Obesity affects 8 million people in France. It can be associated with an increased risk of diseases: diabetes, high blood pressure, heart disease, strokes, certain types of cancer.
In consultations with my patients, as a dietitian, I notice that traditional approaches to weight loss, such as diet and physical exercise, are sometimes difficult to follow in the long term.
Some people turn to bariatric surgery, which alters the anatomy of the digestive system. For others, the weight-loss process remains very complicated and leads to frustration, psychological disorders, and metabolic diseases.
Developed originally to treat diabetes, the drug Ozempic is making headlines today. Indeed, more and more people are using it to lose weight.
With the success of Ozempic, especially on social media, its original manufacturer developed Wegovy. This new drug uses the same molecule, but this time it is intended for people with obesity.
These drugs remain controversial for their use in weight loss. The National Agency for the Safety of Medicines specifies that Ozempic should be used only in the treatment of diabetes.
Also read | Criteria for choosing the best fat burner according to a pharmacist
What are Ozempic and Wegovy?
Ozempic and Wegovy are two drugs approved by the Food and Drug Administration and the European Medicines Agency for the treatment of obesity in adults.
Both contain the same active ingredient, semaglutide. This hormone acts on GLP-1 receptors in the brain to reduce appetite and increase the feeling of satiety.
They therefore have an appetite-suppressing effect. And it is this effect that their consumers are looking for in the context of weight loss.
Marketed from 2018, Ozempic was developed by the Danish pharmaceutical company Novo Nordisk for the treatment of type II diabetes. Indeed, semaglutide has significant effects on glycemic control and body weight regulation.
Seeing the beneficial effects on weight loss, the company developed another drug. Wegovy, with a higher dose of semaglutide, to target people with obesity.
Ozempic and Wegovy are administered in the same way, as weekly injections.
How effective are they for weight loss?
Miracle drug or marketing effect? The stakes are enormous for this type of medication. The market availability of weight-loss medications is highly anticipated by obese patients.
According to clinical trials, Ozempic and Wegovy have shown significant effectiveness in weight loss among obese or overweight patients.
These lose on average between 10% and 15% of their initial weight after 6 months of treatment with Ozempic or Wegovy.
These medications have notably shown promising results for those who have difficulty losing weight with a diet and exercise.
Indeed, according to this study conducted on adolescents, reductions in body weight and improvements in cardiometabolic risk factors, such as waist circumference and levels of glycated hemoglobin and lipids, were greater with semaglutide-based medications than with placebo.
After one year, 72% of adolescents had lost at least 5% of their weight.
According to studies, the weight loss is real. But I must point out that the conditions under which the medication was taken are not always clear. Was the patient dieting at the same time? Did they change their diet?
Semaglutide is not a miracle solution for weight loss. Its use must be accompanied by healthy lifestyle changes to achieve long-term results.
Dangers and side effects of these appetite-suppressant medications
Like any medication, Ozempic and Wegovy can pose a danger for some people and can cause side effects. The most common are nausea, vomiting, diarrhea, and headaches.
There are concerns about the effect of semaglutide on the pancreas, which may lead to pancreatitis. Other side effects have been observed regarding the risk of biliary disease such as cholelithiasis.
In addition, semaglutide can also affect blood sugar and blood pressure. Patients with diabetes or high blood pressure should discuss this with their doctor before taking these medications.
Pregnant or breastfeeding women should not take it.
Although these side effects are rare, it is essential that patients monitor their symptoms.
A trend in the United States, many people who are overweight or obese are buying this drug. In France, between October 2021 and September 2022, 600,000 patients took a medicine containing the molecule semaglutide and 215,000 patients received Ozempic as part of their diabetes treatment.
Of these 600,000 people, the AMS estimates potential misuse of Ozempic at 1%, with use other than for diabetes.
The risk of pharmacy stock shortages may be expected depending on the craze in France. This would be harmful for diabetic patients who take Ozempic and who may not be able to find their treatment in the months to come.
Medical monitoring required
Do you want to try Wegovy for weight loss? To begin with, I recommend making an appointment with your primary care doctor to have a comprehensive health evaluation. Discuss the side effects, risks, and benefits of the treatment with your doctor.
To access Wegovy, your doctor will need to submit your file either to a physician-nutritionist who specializes in obesity and works in partnership with the other professionals involved in obesity, or to a specialized obesity center (CSO).
My opinion on Ozempic and Wegovy in the context of weight loss
Ozempic is a medication to treat diabetes, so in my view, and as the ANSM has just confirmed, it must under no circumstances be used for weight loss.
Regarding Wegovy, developed for this specific purpose, certain conditions must be applied to request its use.
According to the HAS (French National Authority for Health), the patient must have an initial body mass index (BMI) ≥ 35 kg/m² and be under 65 years of age. This medication can be prescribed if nutritional management has been properly followed but has failed (< 5% weight loss at six months).
As a dietitian, I would approach taking this medication with great caution. Indeed, we do not yet know the long-term effects. What about a possible regain of lost kilos? Will the weight be maintained once the injections are stopped?
Wegovy must be used within a very specific framework, with multidisciplinary follow-up around the patient: nutrition, exercise, psychology.
