- Author, Essay
- Role, BBC News World
March 20, 2023
Businessman Elon Musk claims that he has already used semaglutide and, according to some US media, starting this treatment has become “Hollywood’s worst kept secret”.
It is a weight loss injection whose popularity is growing in many parts of the world and whose doses are even missing in some pharmacies.
The drug — sold under the brand names Wegovy, Ozempic and Rybelsus — is used to treat type 2 diabetes and, more recently, has begun to be approved in various parts of the world as a new option for weight loss.
In the United Kingdom, it has just been released for use in the National Health Service, known by its acronym in English NHS.
In Brazil, medicines based on semaglutide for weight loss received approval from the National Health Surveillance Agency (Anvisa) in January. In the country, they are considered an auxiliary treatment to other measures, such as adopting diets with fewer calories and exercising regularly.
The drug, given as an injection under the skin, makes people feel fuller and more satisfied, which causes them to eat less.
Health authorities, such as the Food and Drug Administration (FDA) in the United States, or the National Institute for Excellence in Health and Care (NICE) in the United Kingdom, indicate that the drug is safe and effective for controlling chronic overweight in adults with obesity who have at least one associated disorder, such as hypertension or type 2 diabetes.
As in Brazil, these bodies also emphasize that the use of the drug must be accompanied by a low-calorie diet and physical activity programs.
According to NICE, evidence shows that semaglutide can help reduce weight by more than 10% if implemented in conjunction with changes in nutrition and exercise.
As mentioned earlier, semaglutide works as an appetite suppressant. It “mimics” the action of a hormone produced in the intestine called GLP-1, which targets areas of the brain responsible for regulating satiety and the need for food intake.
The hormone is released after a meal and normally makes people feel full, which helps reduce overall calorie intake throughout the day.
The injections must be prescribed by a doctor and the recommendation is that the medicine be taken for a maximum of two years.
However, the drug’s effect on weight loss is so dramatic that, in many countries, the treatment’s popularity has skyrocketed.
An article published last year in Variety magazine, in the US, reports that the drug “saturated the industry [de entretenimento de Hollywood] over the last few months, helping beautiful and rich people shed extra pounds fast.”
Health plans in the United States refuse to cover the cost of semaglutide, which is about $1,300 (R$6,800) a month for people who are not diabetic or who do not take it as prescribed medication.
In Brazil, insurers may cover the price of treatment in some cases. For now, it is not available on the public health network.
Overseas, semaglutide’s popularity has grown so much that there is now a widespread shortage of doses in that country, with fears that people who depend on the drug for medical reasons will lose access.
In February, the chief executive of Novo Nordisk, the drugmaker that makes the drug, told NBC News that production had been increased to meet growing demand.
“We know for sure that patients are lining up [para comprá-lo]”, said Lars Jorgensen, representative of the laboratory.
Pharmaceutical Novo Nordisk points out that semaglutide should only be used with a medical prescription.
This treatment has side effects and risks. The main ones are nausea, stomach pain, vomiting and diarrhea.
Other adverse events listed by the FDA are: headache, fatigue, indigestion, dizziness, bloating, excessive flatulence, gastroenteritis and gastroesophageal reflux disease.
The American agency also notes that health professionals should warn patients about the potential risk of thyroid tumors.
“Drugs such as Wegovy should not be used in patients with a personal or family history of medullary thyroid carcinoma or in patients with a rare condition called multiple endocrine neoplasia syndrome type 2,” states the FDA.
In addition, rapid weight loss can also cause the skin to have a drop in the amount of substances such as collagen and elastin, leading to what some professionals call a “semaglutide face” – which resembles a haggard appearance.
But for those who have trouble losing weight, or when extra pounds lead to other illnesses, semaglutide is a positive alternative.
American Kailey Wood, 36, took Ozempic for seven months after her doctor prescribed the drug.
She told the BBC that, during the period, she lost just under 30 kilos – with that, she stopped being obese and entered the range of Body Mass Index (BMI) considered healthy.
“I have polycystic ovary syndrome and insulin resistance, but honestly, I didn’t have a problem with my weight until I was 30,” she says.
“I was gaining weight quickly. I had a personal trainer and followed every known diet: ketogenic, low-carb, intermittent fasting… Nothing seemed to work.”
When Kailey went to see the doctor for tests, she was told that she also had high blood pressure and high cholesterol. To make matters worse, because of the risks associated with polycystic ovary syndrome, she was at risk of developing type 2 diabetes.
“The long-term effects [de ser obesa] scared me because I have two daughters,” she says.
“I just wanted to do my best, show them what it’s like to be a healthy mom, able to go out there and play.”
Kailey, who works for a startup technology savvy and has its own TikTok page, notes that anyone wanting to use semaglutide needs to be aware of the drug’s side effects.
“When you start taking this medicine, your body almost goes into shock: you feel a headache, nausea, tiredness…”, he explains.
“But the organism starts to get used to it. You have to be attentive and listen to your body.”
Kailey says she finds it “in very bad taste” that some are promoting the drug in the US media as a “rapid weight loss product”.
She thinks this conveys an inappropriate message.
“What the medicine is really doing is changing people’s lives: treating the patient before he develops other diseases”, he says.
Helen Knight, Director of Medicines Evaluation at NICE UK, says, “For some people, losing weight is a real challenge, so a medicine like semaglutide is a good option.”
Duane Mellor, nutritionist and senior lecturer at Aston University School of Medicine in England, says, “It’s important to remember that living with high body weight or obesity is not a lifestyle choice.”
“To improve health, these individuals must be supported.”
According to the expert, semaglutide should not be seen as a lifestyle treatment, but “with the aim of improving health”.