As more South Africans turn to medical interventions for weight loss, semaglutide – originally developed as a type 2 diabetes (T2D) treatment under the brand name Ozempic® – is gaining popularity. But is this so-called wonder drug effective and, more importantly, is it safe for those who do not have diabetes?
Medicines like semaglutide can be a valuable adjunct to lifestyle changes such as diet and exercise, says Dr. Marius Wasserfall, MD, a specialist at Mediclinic.
“These drugs are not silver bullets,” he notes, “but they can help patients struggling with obesity make real progress when combined with healthy habits.”
Obesity is a growing concern worldwide, with predictions that by 2030, half of the world’s population will be overweight or obese. In South Africa, this figure has already been reached, with more than 50% of adults classified as overweight or obese.
Losing weight requires lifestyle changes, not just medication
“The challenge of obesity is complex. It involves not only willpower, but changes in the brain’s appetite regulation and metabolic processes that make long-term weight loss difficult,” says Wasserfall.
“Semiglutide works by targeting this challenge at the root. It affects hunger and satiety hormones in the brain, helping people feel fuller for longer and reducing their appetite.”
Semaglutide, which belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists, was only officially approved in 2017 for the treatment of T2D. However, during the clinical trial, a secondary effect was revealed – patients experienced significant. lose weight
This discovery led to semaglutide being prescribed off-label for weight management, although it is not approved for this purpose by the South African Health Products Regulatory Authority (Sapra). It remains a prescribed product and can only be sold by a pharmacy with a valid prescription from a doctor.
In 2021, the US Food and Drug Administration (FDA) approved a high dose of Semaglutide, marketed as Wegovy®, specifically for long-term weight management in individuals with obesity or related health conditions. . Since then, demand for semaglutide has skyrocketed, driven by popular celebrity endorsements and widespread attention on social media platforms.
Risks of using Ozympic and similar products for weight loss
While studies show that Semaglutide users may experience 15% weight loss, experts warn of potential risks when it is used without medical supervision or for unapproved purposes.
“Side effects include nausea, vomiting, and diarrhea, and long-term safety for non-diabetic users is unclear,” warns Wasserfall.
“While serious adverse effects are rare, they include acute inflammation of the pancreas and gall bladder problems. Some studies involving rats have found that the drug caused medullary thyroid cancer.” .
Additionally, there are growing concerns about counterfeit semaglutide entering the market. “The high demand for the drug, especially for off-label use, has exceeded expectations and created opportunities for illegal manufacturers to supply counterfeit products,” says Wasserfall.
“When you buy from an unlicensed manufacturer, there is no guarantee of quality. The product may not contain active ingredients or worse, it may contain harmful ingredients.
The FDA and Sahpra have warned about the dangers of counterfeit prescriptions of this drug.
Continued use of Semaglutide for weight loss
Despite its effectiveness, there are also concerns about the long-term sustainability of weight loss achieved through Semaglutide.
Wasserfall emphasizes that it’s a lifelong treatment: “Discontinuing the medication is likely to result in most of the weight being regained.” Studies reverse this, showing that patients regain most of their weight after stopping semaglutide or similar GLP-1 receptor agonists.
The reason for this is how this medicine works. Semaglutide improves the brain’s appetite regulation and changes the body’s biology. However, Wasserfall points out that ‘once you stop using it, your brain biology goes back to its original state, and you will likely gain the weight back’.
Ability, therefore, is a big factor, says Wasserfall. “These drugs are expensive, and most medical schemes will not cover them for weight management, only for diabetes.”
This makes it imperative for individuals considering semaglutide or similar drugs to carefully weigh the costs and recognize the commitment required to maintain results.
Availability of medications for diabetics is stressful
“Availability is another concern,” he adds. As demand grows among those seeking weight loss, drug shortages make it difficult for diabetics who rely on semaglutide to manage their condition to access the drug. This has led to calls for more careful and stricter regulations to ensure that drugs remain accessible to those who need them.
Semaglutide’s popularity as a quick-fix solution to weight loss highlights a broader social issue – the pressure to conform to ideal body standards. Health care professionals emphasize that any weight loss treatment should be done with caution and always in consultation with a medical professional. Medications like Semaglutide are only one part of the puzzle and weight management remains a multifaceted issue that requires long-term lifestyle changes to achieve and maintain results.
While GLP-1 receptor agonists show promising results for weight loss, Wasserfall believes the focus should shift to prevention.
“We need to prioritize obesity prevention, especially among our youth, to reduce our reliance on expensive, life-threatening drugs like semaglutide. Encouraging healthy habits is critical. Ultimately, it comes down to: You will either suffer the pain of self-discipline or the pain of regret – the choice is yours,” he says.
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