Scroll through Instagram, watch an ad on TV, or even talk to friends and family and chances are you will hear something about Ozempic. Also known by its generic name semaglutide, this class of medication known as a GLP-1 agonists, was originally discovered in the venom of Arizona’s own Gila Monster. GLP-1 agonists mimic the gut hormone that reduces blood sugar and slows down the gut. Initially prescribed to manage diabetes, its remarkable weight loss and appetite-curbing benefits have resulted in significant popularity, even amongst celebrities. This degree of fame has also resulted in unintended consequences such as spread of Ozempic myths and misinformation, off-label prescribing, and creation of unproven formulations. So what’s the truth about Ozempic?
Fact or Fiction #1: Ozempic is only for people with diabetes. Technically fact, but it’s a matter of semantics. Ozempic is a name brand (like Kleenex used to refer to tissue paper) for a medication FDA approved for the treatment of diabetes. Several GLP-1 agonist medications on the market for diabetes have “sister” products on the market indicated for weight loss such as Saxenda, Wegovy, and Zepbound. The demand for these medications has led to a large degree of off-label prescribing that has created a severe supply shortage for patients who genuinely need the medication. There are no generic formulations of these medications, and the price can run around $1,000 per month. Many people have turned to compounded medications due to ease of access and generally lower cost.
Fact or Fiction #2: Compounded semaglutide is the same as prescription. False. Compounded drugs are not FDA regulated and there is no external verification of their safety or effectiveness. When a drug is in shortage, compounding pharmacies may prepare a version of that drug that is not subject to the same regulations as the brand name medication. To the public, many times this distinction is not made clear. Some versions of semaglutide are now being created in formulations such as sublingual, which seem appealing because there is no injection required, but have not been proven to be effective. My best advice is to only work with a doctor/pharmacy team you can trust, not the least expensive.
Fact or Fiction #3: The long-term side effects of Ozempic are unknown. Mosty false. There is a Black Box warning regarding these medications causing a rare type of thyroid cancer in rats, although we currently have almost 20 years of data showing no concern of this occurring in humans. Surging evidence of cardiovascular disease protection for some modern GLP-1s is overwhelming. Wegovy, which was originally approved only for obesity is now approved for non- diabetic patients with cardiovascular disease who are overweight, with a BMI of at least 27 kg/m2. Anytime BMI is used clinically, I do have to mention that it is a measurement with multiple flaws that I will gladly write a future article about.
So, what’s the verdict? I really believe that these medications deserve their current degree of popularity and can be revolutionary in the management of diabetes and obesity which are rampant in our society. Just like any other medication, they need to be used only in appropriate circumstances and in an appropriate setting to avoid undue harm.
Editor’s note: This article is brought to you in collaboration with Scottsdale Professionals Collective.
Author: Heather Saran, D.O. is a board-certified Endocrinologist. She completed Internal Medicine Residency at Cleveland Clinic in Cleveland, Ohio, and Endocrinology Fellowship at THE Ohio State University in Columbus, Ohio. She is the owner of Bright Endocrinology, the first concierge Endocrinology practice in Arizona.
