“I started Ozempic six weeks ago”, says an American tiktoker in a video viewed nearly 100,000 times. In leggings and a sports bra, the young woman, visibly much thinner than in her “before” photos, continues: “I didn’t do any exercise, I just injected myself!”.
Ozempic, miracle cure? This injectable product is actually indicated for “the treatment of poorly controlled type 2 diabetes” in adults, specifies the Novo Nordisk laboratory, which has been marketing it in France since 2019.
Semaglutide, its active ingredient, acts by attaching itself to the receptors of a hormone which has a role in the control of blood sugar and stimulates the release of insulin when the level of glucose in the blood is high.
It also slows the emptying of the stomach, thereby reducing appetite and causing significant weight loss, around 10% in one year. A property that has enabled the manufacturer to obtain the marketing of semaglutide in many countries, including the United States, at a higher dose and under another name, Wegovy, for the treatment of obesity.
“Falsified prescriptions”
In France, Wegovy received a favorable opinion from the High Authority for Health (HAS) in the treatment of obesity at the end of December. It is currently limited to very obese people with an associated disease.
Pending a decision from the authorities on its price and reimbursement, Wegovy is delivered in dribs and drabs, “unlike Ozempic which is available with a normal prescription”notes Professor Jean-Luc Faillie, from the University of Montpellier.
Result: “pharmacists have seen prescriptions” of Ozempic for non-diabetics as well as “false prescriptions, used by several people”.
The National Medicines Agency (ANSM) called doctors to order, asking them to strictly respect the indication of diabetes for the prescription. The ANSM does not observe any “particular peak or sudden increase in consumption in recent months”but Ozempic experienced “supply tensions” due to increased global demand.
Novo Nordisk admits that “current supply capacity does not always meet this excess demand”lamenting “intermittent availability and periodic stock-outs”.
Jean-François Thébaut, of the Diabetic Federation, is worried about a possible “rush” of the French on Wegovy when it is on the national market, especially since semaglutide is “extremely effective” against diabetes.
Obesity specialist Karine Clément, from Inserm, insists on the need, when Wegovy becomes available, to “fit your prescription well”. “It is not a ‘magic’ drug. As always in obesity, it must be accompanied by comprehensive care”.
Side effects
Doctors are also concerned about the side effects of semaglutide, “underreported” according to Professor Faillie, in charge of its pharmacovigilance. “This is the ‘outside the box’ problem: neither patients nor prescribers are motivated to report” possible side effects.
Besides nausea, “there are also rarer but more serious risks such as acute pancreatitis, which can occur even at low doses, biliary disorders, rare cases of severe constipation which can lead to intestinal obstruction”he notes, also pointing to a “increased risk of thyroid cancer” after several years of treatment.
Are we risking a new health scandal like that of the Mediator? “We have more perspective on this pharmacological class”, reassures Professor Faillie. However, if the risks of semaglutide are “mastered” in view of the benefits in diabetes, “there are always uncertainties, especially in obese patients over the long term”.
“If we use it to lose a few pounds, there the therapeutic benefit is nil, it’s just aesthetics while the risks are always present”he warns.