Ozempic and Wegovy are model names for the drug semaglutide. Many nations have authorized Wegovy for weight reduction in people who find themselves overweight or obese and Ozempic for folks with sort 2 diabetes.

How do these medicine work?

Medication comparable to semaglutide mimic the actions of a hormone known 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 scale 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 throughout the human physique, whose position 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 into obtainable in formulations which might be stronger and simpler to make use of.

Initially GLP-1 analogues had been authorized 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 being used at a maximum dose of 2 milligrams for sort 2 diabetes.

How extensively obtainable are they?

In 2021, Wegovy was authorized for weight reduction in a number of nations, including the US and Canada. Reward from some celeb customers introduced it widespread publicity.

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

Within the UK, Wegovy was authorized in 2021, however solely got the nod from England’s medical guidelines body the National Institute for Health and Care Excellence in March 2023, when it stated the drug needs to be given by weight reduction clinics throughout the nation’s nationwide well being service. Wegovy is predicted to turn into obtainable within the UK this yr, whereas Ozempic has been obtainable for sort 2 diabetes since 2019.

In June 2023, the UK government announced the introduction of a two-year pilot that gives people with obesity access to new drugs, comparable to Wegovy, exterior of a hospital setting.

How efficient are they?

Very. It’s a cliche however weight problems docs are speaking a few paradigm shift within the area of weight problems administration. Beforehand, a lack of about 5 per cent of physique weight could be thought of an excellent outcome 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 reduction in body weight over a year, when mixed with train and consuming healthily.

In truth, some folks appear to really feel that the GLP-1 analogues have triggered them to turn into 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 unintended effects, with related outcomes usually additionally occurring after weight reduction surgical procedure, he says.

Do the medicine have any unintended effects?

Unwanted effects might be gentle, comparable to nausea, constipation and diarrhoea, which are inclined to happen as folks get used to the drug. Extra worrying unintended 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 vital weight reduction from different causes, comparable to abdomen surgical procedure, says Miras.

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

Do these medicine trigger suicidal ideas?

GLP-1 analogues – comparable to Ozempic and Wegovy – are being investigated by the European Medicines Company (EMA) after latest reviews that they could trigger ideas of suicide or self-harm. This was after Iceland’s well being regulator acquired three such reviews relating to semaglutide and one other drug known as liraglutide, which is an earlier GLP-1 analogue.

The EMA says it’s analysing about 150 reports of possible cases of self-injury and suicidal thoughts. This doesn’t imply the medicines triggered these results, nonetheless, solely that individuals reported these experiences after beginning to take them. “Extra work is required to find out if a causal hyperlink exists,” says Michael Schwartz on the College of Washington in Seattle.

A spokesperson at Novo Nordisk, the producer of liraglutide and the semaglutide medicine Ozempic and Wegovy, advised New Scientist: “GLP-1 receptor agonists have been used to deal with sort 2 diabetes for greater than 15 years and for remedy of weight problems for eight years. The protection knowledge collected from giant scientific trial programmes and publish advertising surveillance haven’t demonstrated a causal affiliation between semaglutide or liraglutide and suicidal and self-harming ideas.”

Want a listening ear? UK Samaritans: 116123; US 988 Suicide & Crisis Lifeline: 988; hotlines in other countries.

Do these medicine assist with addictions?

Maybe. There have been many anecdotal reports of individuals taking these medicines for diabetes or weight management who lose their urge to drink alcohol or see waning of different habits that could possibly be described as “behavioural addictions”, comparable to compulsive purchasing.

That is supported by research in animals that discovered the GLP-1 analogues decrease consumption of alcohol and addictive medicine. A small trial in folks has hinted at the same impact from a GLP-1 analogue known as exenatide, which reduced heavy drinking, but only in people who were obese.

The reason could possibly be linked with the way in which the medicine act on the mind to scale back meals cravings, however the precise mechanism is unclear. We’re solely originally of understanding how these therapies might assist folks with alcohol and drug additions, says Daniel Drucker at Sinai Well being in Toronto, Canada. “The scientific trial knowledge isn’t but in to substantiate the anecdotes.”

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

In an aforementioned research, taking semaglutide as soon as every week led to folks shedding about 15 per cent of their physique weight, in contrast with 2 per cent for these taking a placebo. Carried out in 2022, this two-year trial checked out individuals who had been overweight or obese, however didn’t have diabetes.

In most nations, Wegovy has been authorized to be used for 2 years, but when folks cease taking the drug, they typically regain the misplaced weight – two-thirds of it after one year, according to one trial.

However in 2024, Donna Ryan on the Pennington Biomedical Analysis Middle in Louisiana and her colleagues discovered that taking the identical dose of semaglutide as soon as every week for 4 years led to reductions in weight that had been maintained for the complete interval.

The staff in contrast greater than 17,000 adults in 41 nations who had been overweight or obese and didn’t have diabetes, however did have a type of coronary heart illness. Amongst these taking semaglutide, weight loss continued to week 65 and was sustained over the trial, with the members’ shedding on common 10.2 per cent of their physique weight, in contrast with 1.5 per cent within the placebo group.

“Our long-term evaluation of semaglutide establishes that clinically related weight reduction might be sustained for as much as 4 years in a geographically and racially numerous inhabitants of adults with obese and weight problems however not diabetes,” stated Ryan in a press release.

It has been instructed that utilizing semaglutide for weight reduction must be a long-term method. “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 might be making an attempt to get your physique weight again up kick in once more,” says Cork.

The outcomes have led to calls to increase Wegovy’s remedy to a minimum of 4 years. Beneath the present two-year approval, there’ll most likely be demand from folks for docs to proceed prescribing the drug “off-label”. “I believe there’ll be a giant push to attempt to change these pointers,” says Cork. Ozempic might be prescribed long-term for sort 2 diabetes as a result of the situation is normally life-long.

Do these medicine scale back the danger of heart-related occasions?

It has been instructed that by bringing folks’s weight in the direction of a more healthy vary, these drugs could inadvertently scale back the danger of heart-related occasions, comparable to coronary heart assaults and strokes.

Primarily based on the identical dataset utilized by Ryan and her colleagues, a staff at College Faculty London examined the connection between a change in weight and cardiovascular outcomes. Presenting their outcomes on the European Congress on Weight problems in Venice, Italy, the researchers discovered that semaglutide led to a 20 per cent discount in such occasions, irrespective of individuals’s beginning weight or the quantity they misplaced.

“Our findings present that the magnitude of this remedy impact with semaglutide is impartial of the quantity of weight misplaced, suggesting that the drug has different actions which decrease cardiovascular threat past decreasing unhealthy physique fats,” stated staff member John Deanfield in a press release. “These various mechanisms could embody constructive impacts on blood sugar, blood stress, or irritation, in addition to direct results on the center muscle and blood vessels, or a mix of a number of of those.”

The outcomes recommend that semaglutide might scale back the danger of heart-related occasions amongst people who find themselves simply mildly obese. Nevertheless, the research wasn’t designed to measure its impact as a preventative remedy. Additional analysis can also be required amongst an much more racially numerous group of individuals.