrish Mithal, Chairman and Head, Endocrinology and Diabetes, Max Healthcare.
WHAT ARE SIDE EFFECTS THAT WE NEED TO KNOW?
“It should not be the first-line treatment for obesity for all. Besides, when it becomes available in India — probably in a few months — it is likely to be expensive. It might cost at least Rs 8000 to Rs 9000 a month. Importantly, it also leads to gastro-intestinal side effects such as nausea, vomitting and diarrhoea for the first few weeks,” says Dr Misra. The medicine, he feels, should be prescribed to three categories of people. “First, those who are obese and have some sort of dysfunction because of this obesity, such as diabetes or fatty liver disease. Second, those who are obese but aren’t able to lose weight the traditional way. In fact, it can be given a little early in people who have a family history of gaining weight and keeping it on. The medicine works by making a person feel full with smaller meals. Third, this medicine is meant for those who are obese with uncontrolled diabetes despite taking medicines,” he clarifies.
Adds Dr Mithal, “In India, we have seen ill effects of earlier cousins of Ozempic, so caution is needed. All this hype about weight loss is drowning this fact.”
WHY IT CANNOT BE RELIED UPON AS JUST A WEIGHT LOSS DRUG?
“You will gain back some of the weight once you stop taking the medicine. No matter what method one uses to lose weight, other than bariatric surgery, there is some amount of weight gain once the intervention stops. A longer study has shown that is what happens with Semaglutide as well. Though the weight gained back is still not the same as what it was when the medicine was started, it comes back all the same,” says Dr Misra.
That’s why Dr Mithal is concerned about how far we can take it as an easy alternative in comparison to what matters most —lifestyle correction. “Whatever little data we have shows that the weight comes back. Losing weight won’t serve a purpose unless we maintain ideal body weight. So please rely on the other pillars of diet, sleep and exercise. Also people with diabetes tend to lose little less weight than those without diabetes. So please consult an endocrinologist before you consider using this drug and keep to a medically supervised regime,” says he.