Understanding Ozempic: Safety, Uses, and Health Implications.

By Gabrielle Finora and the Team at LCWNS

Semaglutide is the most popular weight loss drug hitting the market now. Under both names, Ozempic and Wegovy, users reported dropping weight quickly. Celebrities like Elon Musk, Amy Schumer, and more have admitted to using either Ozempic or Wegovy exclusively for weight loss. However, semaglutide was not designed to be a popular weight-loss drug; it was designed to improve the lives of individuals with type 2 diabetes.

In type 2 diabetes, the body cannot regulate blood sugar levels because of insulin resistance. The pancreas produces insulin, but the insulin receptors on the liver cannot sense the hormone. Eventually, the pancreas cannot keep up with the demand for insulin and requires assistance. Individuals with type 2 diabetes have high A1C levels, and Glucose Tolerance Test reveals a slow decline in sugar levels after eating.

Semaglutide works by lowering blood sugar and A1C levels in individuals with T2D through a once-per-week injection. It can also decrease the risk of cardiovascular events such as stroke and heart attack in adults with heart disease. The drug works in three ways:

1. Helps the pancreas produce more insulin when blood sugar is high
2. Prevents the liver from releasing too much stored sugar (glucagon) during fasting
3. Slows down food leaving the stomach to reduce the rate at which sugar enters circulation (flattening a blood sugar spike)

The medication achieves this by mimicking glucagon-like peptide-1 (GLP-1). This hormone is produced in the gut and released from L-cells in response to food. L-cells have direct contact with ingested food and rapidly increase the production of GLP-1 upon direct contact with carbohydrates or lipids in the small intestine. It stimulates insulin secretion and inhibits glucagon secretion (Müller, 2019). In addition to other hormones, GLP-1 helps you feel full after eating a meal as it delays gastric emptying and gut motility. As the gut empties, the vagal nerve in the stomach responds to the size of the organ and relays this information to the brain. If the gut is distended, the vagal nerve recognizes this and tells the brain we are full (Owyang, 2011; Shah, 2014).

Weight loss is one of the many side effects, including intense nausea, vomiting, stomach pain, and constipation. Many users have also noted a decreased tolerance to alcohol consumption.

So, if people can take Ozempic or Wegovy to help lose weight, why is that a problem?

Great question. Here are a few reasons why you should reconsider taking these medications:

1. So far, Ozempic is not FDA approved for individuals without diabetes. Wegovy is FDA approved to help adults and children above the age of twelve with weight-related medical problems to help with weight loss (in addition to diet and exercise).
2. Using these drugs to help lose weight is often a temporary solution. Many people have rebound weight once they stop taking the medication. Additionally, while weight suppression may result in some weight loss, lifestyle changes are necessary to lose significant weight. A healthy diet and exercise are an important addition to the drug.
3. Semaglutide is expensive. Ozempic can range from $900 to over $1000 per dose without insurance.
4. Popularity of the drug for weight loss has caused a drug shortage. Individuals who need it for diabetes treatment are suffering.
5. The side effects of semaglutide are intense. Clinical trials revealed some participants experienced nausea, diarrhea, vomiting, fatigue, indigestion, dizziness and more. 

In conclusion, speak with a health professional before using Ozempic or Wegovy. Not only is a prescription expensive without insurance, but the drug could also have lasting effects on individuals taking them not for the intended purposes. It is currently unknown if there are any long-lasting effects for individuals taking semaglutide without diabetes. 

Helpful Vocabulary:

• Insulin: hormone released by the pancreas after meals to reduce blood sugar levels.
• Glucagon: insulins counterpart, hormone that is released from the liver between meals to breakdown stored sugar to provide the body with necessary energy.
• Glucagon-like peptide-1 (GLP-1): hormone released by L-cells in the small intestine in response to food entering the gut. Stimulates insulin release and causes feelings of satiety. 
• A1C: a measurement of average blood sugar over the past 3 months.

If you are interested in learning about ways to improve your nutrition and wellness habits, Laura Cipullo and her team offer a variety of holistic options to fit your unique lifestyle.

References:

https://www.ozempic.com/why-ozempic/ 

https://www.ozempic.com/how-to-take/side-effects.html

https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/medications-containing-semaglutide-marketed-type-2-diabetes-or-weight-loss

https://www.goodrx.com/ozempic

https://www.uchealth.org/today/wegovy-vs-ozempic-the-truth-about-new-weight-loss-drugs/ 

Müller, T. D., Finan, B., Bloom, S. R., Drucker, D. J., Flatt, P. R., Fritsche, A., Gribble, F., Grill, H. J., Habener,

130. F., Holst, J. J., Langhans, W., Meier, J. J., Nauck, M. A., Perez-Tilve, D., Pocai, A., Reimann, F., Sandoval, D. A., Schwartz, T. W., Seeley, R. J., . . . Tschöp, M. H. (2019). Glucagon-like peptide 1 (GLP-1). Molecular Metabolism, 30, 72-130. https://doi.org/10.1016/j.molmet.2019.09.010

Owyang, C., & Heldsinger, A. (2011). Vagal Control of Satiety and Hormonal Regulation of Appetite.

Journal of Neurogastroenterology and Motility, 17(4), 338-348. https://doi.org/10.5056/jnm.2011.17.4.338

Shah, M., & Vella, A. (2014). Effects of GLP-1 on appetite and weight. Reviews in endocrine & metabolic

disorders, 15(3), 181. https://doi.org/10.1007/s11154-014-9289-5