Weight loss drugs are prime candidates for popular fads, but few have been as disruptive to the healthcare system as the obsession with Ozempic, a Type II diabetes medication.
Due to a nationwide shortage of the active chemical in Ozempic, or semaglutide, some are now turning to the natural supplement berberine and compounds of semaglutide as alternatives.
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Healthcare experts, however, have warned that doing so could have serious consequences.
What is Ozempic?
Ozempic was approved by the Food and Drug Administration in 2017 and is a once-a-week injectable drug to lower blood sugar levels in insulin-dependent Type II diabetics.
The active ingredient in Ozempic is semaglutide, which mimics the hormone that promotes insulin development in the body to reduce blood glucose levels.
Semaglutide is the same active ingredient that is in the medication Wegovy, which was approved by the FDA in 2021 solely as a weight loss drug when paired with lifestyle changes, like diet and exercise. Wegovy is also an injection of semaglutide but at a higher dose than Ozempic.
Because Ozempic and Wegovy are the same chemical compound, they have both been found to be highly effective for weight loss in patients with chronic obesity issues.
How has the popular fad affected the market?
TikTokers have been touting the use of semaglutide for weight loss for over a year, and both Ozempic and Wegovy have been in short supply ever since.
In September, a variety of publications explained Hollywood’s obsession with Ozempic. At that time, the TikTok trend #ozempic was viewed more than 74 million times. Kim Kardashian and Elon Musk have also been vocal about their usage of the drugs for their dramatic weight loss results.
Although there may be other production factors contributing to the shortage, the producers of Ozempic and Wegovy, Novo Nordisk, announced in March that market demand for semaglutide products had significantly outpaced supply capacity.
What does this mean for patient care?
“Patients are upset,” said Veronica D. Kim, MD, a board-certified obesity medicine specialist at St. Luke’s Hospital in St. Louis, Missouri, who handles the daily needs of patients on semaglutide.
Kim told the Washington Examiner that patients “don’t care what the name of the medication is if it is going to help them with their obesity.”
The exorbitant out-of-pocket costs for Ozempic and Wegovy and the general lack of insurance coverage for the drugs in part explain how the medications have become the wonder drugs of the elite.
Even if patients are fortunate enough to have their medications covered by insurance, wait times to fill prescriptions for Ozempic can take several months. This is forcing some patients to ration their medication and some prescribers to get their medications from Canada, according to Kim.
What about Berberine?
Berberine is a supplement that has been marketed as “nature’s Ozempic” and has gotten significant attention this week from health outlets and national media.
Although some suggest that berberine lowers blood sugar naturally regardless of insulin levels, few human studies have been conducted on the efficacy of the supplement.
A meta-analysis of 49 separate studies published in the journal Frontiers in Nutrition in 2022 found that, although the supplement may be beneficial for heart health, there is scant evidence for weight loss effects.
“Many diet supplements claim to have weight loss properties,” said Kim. “The thing is, when it is not evidence-based, meaning that there was no research done, no study done to have efficacy proven, we don’t recommend it.”
Kim added that “there is no specific vitamin or supplement you can take to lose weight.”
Are patients seeking other potentially-dangerous alternatives?
Others have taken to using compounded versions of semaglutide, which means that the base chemical of the drug has been mixed or altered. Compounded medications are not FDA-approved because they have not undergone clinical trials for safety and efficacy.
“FDA has received adverse event reports after patients used compounded semaglutide,” the agency announced Wednesday in response to the shortages.
“Patients should not use a compounded drug if an approved drug is available to treat a patient. Patients and healthcare professionals should understand that the agency does not review compounded versions of these drugs for safety, effectiveness, or quality,” the FDA said.
The Obesity Medicine Association issued a similar warning this March. Chief Medical Officer of the OMA Angela Finch, MD, noted that although compounded medications can tailor drugs for individual patient needs, “compounding peptides should not be intended for pharmacists to mass produce, store, market, and sell replications of patented medications.”
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Kim explained further that when patients take either compounded medication or supplements that are not FDA-approved, they are essentially “on their own” if and when complications arise.
“In the industry for evidence-based, research-based obesity medicine, specialists are against it, but I understand the desperation of my patients,” Kim noted.
