Over the summer I was fortunate to be invited to a 60th birthday party where the after-dinner entertainment was a private performance by one of Britain’s leading male pop stars. More striking than the actual show, however, was how incredible the star looked. He was just a shadow of his former self, prancing around the stage in a silver catsuit. His secret? Semaglutid, or Ozempic as it’s known as the brand, a new diet drug that seems like everyone – but everyone, darling, including one of the world’s most famous supermodels – is taking.
Originally developed to treat type 2 diabetes, it is used off-label (for a different purpose than it was approved for) to treat obesity in both the US and UK. In a study conducted by its billionaire maker, Danish pharmaceutical company Novo Nordisk, patients lost an average of 17 percent of their total body weight over 68 weeks. That compares to five to nine percent for old-school anti-obesity drugs like metformin.
Ozempic is only available in the UK through the NHS if you have type 2 diabetes and can be obtained through a private practitioner. If you’re willing to take it without medical supervision – not recommended by doctors (see panel) – you can get it online through various weight loss programs. It is sometimes taken in tablet form, but more commonly as an injection.
Semaglutide was originally developed to treat type 2 diabetes and is used off-label. It has been branded as a new diet drug that everyone seems to be taking
Predictably, Ozempic has been known to Hollywood much longer than we have – Variety magazine recently joked that the drug deserved its own acceptance speech at the Emmys, since so many stars on the podium had obviously taken it. Elon Musk gushed about his stronger sister drug, Wegovy, on Twitter; Kim Kardashian is hotly rumored to have used Semaglutide to lose 16 pounds to fit in Marilyn Monroe’s Met Ball dress. The hashtag #ozempic has been viewed more than 285 million times on TikTok.
Thanks to the hype, there has been a surge in demand, leading to shortages on both sides of the Atlantic, with a backlash against influencers and celebrities hoarding supplies from desperate diabetics. Predictably, Big Pharma has developed an alternative — tirzepatid (brand name Mounjaro), manufactured by Eli Lilly — but it has yet to be approved by the US Food & Drug Administration for weight loss use.
Novo Nordisk has issued a statement saying its stocks will be replenished by the end of the year, but it hasn’t allayed concerns. At least two middle-aged male friends of mine who started doing it in September are embarrassed to be caught just before the holidays. As a private London GP remarked to me, “It’s like last spring’s HRT panic.”
What exactly is this drug? Semaglutide belongs to a class called GLP-1 agonists, which not only regulate blood sugar but, was discovered about a decade ago, also mimic the gut hormones that regulate our appetite — the ones that tell the brain when we’re hungry or hungry are fed up There are side effects, of course: heartburn, nausea, worsening of IBS symptoms and fatigue (but much less so than previous GLP-1 agonists like Saxenda), as well as pancreatitis, gallstones and, in very high doses, it has thyroid tumors in rats caused. Meanwhile, once you stop using it, the effects wear off immediately, and in some cases, it doesn’t work at all.
“I would call semaglutide an example of very smart science,” says lead consultant endocrinologist Dr. Efthimia Karra from her private practice near London’s Harley Street. “But it’s not a panacea for everyone. Around a fifth of users do not react to it. This is because the human body prefers to gain weight. So when you lose weight, the body will do whatever it takes to get back to its highest BMI. The heavier you are, the harder it is to lose weight. If a patient hasn’t made any progress in three months, I will discontinue them.’
Banker’s wife Laura, a native New Yorker in her mid-50s who vacillated between the decades, began doing it in January. “The Paleo diet, 5:2, CBT, NLP, bootcamp, diet delivery services — I’ve tried them all,” she says of the family home in Hampshire, “and I kept yo-yoing right back. After my last annual check-up, I seriously considered giving up. Then my doctor suggested semaglutide.”
After just a month, she noticed that her clothes had become looser. From then on the weight started to drop. “The strange thing was that I didn’t eat anything else. I just couldn’t physically have seconds, and the idea of pudding after a full meal had lost its appeal.” Three months later, she’s two stones lighter — although she occasionally gets heartburn from eating late at night or drinking alcohol — and when we spoke in the fall, she was looking forward to losing another stone by Christmas.
“There’s a nagging voice telling me that taking a drug to lose weight is both risky and lazy, and I worry that if I stop taking it it will all pile up again . But if it does, I’ll seriously consider taking it indefinitely.’
The private London family doctor Dr. Martin Galy has been prescribing Semaglutide to clients who are unable to lose the weight gained during menopause for about a year. He has also seen it have a transformative effect on much younger women suffering from polycystic ovary syndrome. “PCOS sufferers are difficult to treat, and you can imagine how important body image is when it comes to self-esteem.”
But according to Tom Sanders, Professor of Nutrition and Dietetics at King’s College London, it’s not a miracle cure. Commenting on a study of semaglutide published in the New England Journal of Medicine in 2021, he says, “The challenge after weight loss is preventing weight gain,” he wrote. It may prove useful in the short term, but “public health interventions that encourage behavior change, such as regular physical activity and moderate dietary energy intake, are still needed.”
However, with our rising national obesity statistics and the escalation of co-occurring health problems like heart failure, cancer and obstructive sleep apnea clogging up hospital beds, we’re going to need something. Semaglutide may be the drug of the rich today, but could it be approved for wider use? Only time can tell.