April 12, 2024

Are slimming medications such as Ozempic something for you? Consider these risks (and benefits). : ScienceAlert

After weight-loss drugs like Ozempic hit the market, celebrities and social media influencers were quick to capitalize on their benefits, leading to a rapid increase in their use. In the last three months of 2022, doctors wrote more than nine million prescriptions for these drugs in the United States alone.

As they’ve grown in popularity, we’ve also heard more about their potential side effects – from general gastrointestinal complaints to more serious mental health issues.

But what does science say about how well Ozempic and Wegovy (both brand names of the drug semaglutide) work for weight loss? And what are the possible side effects? Here’s what to look out for if you or a loved one are considering using the drug.

Potential benefits

1) It will probably help you lose weight

The largest, well-conducted trial of semaglutide took place in the UK in 2021. About 1,961 people classified as ‘overweight’ or ‘obese’ were randomly assigned to semaglutide or a placebo and monitored for 68 weeks (about 1.3 years). ) followed. ). All participants also had free access to advice on healthy eating and exercise.

The study found that those taking semaglutide lost significantly more weight than people taking the placebo (-14.9 percent of their body weight compared to -2.4 percent of their body weight).

In another study in the United States, a health care clinic gave 408 people weekly injections of semaglutide. During the first three months, those included in the final analysis (175 people) lost an average of 6.7 kg. During the first six months they lost an average of 12.3 kg.

A more recent trial of semaglutide found large weight losses, indicating that weight loss is a very likely outcome of continued use of the medication.

2) It can reduce the risk factors for chronic diseases

When people in the overweight or obese category lose at least 5 percent of their body weight, physiological changes that go beyond a change in weight or shape often occur.

This can include reduced cholesterol levels, reduced blood pressure and reduced blood sugar levels, all of which reduce the risk of chronic disease.

In one of the semaglutide studies, most people (87.3 percent) lost at least 5 percent of their body weight. Although most of the large studies of semaglutide excluded people with metabolic health problems such as type 2 diabetes, metabolic health benefits were observed, including reduced blood pressure, blood sugar levels and fasting blood lipid (fat) levels.

In the 2021 British study, people taking semaglutide showed greater improvements in physical ability and risk factors for heart disease and diabetes, including a decrease in waist circumference, inflammatory markers, blood pressure and blood sugar levels.

3) It can improve your quality of life, emotional well-being or sense of achievement

The original trial of semaglutide did not focus on this bundle of benefits, but further follow-ups show additional benefits associated with the medication. Compared to the placebo, people taking semaglutide saw significant improvements in their physical functioning and perceptions of their general health, social functioning and mental health.

Anecdotally (not based on scientific research), people who use semaglutide, like Oprah Winfrey, report a recovery or turning point in their lives, social situation and body image.

What about the risks?

1) You may suffer from gastrointestinal complaints

In the US clinical trial, almost half (48.6 percent) of people taking semaglutide reported experiencing side effects. Nausea and vomiting were most common (36.6 percent), followed by diarrhea (8.6 percent), fatigue (6.3 percent) and constipation (5.7 percent).

Nausea and diarrhea were also commonly reported in the British study.

In another study, many participants (74.2 percent) who took semaglutide reported gastrointestinal symptoms. However, almost half (47.9 percent) who took the placebo also reported gastrointestinal symptoms, indicating that symptoms may be similar to those experienced during normal daily life.

Most gastrointestinal symptoms were mild to moderate in severity and resolved in most people without discontinuing study participation.

2) You may feel tired

Fatigue was the second most common side effect for participants in the US clinical trial, affecting 6.3 percent of participants.

3) You may be in the minority who cannot tolerate the drug

Australia’s Therapeutic Goods Administration (TGA) has approved Ozempic as safe to use for the treatment of type 2 diabetes, but it is not yet approved for weight loss. The TGA has also approved Wegovy (a higher dose semagtlutide) for weight loss, but it is not yet available in Australia.

No unexpected safety issues were reported in the US clinical trial. However, five patients (2.9 percent) had to stop taking the medication because they could not tolerate the side effects. Fifteen (8.6 percent) had to reduce their dose or stay on the same dose to avoid side effects.

In other studies, some patients stopped the trial because the gastrointestinal symptoms were so severe that they could not tolerate their continuation.

More serious safety concerns reported in studies include gallbladder-related conditions (usually cholelithiasis, also known as gallstones) in 34 patients (2.6 percent) and mild acute pancreatitis in three patients (0.2 percent). All people recovered during the trial period.

A 2024 European study analyzed psychiatric side effects associated with semaglutide, liraglutide and tirzepatide (which work in a similar way to semaglutide). Between January 2021 and May 2023, the drug database recorded 481 psychiatric events (about 1.2 percent of the total reported) related to these drugs. About half of these events were reported as depression, followed by anxiety (39 percent) and suicidal ideation (19.6 percent). Nine deaths and eleven life-threatening outcomes were reported during the study period.

Due to the severity and fatal outcome of some of these reports, the U.S. Food and Drug Administration investigated further but found no evidence that use of these medications caused suicidal thoughts or actions.

4) It can be difficult to access

Despite being considered safe, the TGA has warned that significant barriers to entry to Ozempic are likely to remain into 2024.

To manage the shortage, pharmacists are being instructed to prioritize people with type 2 diabetes seeking the medication.

5) You may not always get clear information from vested interests

Given the popularity of Ozempic and Wegovy, health organizations such as the World Obesity Federation have raised concerns about the drug’s marketing, PR and strong social media presence.

Some journalists have raised concerns about conflicts of interest over the relationship between some obesity researchers and the manufacturers of Novo Nordrisk, Ozempic and Wegovy. The concern is that researchers could be influenced by their relationship with Novo Nordrisk to produce research results that are more favorable to the drugs.

In short

Ozempic is a medication that should be used in conjunction with your health care provider. But remember: weight is only one aspect of your health and well-being. It’s important to view your health holistically and prioritize eating well, exercising more and getting enough sleep.

Read the other articles in The Conversation’s Ozempic series here.

Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Lecturer, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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