GLP-1 Agonists for Weight Loss: Benefits, Risks, and Dangers of Counterfeit Versions

Most people will tell you as we get older, our bodies can experience substantial weight gain. Whether it’s men growing a pot belly or women going through “the change.” It often comes down to one thing: when your metabolism slows down, the pounds go up. In England, over 64-percent of people aged 45 to 74 are either overweight or obese, reflecting a global trend of rising obesity rates. 

However, in recent years we’ve seen a shift in the war on weight gain. Celebrities like Oprah Winfrey, Amy Schumer, and Tracey Morgan started sharing their weight loss stories that included Ozempic.

Ozempic, a brand name for a semaglutide, was originally approved by the Food and Drug Administration in 2017 to treat type 2 diabetes. Although it was not approved for weight loss, some doctors started prescribing it off-label for this purpose, leading to a surge in demand.

Mona’s Ozempic Story

Celebrities aren’t the only ones using Ozempic for weight loss. People from around the globe, including Mona, who is now in her 60s, lost 50 pounds while on Ozempic in about a year. “I was thin my whole life. I never had problems. I was in the military for 22 years,” Mona said. However, she battled cancer three times, which led to early menopause, resulting in a total weight gain of 50 pounds. “I was always hungry and never full; I did all the diets. I even hired a personal trainer. Nothing worked.” After trying two other medications over two years, her insurance finally approved Ozempic. “This was a miracle drug. I had more energy. Even my thinking got better.” 

However, she did experience some side effects, like fatigue and digestive issues, including constipation, which she managed by taking fiber. As she lost more weight, she also experienced facial changes. Some people have called this ‘Ozempic Face.’ “When you lose a lot of weight, at one point, you look younger, and then at another point, you start to look older because you might look aged because you’ve lost weight in the face.”

Within the first six months, as her weight started falling, Mona says her numbers completely reversed, and her blood pressure and cholesterol were back at healthy levels. However, due to a worldwide shortage, Mona was forced to switch to two other medications for some time, but she later resumed Ozempic and lost weight again.

Amy’s Story 

There are more weight loss stories, including 59-year-old Amy, who lives in California. She initially lost 51 pounds on Ozempic after her insurance approved it for high blood pressure. She went from 180 pounds to 129 pounds over the course of a year. She described the results as a “miracle” and the best thing that has happened to her, since she hasn’t been 129 pounds in 30 years. 

At first, Amy didn’t change her eating habits at all. She continued to eat hamburgers, pizza, ice cream, and beer. “I could eat whatever I wanted and lose weight, and I lost all that weight. The key was I was never hungry and got full quickly,” Amy said. She did experience some diarrhea as a side effect. After losing weight, she also shed her other health problems. “My blood pressure was better, and my cholesterol went down. I had so much more energy.”

However, her insurance company reclassified Ozempic as a diabetes-only specialty medication and stopped covering it. The uninsured price tag was more than 1,000 dollars a month. When she stopped taking it, the pounds came back, and she now weighs 160 pounds.   

Amy is now eating better, exercising two times a day, five days a week but not losing the same weight as when she was on Ozempic. “I’m upset my insurance doesn’t cover it. Once you see what it is like to be thin, you don’t want to be heavy again.” She says she is motivated to lose the weight again.

Semaglutide And How It Works

Ozempic craze has led to high demand, because of the complex process as to how it works in the body.

Semaglutide is administered once a week through an injection, either in the arm, thigh, or stomach. Dr. Michael Horne, DNP, MBA, AGNP-BC, CCK, is a professor who teaches advanced pharmacology at the University of Colorado College of Nursing and breaks down how a semaglutide drug works. “It’s basically augmenting existing hormones in your body. It tells your pancreas to increase insulin production and lower your glucose and tells your body that you are full,” Horne said.

The Science Behind It

And there is science behind it. Dr. Horne adds that semaglutide is in a class of GLP-1 receptor agonists. In your body, you have a natural hormone called glucagon-like peptide or GLP-1. This hormone is released from your gi tract after you eat. This tells your brain that you are full and tells your pancreas to increase insulin production to lower your glucose and decrease glycogen. The medication essentially augments your normal GLP-1 (glucagon-like peptide) so your body reduces blood sugar and promotes a feeling of being full, and that essentially can lead to weight loss. It can also impact how your body responds to food by the signals between your gut and brain.

Long-term Effects And Sustainability

With so many stories of dramatic weight loss out there, is semaglutide sustainable? Dr. Horne says that depending on the study and time frame, patients can lose five to 20 percent of body weight in three to six months. A study by Wegovy’s manufacturer Novo Nordisk, found patients maintained an average of 10-percent weight loss after four years. However, that study was done with patients who stayed on the medication. The long-term effects of semaglutide drugs have been shown to improve diabetes, blood pressure, kidney health, and positive cardiovascular outcomes in some patients. 

REPORTED SIDE EFFECTS:

Dr. Horne says there are reported side effects. The most common are gastrointestinal issues like nausea, diarrhea, constipation, and vomiting. The manufacturer cites a low risk for hypoglycemia, gallbladder or kidney problems, rare but serious risks of pancreatitis, and vision changes. 

Ozempic Vs. Other Weight Loss Treatments

It is important to note that there are other weight loss treatments hitting the market as well. Ozempic was the first approved as semaglutide in a class of GLP-1 agonists. But in 2022, tirzepatide joined the class of GLP-1 agonists and Mounjaro was FDA approved to treat type 2 diabetes. Unlike semaglutide, tirzepatide interacts with a second receptor known as GIP, which also impacts blood sugar and insulin levels. Zepbound was approved in 2023 for weight loss. Clinical trials published in Jama show that the tirzepatide drugs may be more effective than semaglutide in helping people lose body mass. However, it’s important to note that each person’s body can react differently to the GLP-1 agonist receptors. 

Discussing Ozempic With Your Doctor

In the end, with several types of weight loss options, make sure you consult with your doctor for any weight loss medication and confirm any medication is FDA-approved. Ozempic and Wegovy are relatively new to the market, so there have not been any studies on the long-term effects of the drug. Semaglutide caused thyroid tumors and cancer when tested on rats, but the studies are not sure about its impact on humans. There have also been some reports of depression associated with the drug. 

Pros And Cons Of Semaglutide

With so much information about the semaglutide, here is a breakdown of the basic benefits and risks associated with the medicine. 

Benefits 

• Can help reduce obesity related risk factors including improved cardiovascular and kidney health
• Blood sugar control
• Non stimulant weight loss
• Don’t need to take pills
• Typically safe for long term use 

Risks

• Common side effects: Gastrointestinal issues, headaches, dizziness, and fatigue.
• Rare occasions: Could cause serious health problems including heart problems, acute pancreatitis, hypoglycemia, gallbladder or kidney problems
• Weight loss plateau
• Most patients regain some weight after going off the medication
• Shots every week
• Costly out of pocket for weight loss when not covered by insurance

Summary

In conclusion, GLP-1 agonists have shown to be effective in impacting weight loss and other health problems. However, there are potential health risks and associated costs. 

OZEMPIC: Ozempic usually covered by insurance for diabetes. Some doctors are prescribing it off label for weight loss. Most insurance companies will not cover for weight loss.

$900 – $1,500 a month range

WEGOVY: FDA approved for weight loss. Coverage depends on the insurance provider. Some insurance companies will cover it, but others won’t. 

Could exceed $1,000/month without insurance

COMPOUNDED SEMAGLUTIDE:  Not FDA approved. Not regulated. Hard to determine the amount of semaglutide or what type of semaglutide. 

Cost:  Starts from about $150 /month – Upwards

Availability: More available but not regulated

FDA warning about non-FDA approved compounded versions of semaglutide. No safeguards in place to confirm safety. Could cause adverse health problems.