A Dietitian’s Thoughts on Wegovy and Ozempic
Today’s Post by Kelsey Chadwick, MS RDN
August 24th, 2023
You’ve most likely heard about the latest frenzy over Ozempic and Wegovy. Ozempic—a medication that was approved in 2017 for treatment of diabetes—is now being marketed for weight loss under the name Wegovy after receiving FDA approval in 2021.
These medications fall under the category semaglutide, a class of medications known as glucagon-like peptide-1 receptor agonists. One role of this class of drugs is to prompt the body to produce more insulin and reduce blood sugar. This medication can be a useful tool for diabetics to manage their condition and has been used for more than 15 years (1).
Now, fast forward to present day and these medications are in the news several times per week and have gained a lot of attention on social media. They have been described as a “miracle weight loss drug.” Due to the high demand by individuals who want to lose weight, some folks with diabetes have been unable to get their medication. Aside from this troubling fact, in today’s post I’d like to offer some other concerns I have about the widespread use of these drugs for weight loss.
To start there are many reports of some pretty serious side effects—pancreatitis, gallstones and gallbladder problems, hypoglycemia, change in vision in patients with type 2 diabetes, kidney failure, increased heart rate, severe allergic reactions, and depression or thoughts of suicide. The most common side effects experienced are diarrhea, vomiting, nausea, constipation, stomach pain, headache, fatigue, upset stomach, dizziness, bloating, gas, sore throat, and heartburn.
These medications are not meant to be prescribed forever, yet as soon as you stop taking the medication it is likely that weight regain will occur. One study reported that within one year of stopping the once weekly injections, participants regained two thirds of their prior weight loss (2). I’ll also note that it can cost over $1000 for a one month supply of these medications at this time.
Ultimately, my feeling is that prescribing Wegovy further perpetuates diet culture and reinforces the narrative that “a thin body is a better body.” We live in a society where it is extremely hard to escape diet culture messaging. Nearly 29 million Americans or 9% of the U.S. population will have an eating disorder in their lifetime and, equally concerning, “people in larger bodies are half as likely as those at a 'normal weight’ or ‘underweight’ to be diagnosed with an eating disorder” (3,4). You cannot simply look at someone and determine if they have an eating disorder and I can’t help but wonder how many individuals have been prescribed weight loss medication who meet criteria for an eating disorder diagnosis.
I’m also concerned about the lack of research we have about long-term use of semaglutide for weight loss. While we do have some randomized control trails, we still are not able to understand the impact of long-term use, which leaves many questions unanswered.
I don’t judge individuals for using Wegovy or similar medications for weight loss. Everyone has autonomy over their body and I recognize the significant pressure that people in larger bodies face in modern society. I do, however, look forward to a time where the culture shifts towards greater appreciation of diverse bodies. My hope is that the future brings much less demand for these expensive, side-effect-laden, and poorly researched medications.
Sources
UCLA Health. “Semaglutide for Weight Loss - What You Need to Know.” UCLA Health System, www.uclahealth.org/news/semaglutide-weight-loss-what-you-need-know. Accessed 1 June 2023.
Wilding JPH, Batterham RL, Davies M, Van Gaal LF, Kandler K, Konakli K, Lingvay I, McGowan BM, Oral TK, Rosenstock J, Wadden TA, Wharton S, Yokote K, Kushner RF; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022 Aug;24(8):1553-1564. doi: 10.1111/dom.14725. Epub 2022 May 19. PMID: 35441470; PMCID: PMC9542252.
Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020.
Nagata, J. M., Garber, A. K., Tabler, J. L., Murray, S. B., & Bibbins-Domingo, K. (2018). Prevalence and Correlates of Disordered Eating Behaviors Among Young adults with Overweight or Obesity. Journal of General Internal Medicine, 33(8), 1337-1343.