Drugs that trigger weight loss like Ozempic and Wegovy are seemingly in all places — mentioned on podcasts, speculated on by celeb followers, whispered about at dinner events. And ahas fueled additional hypothesis about who’s getting them as they’ve exploded in reputation.
— semaglutide, which is offered underneath the model names Ozempic and , together with tirzepatide, offered as Mounjaro, and liraglutide, generally known as — all perform in an analogous method. And they’re extremely efficient: One physician advised CBS News these medicine might help folks lose about 15% of their physique weight – greater than earlier generations of weight loss medicine.
For folks scuffling with their weight — 73.6% of adults within the U.S. over the age of 20 are considered both obese or overweight — they’ll appear to be a miracle drug. Here’s what docs must say about them.
Who are they for and how do they work?
Semaglutide medicine work by imitating a intestine hormone known as GLP1, or glucagon-like peptide hormone, that “makes that gut hormone work better to enhance communication between the gut and the brain and make us feel fuller and also help with reducing appetite,” stated Dr. Amanda Velazquez, who works at Cedars-Sinai Center for Weight Management and Metabolic Health in Los Angeles. “Overall it’s telling the body it’s okay to be at a lower set point.”
Ozempic and Mounjaro, which has a barely totally different mechanism, are FDA authorised to deal with kind 2 diabetes whereas Saxenda and Wegovy are FDA authorised for weight loss. And insurance coverage firms sometimes look for sure standards earlier than they are going to approve cost for certainly one of these medicine.
Velazquez says she would prescribe these medicine to sufferers who’ve a BMI between 27 and 30 – labeled as obese – plus, have a weight-related medical situation, resembling diabetes, hypertension or sleep apnea.
Or, sufferers with a BMI of 30 or better – labeled as overweight – would qualify for a weightloss drug, she stated
But these medicine can have uncomfortable side effects, together with nausea and constipation. Some speculate that these are contributing elements to weight loss, however Velazquez stated “that’s not the mission of the drug.”
“The goal is not to make someone not eat,” she advised CBS News. “The goal is to help someone be able to navigate and manage what they’re eating to have healthier choices and feel fuller with those options.”
Velazquez says sufferers must also be training a wholesome way of life at the side of the medicine.
Dr. Holly Lofton, who makes a speciality of weight problems medication at NYU Langone, stated she prescribes these medicine to people who find themselves not technically overweight or obese. obese or have weight problems — a follow generally known as off-label prescribing.
“We still follow the patients and make sure they have a lifestyle plan and we follow up,” she stated. “It’s not that we’re giving it to them and saying, ‘Good luck on your own.'”
Lofton stated she wouldn’t give a affected person with a traditional BMI Ozempic or Wegovy as a result of the medicine might put them in a sub-optimal weight. But along with BMI, she additionally thought of elements like race and comorbidities.
“Say there was a patient with Asian ethnicity and their BMI is 25 – that BMI is technically overweight in an Asian patient – and they have fatty liver. That patient qualifies in my mind because they are not only overweight as a diagnosis, they have a comorbidity, even if the guidelines don’t state that,” she stated.
Lofton stated she wouldn’t prescribe these medicine to folks with a historical past of thyroid most cancers or pancreatitis — research discovered they’ll improve threat of thyroid most cancers in rodents, and researchers did not discover their impact on people with medullary thyroid most cancers or with a household historical past of thyroid most cancers.
Velazquez stated it’s not but identified how the medicine would impact people who find themselves not thought of obese or overweight, as a result of the medicine weren’t examined in these sufferers.
How efficient are they?
Velazquez stated the primary driver of demand is that these medicine are extremely efficient. “That’s what has really caught attention and interest,” she stated. “Providers are more interested in trying this because they can see greater changes in their patients’ health, there’s more demand because they can see the benefit of it.”
Dr. Alex Foxman of Achieve Health and Weight Loss, a Beverly Hills medical follow that makes a speciality of weight loss packages, has seen first hand how efficient these medicine could be – as a result of he each prescribes them and has additionally used them himself.
“I’m 51 years old. A year ago, I was 190 lbs, which puts me at a body mass index of 27, which is just overweight,” he stated, including that he had bother holding his weight down, regardless of making an attempt to food regimen and train. “I got on semaglutide a year ago and in three and a half months, I lost 30 pounds.”
“It was probably one of the most effective and amazing experiences I had as a physician or as a person,” he stated. “It decreased my appetite; I felt full faster. There are some side effects, but all in all I maintained a healthy program, I exercised and I continued to do that and I’ve been able to maintain my weight now for seven months.”
Foxman stated as a result of weight problems is not only a medical drawback, however an arrogance drawback, folks could flip to those medicine wanting for a “quick fix.” “This is not a quick fix,” he stated. “These medications are a tool. And it has to be used as a tool with other programs and services that are medically supervised for it to be successful.”
Velazquez stated as an weight problems medication specialist, she prescribes these medicine “day in and day out.”
Velazquez believes sufferers should not must “prove” themselves by making an attempt to food regimen and train earlier than being prescribed a weight loss drug. “The same way if someone came in with diabetes. You’re not going to have them prove to you that they’re cutting back on carbohydrates before giving them medicine, when their sugars are out of control.”
What about sufferers who aren’t overweight or haven’t got diabetes?
Foxman stated that typically docs, together with himself, follow whats generally known as off-label prescribing.
“The vast majority right now of patients who are coming to see us wouldn’t be considered morbidly obese or obese, many of them do not have diabetes. Many of them are either overwieght, or are struggling to keep their weight to the point where they need to,” Foxman advised CBS News.
Foxman stated sufferers who’ve diabetes will probably be authorised by insurance coverage to get Ozempic. “But those who do not qualify for that, we have a very frank conversation. We explain to them we will not lie or deceive the insurance company or medicare about their health, so if they don’t have diabetes, we write that. And if they’re not approved, it’s going to cost them $1,300 or $1,000 a month for the medication.”
Why are there shortages of those medicine?
The mixture of the excessive demand for these medicine and that some docs prescribe them off-label has maybe contributed to a different rumor: Wealthy sufferers who do not qualify for these medicine are nonetheless capable of get a prescription and pay out of pocket, thus making a scarcity.
Velazquez stated she has heard anecdotally that some docs are prescribing the medicine to sufferers who do not qualify, however can afford them with out insurance coverage.
“Nonetheless, I think there’s multiple factors as to why there’s such a high demand,” she stated. “Although, yes some of these people are potentially getting it who are not meeting criteria, that’s a minority of patients.”
The similar drug company makes Ozempic and Wegovy, however Ozempic is authorised for diabetes and helps folks lose weight, whereas Wegovy is the next dose, and is authorised for simply weight loss. When a scarcity of Wegovy started, suppliers began prescribing Ozempic, Lofton stated.
But apart from the recognition, provide chain points additionally contributed to the scarcity, in accordance with Velazquez. “The demand exceeded the expectations any of these drug manufacturers could’ve imagined.”
Lofton stated weight problems impacts about 40% of Americans and diabetes impacts about 11%. “To say that people with obesity are stealing these medications from people with diabetes, it’s not really fair,” she stated. “Obesity is a real disease too, it leads to social issues, medical issues, psychological issues.”
She stated individuals who hunt down these medicine ought to do so from a health care provider — not, as she’s heard, a med spa or hair salon. “These should be prescribed by a physician who decided, one, you’re a candidate and that two, if you have a side effect, you could be treated.”
Still, there are issues to think about earlier than asking your physician a couple of prescription — and for docs to consider earlier than prescribing them.
Foxman stated these medicine are very highly effective and affected person use have to be monitored by docs. “The problem is, many doctors don’t understand these medications and are being pressured by their patients to prescribe these medications,” he stated. “They’re prescribing them with no regard to putting in the proper things on the forms, and I think what you’re going to start seeing is a lot of doctors being reprimanded, losing their licenses and other things, if they’re not careful.”
“Patients who think they can just inject themselves and do well are going to fail,” he stated. “And you’re going to find a lot of stories of people getting sick if they inject the wrong dose.”