Is Ozempic a miracle cure?
Dartmouth Health
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Celebrities, social media influencers, and billionaires are taking Ozempic? and singing its praises on TikTok, Instagram, talk shows, and podcasts. Influencer Ben Soffer is one of them.
"I was skinny until 11," he said during a January episode of his podcast, Good Guys. He weighed 290 pounds in high school and took Ozempic to help shed the weight.
Last month, he touted the perks of Ozempic again, calling it a miracle drug that transformed his thoughts around food.
Now, "my life doesn't revolve around my next meal," said Soffer, who has 1.4 million followers on Instagram.
Is Ozempic the marvel Soffer says it is?
"When used appropriately, it's absolutely a miracle," says Lee Kaplan, MD, PhD, Obesity Medicine Section Chief at Dartmouth Hitchcock Medical Center (DHMC).
But skyrocketing demand, limited availability, high costs, and varied insurance coverage raise questions about the new age of weight-loss medicine and treating obesity.
The rise of weight-loss drugs
Ozempic hit the market as an FDA-approved diabetes drug in 2017. Its weight-loss benefits became an overnight sensation.
Ozempic, Wegovy, Mounjaro, and Zepbound are GLP-1 receptor agonists, a class of medications that control blood sugar levels in Type 2 diabetes, initiate weight loss and treat obesity. All are injectable medications that require weekly shots.
Like Kleenex is for tissues, Ozempic is the most recognized brand and essentially a catch-all name for this category of drugs.
How does Ozempic work?
Ozempic and its counterparts curb hunger signals and quiet what obesity medicine experts call "food noise"—constant, obsessive thoughts about food.
"Can you imagine how much brain space that gives people back?" says Sivan Rotenberg , PhD, an obesity medicine psychologist at DHMC.
But as soon as you stop taking the medication, the food noise and weight usually return.
"What's very worrisome is when a patient loses access and gets into horrible cycles of losing and gaining weight," says Suzannah Luft, MD, a gastroenterologist and obesity medicine specialist at Cheshire Medical Center. "It's very hard for the patient, physically and mentally."
Obesity by the numbers
A new study reveals that more than 1 billion people globally are living with obesity. Worldwide, obesity among adults has more than doubled since 1990 and quadrupled in children and teens ages 5 to 19.
"Obesity is a disease," Dr. Kaplan says. "It reflects dysfunction of the human body in some way and is responsible for an enormous amount of ill health, disability and premature death."
The United States adult obesity rate is 42.4%, increasing by 26% since 2008. New Hampshire and Vermont's obesity rates are slightly below the national average.
"Our region is not in the highest range, but it doesn't matter," Dr. Kaplan says. "The environment has changed in ways that we don't fully understand, and that change is acting on susceptible individuals. If a person's body were working correctly, then they wouldn't have obesity, period."
Obesity can be inherited or result from physiological and environmental factors, including chronic stress, environmental toxins, highly processed food, lack of sleep, and circadian rhythm dysfunction.
Dr. Kaplan says that in the past 20 years, sugar and solid fats, like butter, shortening and cream, have been consumed less by the population. More people are also exercising.
"We've been doing all the so-called right things to fix obesity as a society, and yet obesity keeps going up," he says. "That tells you that addressing obesity with just diet and exercise is not the answer."
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Obesity's false narrative
Patients with obesity experience a high rate of external and internalized stigma.
"Many of my patients will say, 'I'm unlovable because I'm obese,'" Rotenberg says.
Harmful stereotypes and biases wrongly associate obesity with laziness, irresponsibility and lack of self-control.
"There's the narrative that obesity is a personal failure," Rotenberg adds. "For a person with obesity, they might feel it's a reflection of their own doing, and that body size is 100% controllable. And that's not at all true."
Ethics, challenges, and a potential alternative
Many people taking the drug are trying to tackle not just obesity but mobility issues, diabetes, cardiovascular disease, and infertility.
"For patients suffering from obesity and obesity-related medical conditions, there is a pronounced health and quality of life benefit to being on these medications to lose weight." Dr. Luft says.
But for every person who needs these drugs and whose insurance doesn't cover them, someone can bypass the system and pay out of pocket.
"There's a lot of ethics involved here that I think, as a country, we need to sort out," Dr. Luft says.
The cost of Ozempic depends on various factors, including dosage and insurance coverage. According to Novo Nordisk, the manufacturer of Ozempic, the list price for a single 1.5 mL pen is $935.77.
If a weight-loss medication is out of reach for financial reasons or low supply—or a patient doesn't respond well to the drug—bariatric surgery is a potential option.
Bariatric surgery is typically performed laparoscopically and involves changing your digestive system to help you lose weight.
"For people who don't want to be on a lifelong medication, bariatric surgery can lead to durable weight loss in many situations," Dr. Luft says.
Using Ozempic to treat obesity
Dr. Kaplan estimates about 180,000 people in our region are living with obesity, but only a fraction of them seek care.
He says access to obesity care and resources is scarce, and education and awareness must improve to better serve the population.
That also means proper use of weight-loss drugs.
"If people want weight-loss medications to lose 10 or 15 pounds, then I wouldn't recommend it. It's inappropriate." Dr. Kaplan says.
"But there are 140 million people with obesity in this country, and these drugs can be highly beneficial to their health."
People like influencer Ben Soffer are living proof.
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