Ozempic, a FDA approved drug to help decrease blood sugar levels in type two diabetics, continues to be touted by celebrities for one of its off-label uses, weight loss. Even former UK Prime Minister Boris Johnsonadmitted having taken the drug. If the drug can ultimately result in weight loss and help obese patients curb their weight, then shouldn’t it be lauded as a drug that could transform the obesity epidemic? More than 2 in 5American adults are obese, and nearly 1 in 5 American children are obese, according to the National Health and Nutrition Examination Survey.
Ozempic is not FDA approved for the treatment of obesity, and it has serious side effects and consequences for people that use it for the short-term. Even if it was FDA approved for obesity, wide-scale adoption of the drug is not the solution for obesity. Obesity is a chronic medical condition that requires a multifaceted approach for treatment. This includes but is not limited to lifestyle modification with appropriate dietary restrictions of fat and carbohydrates, regular cardiovascular exercise, health counseling, and appropriate drug therapy as prescribed by physicians. The treatment of obesity must focus on enhancing the overall health and well-being of individuals, and not necessarily decreasing the number on the weight machine. In theory, people could take Ozempic and lose weight, but still continue with a sedentary lifestyle and eat foods high in cholesterol and fat. While the end result could mean a significant reduction in weight, these same individuals would still be at high risk for cardiovascular disease, heart attacks, and stroke. In one study, those that reported sitting most of the time had a 54% higher risk of dying from cardiovascular disease when compared to those that reported sitting almost none of the time. The public health message to treat obesity should be one of lifestyle modification, not the use of a drug that will affect just one aspect of the disease, namely weight.
Recent studies have also investigated whether an oral form of Semaglutide, the active ingredient in Ozempic (which requires an injection and cannot be taken orally), can lead to significant weight loss in overweight or obese patients. A study published in The Lancet found that those that took 50 mg of Semaglutide orally once daily had a 15.1% average bodyweight change over the course of the study when compared to 2.4% average bodyweight change for those that took a placebo drug. An oral form of Ozempic would undoubtedly make the drug much more accessible to the general public, removing the barrier of having to have a needle for injection as it is currently taken. Ozempic as an oral drug becomes problematic because more individuals will turn to the drug for short-term weight loss, something already occurring with the drug in the injectable form. An unintended consequence will be the perpetuation of America’s cultural obsession with being and staying thin, which is often glamorized in the entertainment industry. From a public health perspective, this can have devastating consequences, providing people a drug to perpetuate eating disorders like anorexia or bulimia. As A. Janet Tomiyama, a Professor at the University of California, Los Angeles who has studied eating disorders, states, “Any time there are medications for weight loss, we know that is a tool that people can use for a disordered eating reason.”
Like everything in life, there are pros and cons to nearly all decisions we make. As Ozempic continues to make its way into the headlines, we must not lose sight of the public health consequences that such a drug can potentially create.
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