Every day, a new fad rips its way through Hollywood before filtering down to the rest of us. It’s no big deal when it’s a fashion trend, but when it affects your health, that’s a little different.
Philip Collins, DO
Ozempic, a brand name for an injectable medication used to regulate blood sugar, has seen a sharp rise in popularity in recent years – not just for its FDA-approved use in treating Type 2 Diabetes but also as an off-label remedy for weight loss. Which isn’t always a good idea, says Philip Collins, DO, a family medicine physician who oversees Rowan School of Medicine’s weight management programs.
“It’s often extremely effective at treating Type 2 Diabetes – its intended purpose,” he says. “Essentially, the drug mimics the effects of a hormone that our bodies naturally produce to help regulate blood sugar. By increasing insulin when someone needs it, it can decrease appetite and slow down how quickly the stomach empties, which helps people feel full for longer.”
For people with Type 2 Diabetes, it’s a lifesaver. Uncontrolled blood sugar can lead to any number of serious complications, like heart attack, stroke, kidney failure, vision loss and nerve damage. While patients take Ozempic to avoid those risks, the medication often has another effect – substantial weight loss.
“This is a part of a larger family of medications that work in similar ways to treat different conditions. One medication, called Wegovy, is FDA-approved for weight loss,” says Collins. “So why, then, are people using a diabetes medication instead?”
Last year, there was a shortage of Wegovy, and as a result, Ozempic started to be prescribed more off-label. There are times, he says, when it’s appropriate to prescribe a medication for something other than its FDA-approved use, like in a shortage. But in this case, it became very popular among people who didn’t necessarily meet the criteria, which was amplified over social media.
“All of a sudden,” says Collins, “people started to see celebrities drop dress sizes seemingly overnight. Then, when a friend says they also lost weight on this medication, it seems like it could be a great option.”
But there are substantial risks to taking medical advice from the Real Housewives instead of your doctor. To properly and safely qualify for this medication, you have to meet specific criteria – a BMI of 30 or greater, or a BMI of 27 or greater along with a weight-related comorbid condition such as high blood pressure, high cholesterol, sleep apnea or fatty liver disease, says Carmen Eberly, APN, of Salvéo Weight Management.
Carmen Eberly, APN
“In these cases, this family of medications is a phenomenal option to manage dangerous weight gain,” she says. “When people are struggling with chronic conditions of obesity, it’s very difficult to make the diet and lifestyle changes needed to get back to a healthy BMI. The medication really allows a patient to take a step back from hunger and think about their food and lifestyle choices much more easily.”
But because the medication drastically reduces your body’s hunger signals, it’s vital that patients work closely with their doctors to make sure they are still getting the nutrients they need. When taken without a prescription or any medical guidance as a weight loss shortcut, it can put people at serious risk of malnutrition.
“It’s entirely possible for people to lose too much weight, which creates the risk of wasting away their muscle mass,” says Eberly. “One of the first things I do when I put a patient on this medication is give them a very detailed nutrition plan with a high emphasis on protein. I educate them on how the body functions – why carbohydrates might be bad for one specific body type but not another, and how metabolism and family history comes into play.”
She also encourages patients to plan frequent, small meals ahead of time. Because their body doesn’t have the same hunger cues, it’s easy to skip meals, she says, and they often can’t eat as much as they used to in one sitting, which means patients can become malnourished without even noticing.
“Another reason people shouldn’t take these medications without prescriptions – as if we needed more reasons – is they often don’t realize how much they need to adjust their drinking habits,” she says. “Because the medications slow down your stomach, alcohol can sit longer, which makes you intoxicated much more quickly. If you don’t have enough food in your stomach to help your body process some of that alcohol, it’s even worse.”
People may also experience other side effects like nausea, acid reflux and constipation, says Collins.
“When it’s prescribed properly and started on a low dose that’s gradually increased, there are often little to no side effects,” he says. “But when it’s self-prescribed, there’s a much higher risk that you’ll experience more, and worse, than the weight loss.”
Plus, he adds, for those who don’t need the medication, its effects will likely wear off as soon as they stop taking it.
“We always advocate for lifestyle changes, like diet and exercise, alongside the medication,” says Collins. “So when it’s used as a quick fix without any other changes to back it up, there’s going to be substantial weight gain pretty quickly after you stop taking it.”
While it is approved for long-term use, that use is only safe for those who medically qualify and are being properly monitored by their physicians, he says.
“Social media is a great way to spread information, but any time someone reads about a medical issue, whether it’s a potential diagnosis, medication or treatment, it should be discussed with a physician,” says Eberly. “This treatment can be very effective for those who need it. But not everyone needs it.”
