Ahead, doctors break down everything you need to know about taking Ozempic and Wegovy for the treatment of chronic conditions—as well as who qualifies, what’s causing the shortage, side effects, and more.
What is Ozempic?
Ozempic is actually a brand-name for semaglutide, which is FDA-approved for the treatment of type 2 diabetes. Semaglutide is also available under the brand name Wegovy, which is FDA-approved for obesity, and in pill form as Rybelsus, which is intended for type 2 diabetes.
Semaglutide is a GLP-1 agonist, which means it mimics GLP-1, a hormone the body produces that releases insulin and reduces appetite after eating food. “But semaglutide has a much longer half-life than our natural GLP-1, meaning it lasts longer in our system,” Dr. Nadolsky explains. Translation? It makes you feel full for longer.
“Medications that enhance the activity of the GLP-1 hormone cause you to feel satisfied—less hungry—more often, which typically leads to decreased food intake,” says Jessica Cutler, MD, a weight-loss surgeon at the Maryland Bariatric Center at Mercy in Baltimore. That is how the drug causes people to lose weight: via appetite control in the brain.
Semaglutide has more straightforward health benefits too. “These medicines help lower blood sugars—only if they are elevatedm not when they are normal—by helping our pancreas release more insulin, which lowers blood sugars, and decreasing glucagon, a hormone that increases blood sugars, along with slowing down our gastric emptying, which slows down our GI tract,” Dr. Nadolsky says. Ozempic and Wegovy are taken via a once-weekly injection in either the thigh or stomach.
Who is qualified to take Ozempic?
According to Heather Martin, DO, family physician and medical director of the primacy care program at K Health, most prescribers have very strict criteria when it comes to prescribing these drugs.
“Patients must have a BMI over 30, or a BMI over 27 with one weight-associated condition like hypertension or type 2 diabetes, and must have been unable to lose and keep off weight with lifestyle changes alone like diet and exercise,” she says. “We also do a full intake which includes blood tests to ensure you’re a good fit.”
What’s causing the Ozempic shortage?
“Unfortunately, manufacturers sometimes make mistakes and sometimes can’t keep up with demand,” Dr. Nadolsky says. Dr. Cutler agrees: “We have seen a lot of supply-chain issues which have limited the availability of these medications. I wish we lived in a world where every person who could benefit from a medication would have the choice to take it.”
What about compounded semaglutide?
Some people are turning to compounding pharmacies (which can mix specific formulations in-house) for compounded semaglutide, as this route doesn’t contribute to the shortage or take resurces away from patients who need them. However, Dr. Nadolsky notes that while compounded drugs do require a prescription, they are technically not FDA-approved.
“I highly recommend against compounded GLP-1 agonists as I cannot attest to the quality and efficacy of them,” he says. “If one is using a GLP-1 agonist for vanity weight loss, then they are already using it for an off-label reason. The compounded versions would add an extra element of unstudied territory.”
How many GLP-1 medications are there, and how do they differ from one another?
There are at least eight GLP-1 medications that are FDA-approved, the newest of which are semaglutide as Rybelsus and Wegovy, and tirzepatide, otherwise known as Mounjaro. “Mounjaro is a new medication which also works to enhance the activity of GLP-1, but also another molecule known as GIP, or gastric inhibitory polypeptide,” Dr. Cutler explains. Like GLP-1, GIP stimulates the release of insulin. “Put together, augmentation of both these molecules seems to produce a very strong effect on appetite suppression,” she says. Mounjaro has also been given an FDA “fast track” approval process, meaning it’s likely to be approved for obesity in 2023.