At My Physical Last Week My New Family Doctor Offered to Give Me A Weight-Loss Prescription

For the past few years, my life has gone from active to sedentary. First, it was the failing left knee that reduced walking. Then it was COVID-19, heart complications, two heart procedures, knee replacement, our dog passing away (the incentive to walk), another surgery, and a second encounter with COVID, all happening within three years. During that period, I gained on average about 4.5 kilograms (close to 10 pounds) a year. Now I’m trying to reduce my calorie intake and increase my activity because, at my latest medical appointment, my bloodwork showed I was pre-diabetic.

During these last three years, the only medical checkups happened in hospital pre-admissions or consisted only of bloodwork. Our family doctor retired which happened a lot to lots of people during the pandemic. Now we have a new general practitioner who I finally have met. At my first appointment, she told me that the general practice of doctors with which she is associated have been getting great results from a weight-loss drug and suggested I consider going on it because of my increased body mass and rising blood sugar levels indicated in my bloodwork.

According to the U.S. Centers for Disease Control (CDC), pre-diabetes is a condition where rising blood sugar levels are higher than normal, but not high enough to be considered Type 2 Diabetes. One in three adult Americans is pre-diabetic. More than 80% don’t know they have the condition. That amounts to 90 million. In Canada, the number is 5 million.

Since the fastest way to reverse pre-diabetes is weight loss which can be done gradually by dieting and exercise, or now through a weight-loss panacea, my doctor was offering me the latter as a quick way out.

“Have You Heard About Ozempic?”

For the past few months, the above phrase has been shouted out in television ads. Ozempic is a drug developed for people with Type 2 Diabetes to help reduce blood sugar levels. It has also become fashionable to use as a quick fix to shed weight. The campaign by its creator, Novo Nordisk, has been widely distributed across the media.

At the Oscars in Hollywood last month, host Jimmy Kimmel surveyed the audience and declared, “Everybody looks great. When I look around this room, I can’t help but wonder: Is Ozempic right for me?” That’s because Ozempic is now being referred to as “the worst-kept secret in Hollywood” with celebrities flaunting before-and-after pics showing just how effective the drug has been for them to slim down.

Ozempic isn’t supposed to be a weight loss drug. The side effect, however, has made its manufacturer develop a separate product on its own it calls Wegovy, and the company is cashing in.

Ozempic and Wegovy are semaglutides part of a collective category known as GLP-1 agonists. Semaglutides mimic the glucagon-like peptide-1 (GLP-1) which is a naturally produced hormone that stimulates the production of insulin, while at the same time affecting appetite-control areas of the brain and depressing feelings of hunger.

Semaglutides are offered as a pill or injection. The pill is taken once a day, and the injectable once a week. On the WebMD site, it states:

“Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.”

I know one person who was on Ozempic to treat Type 2 Diabetes. He experienced rapid weight loss, nausea and vomiting. Eventually, he had to stop. The manufacturer reports most of the side effects including diarrhea, constipation and abdominal pain usually go away after a few weeks.

A recent CBC article suggests that Ozempic shouldn’t be considered a panacea for weight loss. The headline reads, “Despite social media buzz, Ozempic is not a quick-fix weight loss solution, doctors say.” The article describes how demand for the drug to treat obesity has escalated in Canada although it was first marketed to treat diabetes. It goes on to quote doctors who express concern that once on Ozempic it likely means you stay on it for life. One physician is quoted stating, “Nobody should think that they’re using this for short term and going to stop it. This is a forever medication because [obesity is] a genetic disease.”

Novo Nordisk cannot keep up with demand for either of its branded semaglutides. Other drug makers have noted this and now are jumping on the weight-loss bandwagon. The latest is In Eli Lilly with plans to release Mounjaro this summer noting that in trials, participants on average have shed 20% of their weight.

Obesity is a Global Problem

Weight-loss drugs are being touted as a license to print money. Why is that? Because obesity has become a global problem. In its latest report, the World Obesity Federation notes that:

• the global economic impact of being overweight and obese is forecasted to grow to USD 4.32 trillion annually by 2035 without prevention and treatment. This is comparable to COVID-19’s 2020 economic impact.
• 51% or over 4 billion people will be overweight or obese by 2035 based on current trends. One in four will be classified as obese representing 2 billion.
• By 2035, childhood obesity rates will double among boys to 208 million, a 100% increase, and more than double with girls to 175 million, a 125% increase. The rise in obesity in children will be faster than in adults.

Research shows that commonly used weight-loss solutions to eat less and exercise more only work for 10% to 20% of the population. Why is that? Because human metabolic processes stimulate hormones to counter efforts to keep the weight off.

So it’s a survival thing! 

In other research, obesity has been observed to be genetically predisposed. Dr. John Speakman, at the University of Aberdeen, has been researching body weight and has discovered that between 45% and 65% of humans inherit the tendency to become obese.

So it’s a generational thing!

Add to this our more sedentary lives combined with the eating of more processed and fast foods and you have the makings of a perfect obesity storm.

So it’s a lifestyle thing!

For the many who through diet and exercise have failed to achieve weight loss, what’s left?

Some have opted for a last resort treatment called bariatric surgery which puts a band around the stomach or small intestine to decrease the amount of food we ingest and digest.

The last resort may be the simplest. Pop a pill or self-inject.

No surprise that Ozempic has found a happy home as a prescription for slimming down.

So should I take up my doctor’s offer? It’s tempting, but for the moment, my answer is
“no.”

A Biopharmaceutical Footnote

Ozempic isn’t the first drug, nor will it be the last to find a purpose for which it was not intended. I am reminded of Viagra, originally developed by Pfizer to be used to treat cardiovascular conditions including hypertension and angina. It turned out not to be all that effective on the heart side, but the side effect of keeping a man’s penis erect was a big hit and so begat a new disease, erectile dysfunction, and the last big biopharmaceutical license to print money.