Weight-loss drugs like Ozempic and Vegovy are seemingly everywhere — discussed on podcasts, speculated upon by celeb followers, whispered about at dinner parties. and aThe explosion in popularity has further fueled speculation about who is receiving them.
— semaglutide, sold under the brand names Ozempic and With tirazeptide, sold as Monjaro, and liraglutide, known as – All work in the same way. And they’re highly effective: One doctor told CBS News that these drugs can help people lose about 15% of their body weight — more than previous generations of weight-loss drugs.
For those struggling with their weight – 73.6% of adults over the age of 20 in the US are considered either overweight or obese – they can seem like a miracle drug. Here’s what doctors have to say about them.
Who are they for and how do they work?
Semaglutide drugs work by mimicking a gut hormone called GLP1, or glucagon-like peptide hormone, which “makes that gut hormone work better to increase communication between the gut and the brain and make us feel full and reduce appetite.” also helps,” said Dr. Amanda Velazquez, who works at the Cedars-Sinai Center for Weight Management and Metabolic Health in Los Angeles. “Overall it is telling the body that it is okay to be at a lower level.”
Ozempic and Monjaro, which have slightly different mechanisms of action, are FDA approved for the treatment of type 2 diabetes while Saxenda and Vegovy are FDA approved for weight loss. And insurance companies typically look for certain criteria before approving payment for one of these drugs.
Velazquez says she’ll prescribe these drugs to patients who have a BMI between 27 and 30 — classified as overweight — plus, have a weight-related medical condition, such as diabetes, high blood pressure or sleep apnea.
Or, patients with a BMI of 30 or higher — classified as obese — would qualify for weight-loss medication, she said.
But these drugs can have side effects, including nausea and constipation. Some speculate that these may be contributing to the weight loss, but Velazquez said “that’s not the mission of medicine.”
“The goal is not to dissuade anyone from eating,” he told CBS News. “The goal is to help someone be able to navigate and manage how to have healthy choices and feel fulfilled with those choices.”
Velazquez says patients should practice a healthy lifestyle along with the medications.
Dr. Holly Lofton, who specializes in obesity medicine at NYU Langone, said she prescribes these drugs to people who aren’t technically obese or overweight. Overweight or obese – a practice known as off-label prescribing.
“We still follow up with patients and make sure they have a lifestyle plan and we follow through,” she said. “It’s not like we’re giving it to them and saying, ‘Good luck to you.'”
Lofton said she wouldn’t give a patient with a normal BMI Ozempic or Vegovi because the drugs could put them at a sub-optimal weight. But in addition to BMI, they also considered factors such as race and co-morbidities.
“Say there was a patient of Asian ethnicity and they have a BMI of 25 – that BMI is technically overweight in an Asian patient – and they have fatty liver. That patient qualifies in my mind because they are diagnosed as are not only overweight, they have a comorbidity, even though the guidelines don’t state that,” she said.
Lofton said she wouldn’t prescribe these drugs to people with a history of thyroid cancer or pancreatitis — studies found they may increase thyroid cancer risk in rodents, and researchers haven’t explored their effects on humans. thyroid cancer.
Velazquez said it is not yet known how the drugs affect people who are not considered overweight or obese, because the drugs were not tested in those patients.
How effective are they?
Velazquez said the main driver of demand is that these drugs are highly effective. “It’s really got attention and interest,” she said. “Providers are more interested in trying it because they can see more change in their patients’ health, there’s more demand because they can see the benefit.”
Dr. Alex Foxman of Achieve Health & Weight Loss, a Beverly Hills medical practice that specializes in weight loss programs, has seen firsthand how effective these drugs can be — because he both prescribes them and uses them himself. Let’s use
He said, “I’m 51 years old. A year ago, I was 190 pounds, which puts me at a body mass index of 27, which is just overweight.” Diet and Exercise. “I got on semaglutide a year ago and I lost 30 pounds in three and a half months.”
“It was probably one of the most impactful and surprising experiences for me as a physician or as a person,” he said. “It reduced my appetite; I felt full faster. It has some side effects, but overall I maintained a healthy schedule, I exercised and I continue to do so and I’ve been able to maintain my weight for seven months now.” I am capable.”
Foxman said because obesity is not just a medical problem, but a vanity problem, people may turn to these drugs in search of a “quick fix.” “It’s not a quick fix,” he said. “These drugs are a tool. And it must be used as a tool along with other programs and services that are medically supervised for it to be successful.”
Velazquez said that as an obesity medicine specialist, she prescribes these drugs “day in and day out.”
Velazquez believes that patients should not “prove” themselves by trying to diet and exercise before being prescribed a weight-loss drug. “Same way if someone came in with diabetes. You’re not going to prove to them that they’re cutting carbohydrates before giving them medication when their sugars are out of control.”
What about patients who are not obese or do not have diabetes?
Foxman said that sometimes doctors, including herself, practice what is known as off-label prescribing.
“Most of the patients who are coming to see us now would not be considered morbidly obese or obese, many of them do not have diabetes. Many of them are either overweight, or trying to keep their weight up to that point. struggling where they should,” Foxman told CBS News.
Foxman said patients who have diabetes will be approved by insurance to receive Ozempic. “But for those who don’t qualify, we have very frank conversations. We explain to them that we will not lie or cheat an insurance company or Medicare about their health, so if they don’t have diabetes, we Prescribe it. And if they’re not approved, they have to spend $1,300 or $1,000 a month for the drug.”
Why is there a shortage of these medicines?
The combination of high demand for these drugs and some doctors prescribing them off-label may have contributed to another rumor: Wealthy patients who don’t qualify for these drugs can still get a prescription and pay out-of-pocket. Are able to do, thus building. Shortage.
Velazquez said she has heard that some doctors are prescribing the drugs to patients who are not eligible but can afford them without insurance.
“Still, I think there are many factors as to why there is such a high demand,” she said. “Although, yes there are some of these people potentially getting it who are not meeting the criteria, it is a minority of patients.”
The same drug company makes Ozempic and Wegovy, but Ozempic is approved for diabetes and helps people lose weight, while Wegovy is a higher dosage, and only approved for weight loss. When the shortage of Vagovi began, providers began prescribing Ozempic, Lofton said.
But besides popularity, according to Velazquez, supply chain issues also contributed to the shortage. “The demands on these exceed expectations any drug maker could have imagined.”
Lofton said obesity affects about 40% of Americans and diabetes affects about 11%. “To say that people with obesity are stealing these drugs from people with diabetes, that’s really not fair,” she said. “Obesity is also a real disease, it gives rise to social issues, medical issues, psychological issues.”
She said people who seek these drugs should do so from a doctor – not a med spa or hair salon, as she heard. “These should be prescribed by a physician who has decided, one, you are a candidate and two, if you have any side effects, you can be treated.”
Still, there are a few things to consider before asking your doctor about a prescription — and doctors to think about before prescribing them.
Foxman said these drugs are very potent and patient use should be monitored by doctors. “The problem is, many doctors don’t understand these drugs and are being pressured by their patients to prescribe these drugs,” he said. “They’re dictating them with respect to putting the proper things on the forms, and I think what you’re going to start to see is a lot of doctors getting reprimanded, losing their licenses and other things, if they’re not Precaution.”
“Patients who think they can just inject themselves and do well are going to fail,” he said. “And you’re going to find a lot of stories of people getting sick if you inject the wrong dose.”