Recently, there has been a surge in celebrities and social media influencers using semaglutide (also known as Ozempic and Rybelsus), a type of medication traditionally used to treat patients with type 2 diabetes. However, many of them aren’t using the medication to help treat their diabetes, but instead as a quick fix for weight loss.
While off-label use of medication isn’t something new, there are some things to be mindful of when taking any medication when it isn’t medically necessary.
What is Semaglutide?
Semaglutide is a type of injectable drug that works by mimicking the activity of a hormone called GLP-1, which helps to regulate blood sugar levels. Furthermore, the same hormone can also suppress appetite and slow digestion which can also help regulate blood sugar while helping you feel fuller longer. That’s where the weight-loss aspect comes into play.
One pivotal study early in clinical trials showed that Ozempic helped recipients drop nearly 10 pounds in 30 weeks, or nearly 5% of overall body weight.
Weight loss is a helpful side effect for those with type 2 diabetes because excess weight is a major risk factor for the condition. Among other health benefits, weight loss can also lower blood sugar and blood pressure, and reduce the need for other diabetes medications.
Additionally, the makers of Ozempic capitalized on semaglutide’s effect on weight and upped the dose to see if it would be helpful for those without diabetes but who were overweight or obese. Clinical trials proved the medication was just as effective, and the medication Wegovy was created and advertised as a weight loss drug.
However, there’s a catch: to maintain this weight loss, patients must use the medication for the rest of their life — not a foreign idea to those with diabetes or someone with lifelong health conditions, but not ideal for someone looking for a quick fix for weight loss.
How Social Media and Celebrity Culture Raised Demand
Following the approval of Wegovy, celebrities and social media influencers began taking and sharing their positive weight loss experiences with the drug. This may have contributed to the high demand for Wegovy among individuals seeking to lose weight, even if they did not have a medical need for the drug.
As demand for Wegovy increased and the drug became in short supply, some individuals turned to Ozempic and Rybelsus as an alternative. However, this increased demand for Ozempic also led to shortages, which posed a threat to the health of individuals with type 2 diabetes who rely on the drug for its approved medical use.
The Downside of Taking Semaglutide Off-Label
That leads us to the potential pitfalls of taking semaglutide for strictly weight-loss purposes. While the FDA has not authorized Ozempic or Rybelsus for weight loss, Wegovy has been due to its higher dose of semaglutide.
“They’re all the same medication, essentially, the only difference is the method (Rybelsus is a pill versus an injection) and the dosage,” says Rob Gonzalez, a registered dietitian and certified diabetes educator at Texas Health Dallas. “In fact, these three are just a few examples of many more medications just like them. That’s not unusual to see, and it gives patients a lot of alternatives if they have symptoms or their insurance won’t cover one or the other. That’s also how we get medications from the same class being marketed for different medical conditions.”
Unlike Ozempic and Rybelsus, Wegovy is marketed toward adults with obesity or adults with excess weight and weight-related medical problems, in addition to following a reduced-calorie meal plan and increased physical activity.
All forms of the medication are not without risk. According to their respective websites, Ozempic, Rybelsus and Wegovy all warn that the use of this medication may cause serious side effects, including possible thyroid tumors, including cancer. Other serious side effects include pancreatitis, vision changes, low blood sugar, kidney failure, serious allergic reactions, and gallbladder problems. Additionally, Wegovy warns of increased heart rate and depression or thoughts of suicide.
The most common side effects may include nausea, vomiting, diarrhea, stomach (abdominal) pain, constipation, headache, fatigue, dizziness, feeling bloated, belching, gas stomach flu, and runny nose or sore throat — to name a few.
Additionally, Gonzalez notes that because this class of medication may cause harm to an unborn baby, it is advised that women discontinue taking semaglutide at least two months before a planned pregnancy due to the long washout period, or the period of time it takes your body to flush out the medication. If you become pregnant while taking semaglutide, you should stop taking the medication and inform your doctor right away.
Even if you don’t experience these symptoms, as we mentioned earlier, the biggest drawback of using semaglutide off-label for weight loss is the fact that most people tend to regain the weight lost as soon as they stop taking the medication. An April 2022 study showed that after stopping Ozempic, most people regained two-thirds of the weight they had initially lost. Blood pressure, cholesterol levels and other measures of health also returned to what they were prior to starting the drug.
“In short, if you’re looking for an easy solution to drop 10lbs. before an event or a vacation, this isn’t appropriate,” says Gonzalez. “We like to look at this class of medication as a bridge that helps you on your journey of learning healthier habits. It’s going to help ease those symptoms of hunger when you’re making a big diet change. If you’re working with a dietitian or your doctor on reducing your daily calorie intake and getting more exercise, it can make the transition a bit easier for you. It’s there to help you while you’re learning how to make the mindful, healthy decisions you’ll need for the long run to live healthier, but once you stop taking it, if those tools aren’t in place, the weight is going to come back.”
Achieving Weight Loss Healthfully
While semaglutide offers promising results for those with type 2 diabetes and those with obesity, it should not be taken by or prescribed to those without these conditions. There is also limited research on the long-term safety of this class of medication for both those who have a medical condition and those who do not, so you should only take this medication after having a thorough discussion with your health care provider.
While losing weight healthfully isn’t as fast and easy as a once-a-week injection, there is merit behind the quote, “Nothing worth having comes easy.” Building healthful behaviors can have a positive impact on overall health and well-being, and once these behaviors become second nature, it will feel just as easy for you to follow.
“I recommend meeting with a registered dietitian and making a nutrition plan that is specific to you and will allow you to lose the unwanted weight while maintaining or improving your health,” says Kaylee Jacks, a sports nutritionist at Texas Health Sports Medicine
Sometimes, meeting with a dietician isn’t feasible, but Jacks has some tips for that as well.
“Find your specific dietary behaviors that are less healthful and change them one at a time. Healthy behavior changes may include being more physically active, incorporating more vegetables or lean proteins in the diet, increasing water intake, and avoiding fried, baked, and sugary foods.”
Finding a physician who can partner with you for your health is essential. We can help find a physician that’s appropriate and convenient for you. Call 1-877-THR-WELL (847-9355) or visit TexasHealth.org/FindaProvider today.