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Ozempic is an injectable drug used to treat diabetes that has gained lots of attention amongst celebrities and influencers on Tik Tok for its ability to help weight loss, as it increases insulin sensitivity and suppresses appetite. Ozempic, manufactured by the Norwegian company Novo Nordisk, was first approved by the Food and Drug Administration as an injectable diabetes medication in 2017. In 2021, the agency approved another drug manufactured by Novo Nordisk, with a higher dosage of the active ingredient in Ozempic to treat obesity, under the brand name Wegovy. These “diabetes-miracle” drugs work by imitating a naturally occurring hormone, GLP-1 (glucagon-like peptide one), to manage hunger and slow stomach emptying. For diabetics, it reduces insulin resistance and lowers blood sugar as well as suppressing appetite, making it effective for those with obesity. Ozempic and Wegovy have also been found as effective treatments for those with polycystic ovary syndrome (PCOS) and prediabetes. The most common side effects of Ozempic include nausea, vomiting, diarrhea, and constipation, with patients experiencing varying degrees of symptoms depending on dosage.

“Semaglutide, the active ingredient in these drugs, lasts longer than the natural one our body produces, making it more effective in keeping us feeling satiated or full for longer; causing a reduction in food consumption.”

Ozempic and its cousin drugs, Wegovy and Mounjaro (from Eli Lilly and Company in 2022) work as an appetite control through the brain by mimicking GLP-1, a hormone the body produces that releases insulin and reduces appetite after eating food. Semaglutide, the active ingredient in these drugs, lasts longer than the natural one our body produces, making it more effective in keeping us feeling satiated or full for longer; causing a reduction in food consumption. Soon after the FDA approved Wegovy for treatment of obesity in 2021, talk of the drug arose quickly on the internet with celebrities such as Elon Musk giving credit to the drug for his “fit, ripped and healthy” new body and Andy Cohen posting about Ozempic’s growing acclaim. On Tik Tok, the hashtag #Ozempic has been viewed over 591.2 million times with endless stories of people’s shock over the effectiveness of these drugs for weight loss as well as their stories of the various side effects they have experienced. These symptoms have made the drugs especially appealing for those looking to lose weight and curb cravings, causing an uptick in off-label prescriptions. It is both legal and common for doctors to prescribe drugs off-label, or to treat a condition other than what the FDA approved as the intended use of the medication. In fact, one in five prescriptions written today are for off-label use. As more and more celebrities and influencers on Tik Tok shared their weight loss “success” stories, hordes of non-diabetic patients looking to lose some weight started asking for these drugs by name. Dr. Holly Lofton, the program director at NYU Langone Health’s Weight Management Program shared that in the last six months she’s written over 1,400 prescriptions, making Ozempic and Wegovy by far the most common prescription since they’ve been released.

“Due to rising popularity, there is currently a severe shortage of both Ozempic and Wegovy on the market, pushing patients to seek the drugs out in other ways.”

Due to rising popularity, there is currently a severe shortage of both Ozempic and Wegovy on the market, pushing patients to seek the drugs out in other ways – either through medi-spas or private dealers in person or online. Novo Nordisk’s operating profits increased 58 percent since they introduced Ozempic in 2017, and sales of the GLP-1 agonists grew 42 percent last year, which accounted for 98 percent of the company’s overall growth. According to IQVIA, a health-care data-analytics company, 1.2 million prescriptions for Ozempic were filled nationwide in December 2022, a 64 percent increase from the previous December. Komodo Health, a firm that tracks health-care data for 330 million patient files, has tracked a spike in patients with no history of diabetes receiving these drugs, with a significantly young demographic (40% are between 25-44) and a fourfold increase in California alone. As demand continues to rise and shortages have become common, more companies are releasing their own versions of semaglutide drugs to treat obesity. Mounjaro is the newest GLP-1 medication that has been given “fast track” FDA approval and uses an additional molecule called GIP, or gastric inhibitory peptide, which stimulates the release of insulin, producing a very strong effect on appetite suppression.

“This dangerous stigma can have especially harmful effects on adolescents and teens who are incredibly vulnerable when it comes to eating disorders and unhealthy body image.”

Ozempic has been running especially rampant amongst the fashion and entertainment industries, where body image is highly scrutinized. These industries are known to cosmetically alter faces and bodies and set a dangerous standard of what an “acceptable” body should look like. Thin bodies have been showcased as the “ideal” body type and are deemed more valuable, with skinny actresses and models bringing in the biggest profits in Hollywood and the fashion industry. This dangerous stigma can have especially harmful effects on adolescents and teens who are incredibly vulnerable when it comes to eating disorders and unhealthy body image. When Hollywood and the mainstream media continue to idealize thin bodies, it only makes the effort to develop healthy relationships with food and body image that much more difficult. Not only is this weight bias dangerous for mental and physical health, but history has also shown the fatal consequences of the lengths those have taken to achieve these idealized figures. Diet fads and weight loss elixirs have come and gone with the same lesson learned at the end: magic cures don’t exist. For those who remember the fen-phen craze of the ’90s – a drug cocktail of fenfluramine and phentermine – can recall the devastating finding that fenfluramine can cause cardiac-valve damage, leading to death in some patients. Although the hope of a quick weight loss solution still seems to be in high demand, silver bullets always come with high risks that should not outweigh the “reward”.

“These medications are deemed safe for patients diagnosed with the conditions Ozempic and Wegovy have been approved for, but little to no research has been done on the side effects on those who are using these drugs for cosmetic weight loss purposes.”

These medications are deemed safe for patients diagnosed with the conditions Ozempic and Wegovy have been approved for, but little to no research has been done on the side effects on those who are using these drugs for cosmetic weight loss purposes. Due to the appetite suppressing qualities of these GLP-1 drugs, some patients have actually had to remind themselves to eat, which is why it is recommended to work with a dietician or nutritionist to make sure patients are getting adequate amounts of protein, vitamins, and nutrients to properly nourish their bodies. An FDA warning alerts users of Ozempic to the development of thyroid tumors in rodents, and the increased risk for those who have (or have a history of) pancreatitis or a certain type of thyroid cancer. There is little to no research done on the use of Ozempic in nondiabetic patients. “The truth is we really don’t know,” says Dr. Lofton. “We don’t have enough evidence in those people because we never studied it in those people. So we have to find out.” Although these drugs are an exciting medical development for those suffering from diabetes, the incredibly high demand makes it clear that more research is needed on the long-term effects of these drugs before widespread off-label use.