As an internal medicine and obesity physician, I’ve been prescribing Ozempic to my patients since 2018. Lately, influencers and celebrities as well-known as Elon Musk have touted it as a weight-loss method on social media. Oscars host Jimmy Kimmel joked about the drug’s rumoured use among A-listers at this year’s ceremony, and in March, ads for Ozempic casually showed up in the New York subway system. It’s a classic diet craze: Hollywood adopts a certain technique and then it trickles down to the general public. As a result, Ozempic is gaining popularity as a get-thin-quick hack. This is a problem.
For those who don’t know, Ozempic is one of the brand names for semaglutide, a drug whose core molecule, GLP-1, has been used to treat type-2 diabetes for more than a decade. (Another well-known brand is Wegovy.) In many countries, semaglutide medications have also been approved as treatments for obesity because they imitate one of the body’s naturally occurring satiety hormones, limiting patients’ appetites. When prescribing these drugs, doctors require patients to meet specific criteria: a BMI greater than 30‚ or greater than 27 with one weight-related condition, like non-alcoholic fatty liver disease or obstructive sleep apnea. The benefits of semaglutide can be huge—improved blood sugar control, a reduced risk of diabetes and cardiovascular disease, and a better quality of life.
The worst part of this new fad is that it could create shortages that affect people who actually need these drugs. When Novo Nordisk, the Danish pharmaceutical company that makes Wegovy, launched the drug in the U.S. in 2021, uptake was so high that they quickly ran out of product. In Canada, Ozempic was unavailable in some Canadian pharmacies late last year due to similar shortages. And less than a month ago, British Columbia moved to restrict sale of Ozempic to Americans who were buying the drug from the province’s pharmacies. Then there’s the impact of the Ozempic obsession on my own practice: in addition to my work as a physician, I post educational content about obesity on TikTok. Recently, people with neither diabetes nor obesity have been messaging me to ask if I’d prescribe them the drug to “kickstart” their weight loss. I always respond by saying they should consult their own health care professional.
Ozempic isn’t intended to help you go from a size six to a size two. Using it in the short term to achieve thinness could lead to serious health issues. Semaglutide is a relatively safe compound, with some known gut-related side effects, like nausea and reflux. But when these drugs are used inappropriately, those gastrointestinal issues can be more severe. Plus, when people stop taking them, they tend not to maintain their new weight—and then they say the drugs were the problem. Weight cycling can have a negative effect on cardiovascular health, not to mention the huge psychological impact. When they’re prescribed for obesity, semaglutide meds should be paired with behavioural supports, like nutrition counselling and cognitive behavioural therapy, so patients can achieve and maintain a healthy lifestyle that’s realistic for them.
Another problem with the Ozempic craze is that it perpetuates unrealistic expectations about how body shape and weight are viewed in broader society. I understand why the idea of taking an injection and losing five pounds appeals to so many. We live in a culture that glorifies thinness, so we are always going to have people who rely on easy fixes. We may think that members of Gen Z—who have grown up in an era of more body positivity—are not as susceptible to weight-loss messaging, but that isn’t true for everyone. And so many people who grew up in the ’80s and ’90s had Kate Moss–covered magazines by their bedside. Some still really struggle with not meeting that aesthetic.
I’ve had many discussions with colleagues about what the ubiquity of Ozempic will mean for our patients. First, more and more people will likely request it for non-medical reasons. (At the moment, this appears to be more common in the United States, where Ozempic is offered by some practices specializing in aesthetic medicine, like botox clinics and plastic surgery centres.) A second, more positive effect is that Canadians with obesity will become more aware of available medical treatments for their disease. There are still so many missed opportunities to prescribe these medications appropriately. Physicians often tell patients with obesity to “try harder” or eat less and exercise more, then withhold potentially helpful drugs due to stigma and a lack of education. Semaglutide can be the right treatment for the right patient. For everyone else, there is no quick fix.
–As told to Alex Cyr