Semaglutide: The science behind the weight loss drugs Ozempic and Wegovy

Ozempic and Wegovy are model names for the drug semaglutide. Many international locations have permitted Wegovy for weight reduction in people who find themselves overweight or chubby and Ozempic for folks with sort 2 diabetes.

How do these medicine work?

Medication equivalent to semaglutide mimic the actions of a hormone referred to as glucagon-like peptide-1, or GLP-1. These so-called GLP-1 analogues have a number of results, together with slowing abdomen emptying, appearing on the mind to cut back urge for food and boosting the discharge of insulin, which helps to control blood sugar ranges.

For greater than a decade, GLP-1 analogues have been used to assist folks with sort 2 diabetes management their blood sugar and a few customers skilled modest weight reduction. “These medicine increase a system that already exists inside the human physique, whose function it’s to suppress urge for food following meal ingestion,” says Simon Cork at Imperial Faculty London.

Why are they making headlines now?

GLP-1 analogues have began to be prescribed for weight reduction in folks with out sort 2 diabetes. They’ve additionally turn out to be out there in formulations which can be stronger and simpler to make use of.

Initially GLP-1 analogues had been permitted to be used at a decrease dose and wanted to be given by twice-daily injections. Within the newest formulations they’re once-weekly injections, with Wegovy’s full dose being 2.4 milligrams for weight reduction and Ozempic getting used at a most dose of two milligrams for sort 2 diabetes.

How broadly out there are they?

In 2021, Wegovy was permitted for weight reduction in a number of international locations, together with the US and Canada. Reward from some superstar customers introduced it widespread publicity.

Manufacturing issues meant its producer, Novo Nordisk, had hassle assembly international demand, so some docs began prescribing Ozempic, which had been permitted for folks with sort 2 diabetes in sure international locations a number of years earlier. This led to shortages for individuals who required it for diabetes management.

Within the UK, Wegovy was permitted in 2021, however solely received the nod from England’s medical tips physique the Nationwide Institute for Well being and Care Excellence in March 2023, when it stated the drug must be given by weight reduction clinics inside the nation’s nationwide well being service. Wegovy is predicted to turn out to be out there within the UK this 12 months, whereas Ozempic has been out there for sort 2 diabetes since 2019.

How efficient are they?

Very. It’s a cliche however weight problems docs are speaking a few paradigm shift within the subject of weight problems administration. Beforehand, a lack of about 5 per cent of physique weight can be thought-about consequence for any weight reduction intervention exterior of abdomen surgical procedure and is taken into account a benchmark in weight problems drug trials.

Wegovy results in a few 15 per cent discount in physique weight over a 12 months, when mixed with train and consuming healthily.

Actually, some folks appear to really feel that the GLP-1 analogues have triggered them to turn out to be too gaunt, as mirrored within the rise of the search phrases “Ozempic face” and “Ozempic butt”. “Ozempic doesn’t do something particular to the pores and skin,” says Alexander Miras at Ulster College, UK. It’s the weight reduction that causes these obvious unwanted side effects, with comparable outcomes usually additionally occurring after weight reduction surgical procedure, he says.

Do the medicine have any unwanted side effects?

Negative effects will be gentle, equivalent to nausea, constipation and diarrhoea, which are likely to happen as folks get used to the drug. Extra worrying unwanted side effects embody irritation of the pancreas, though that is comparatively uncommon.

How about hair loss?

Hair loss has been reported by some semaglutide customers. That is additionally generally seen after important weight reduction from different causes, equivalent to abdomen surgical procedure, says Miras.

Hair loss following weight reduction surgical procedure is considered resulting from physiological stress on the physique inflicting an elevated variety of hair follicles to enter their “resting” part, which ends up in the hairs falling out a number of months later. It stops when the burden loss stabilises, nonetheless, the hair doesn’t all the time develop again, says Miras.

What occurs to a consumer’s weight long-term?

The longest trial of Wegovy lasted two years and located that folks’s weight broadly plateaued within the second 12 months.

In most international locations, Wegovy has been permitted for 2 years’ use, but when folks cease taking the drug, they typically regain the misplaced weight – two-thirds of it after one 12 months, in response to one trial.

“The burden loss is simply sustained for so long as the drug is taken as a result of as quickly as you cease the drug, all of these physiological processes which can be attempting to get your physique weight again up kick in once more,” says Cork.

This means that after two years of use, there shall be demand from shoppers for docs to proceed prescribing the drug “off label”. “I feel there’ll be a giant push to attempt to change these tips,” says Cork.

Ozempic will be prescribed long-term for sort 2 diabetes as a result of the situation is often life-long.