weight loss drugs are prime candidates for popular fads, but few have been as disruptive to the healthcare system as the obsession with Ozempic, a drug for type II diabetes.
Due to a nationwide shortage of the active chemical in Ozempic, or semaglutide, some are now turning to the natural supplement berberine and semaglutide compounds as alternatives.
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Health experts, however, have warned that this could have serious consequences.
What is Ozempic?
Ozempic was approved by the Food and Drug Administration in 2017 and is a once-weekly injectable drug to lower blood sugar levels in insulin-dependent type II diabetics.
The active ingredient in Ozempic is semaglutide, which mimics the hormone that promotes the development of insulin in the body to reduce blood glucose levels.
Semaglutide is the same active ingredient found in the drug Wegovy, which was approved by the FDA in 2021 solely as a weight-loss drug when paired with lifestyle changes, such as diet and exercise. Wegovy is also a semaglutide injection but at a higher dose than Ozempic.
Since Ozempic and Wegovy are the same chemical compound, both have been found to be very effective for weight loss in patients with chronic obesity problems.
How has popular fashion influenced the market?
TikTokers have been advertising the use of semaglutide for weight loss for over a year, and both Ozempic and Wegovy have been in short supply since then.
In September, a variety of publications explained Hollywood’s obsession with Ozempic. At that time, the TikTok trend #ozempic was viewed more than 74 million times. Kim Kardashian and Elon Musk have also spoken out about their use of the drugs for their dramatic weight loss results.
While there may be other inputs contributing to the shortage, Ozempic and Wegovy’s makers Novo Nordisk announced in March that market demand for semaglutide products had significantly exceeded supply capacity.
What does this mean for patient care?
Patients are upset, said Veronica D. Kim, MD, a board-certified obesity medicine specialist at St. Lukes Hospital in St. Louis, Missouri, who cares for the daily needs of patients treated with semaglutide.
Kim told the Washington Examiner that patients don’t care what the name of the drug is if it will help them with their obesity.
The exorbitant out-of-pocket costs for Ozempic and Wegovy and the general lack of drug insurance coverage partly explain how drugs have become the wonder drug of the elite.
Even if patients are lucky enough to have their drugs covered by insurance, wait times to fill prescriptions for Ozempic can take several months. This is forcing some patients to ration their medications and some prescribers to get their drugs from Canada, according to Kim.
And the berberine?
Berberine is a supplement that was marketed as natures Ozempic and received significant attention from healthcare outlets and national media this week.
Although some suggest that berberine lowers blood sugar naturally regardless of insulin levels, few studies have been done on the supplement’s effectiveness.
A meta-analysis of 49 separate studies published in the journal Frontiers of nutrition in 2022 found that while the supplement may be beneficial for heart health, there is little evidence of any effects on weight loss.
Many dietary supplements claim to have weight-loss properties, Kim said. The thing is, when it’s not evidence-based, meaning no research or studies have been done to prove efficacy, we don’t recommend it.
Kim added that there isn’t one specific vitamin or supplement you can take to lose weight.
Are patients looking for other potentially dangerous alternatives?
Others have begun using compounded versions of semaglutide, which means the base chemical of the drug has been mixed or altered. Compound drugs are not approved by the FDA because they have not undergone clinical trials for safety and effectiveness.
The FDA has received adverse event reports after patients used the compound semaglutide, the agency announced Wednesday in response to the shortages.
Patients should not use a compound drug if a drug approved to treat a patient is available. Patients and healthcare professionals should understand that the agency does not review compounded versions of these drugs for safety, efficacy or quality, the FDA said.
The Obesity Medicine Association issued a similar warning this March. OMA Chief Medical Officer Angela Finch, MD, noted that although compound drugs can tailor drugs to individual patient needs, compound peptides should not be intended for pharmacists to make, store, market and sell drug replicas patented.
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Kim further explained that when patients take compound drugs or supplements that aren’t FDA-approved, they’re essentially on their own if and when complications arise.
In the area of evidence-based and research-based obesity medicine, specialists are against it, but I understand my patients’ desperation, Kim noted.