Semaglutide: The “Miracle” Weight Loss Drug That’s Not Without Risks

　　Recently, Novo Nordisk’s new indication application for a drug was accepted by the State Food and Drug Administration, which has aroused widespread concern.
　　As a multinational pharmaceutical giant, it is not uncommon for Novo Nordisk to apply for new indications for drugs. Why is there such a strong response this time? In the final analysis, it is still this drug named Ozempic or Wegovy-it is almost unknown in Europe and the United States, so that in China, many people have also heard of its “miraculous effect” on weight loss.
　　The main ingredient of this drug is “semaglutide”, which is currently suitable for the treatment of diabetes in China. In Europe and the United States, semaglutide is often regarded as a “magic drug for weight loss”, known as “no diet, no exercise, no pain, just an injection to lose weight”.
　　In August last year, Musk, who successfully lost weight, even appeared on social media to recommend Wegovy, which attracted countless people to follow suit.

　　Ironically, when the number of views of videos with the hashtag #Ozempic exceeds 600 million on the short video platform, people with diabetes are anxious like ants on a hot pot because they cannot buy medicine. More and more people who are not within the scope of semaglutide indications are scrambling to buy it. The US Food and Drug Administration (FDA) once included Ozempic and Wegovy among dozens of drugs in short supply.
　　Everyone has a desire for beauty, and it is understandable to want to pursue the so-called “perfect body”, but it is ridiculous to want to be thin without moving, and to rely on drugs to achieve this effect. All medicines have their own indications. With the current level of human science and technology, there is no “magic medicine” for weight loss that does not have any side effects and is suitable for everyone.

　　Semaglutide is a long-acting glucagon-like peptide-1 receptor agonist (GLP-1). This “GLP-1 class” of drugs is currently one of the most popular drugs in the field of diabetes treatment.
　　GLP-1 is a hormone naturally produced in the gut. After eating, GLP-1 will enhance insulin secretion and inhibit glucagon secretion, resulting in the effect of lowering blood sugar and suppressing appetite.

　　Semaglutide produced the strongest weight loss intervention other than gastrectomy.

　　As early as 2005, Exenatide, the first GLP-1 drug, was approved by the FDA for the treatment of type 2 diabetes; Laglutide”, but limited to technology, both drugs need to be injected twice a day.
　　The real change came in 2017 when Novo Nordisk launched Ozempic, a semaglutide injection, which extended the half-life of the drug to 7 days, and patients only needed to inject it once a week. In 2019, Rybelsus, an oral semaglutide tablet, was approved for marketing. These two items were originally technological advancements that greatly facilitated patients, and also paved the way for its future popularity.
　　In February 2021, the Northwestern University team published a study on the weight loss effect of semaglutide in the top medical journal “New England Journal of Medicine”. Researchers recruited more than 1,900 overweight/obese adults without diabetes at 129 sites in 16 countries in Asia, Europe, and the Americas.
　　After 68 weeks of treatment, under the same intervention, the average body weight of the treatment group injected with 2.4 mg semaglutide per week decreased by 14.9%, and more than one-third of the people lost more than 20%, with an average weight loss of 15.3kg, far exceeding the drug trial qualification standard of 5% weight loss for weight loss drugs; while the average weight of the control group injected with placebo only decreased by 2.4%, and the average weight decreased by 2.6kg, the difference between the two is significant.
　　Perhaps thanks to this, in June of the same year, the FDA approved another semaglutide injection, Wegovy, for obesity or overweight, and at least one weight-related adult patient for long-term weight management. This is also the first FDA-approved drug for long-term weight management in generally obese or overweight adults since 2014. 　　A person from the FDA Drug Evaluation and Research Center said: ” Semaglutide provides　a beneficial new treatment option for this population.”
, the strongest weight loss intervention effect, can be called a “paradigm shift” for weight loss. In an interview with The Washington Post, some researchers even praised the efficacy of semaglutide as “enough to change the rules of the (weight loss) game”.

　　With the endorsement of FDA and top scientists, semaglutide immediately caused a storm of influence in Europe and the United States. During the prime time of major TV stations in the United States, the brainwashing commercial song “oh oh oh Ozempic” left a deep impression on the audience.
　　Last year, when Elon Musk shared his experience of successfully losing 20 pounds (about 9kg), in addition to regular fasting, he also mentioned that he was using Wegovy. This intentional or unintentional “endorsement” behavior continued to promote the popularity of semaglutide. Since then, bloggers from all walks of life have become more and more keen to check in and share their experience and effects of using semaglutide for weight loss, and they all exclaim in unison “Miracle”.
star secret

　　At this year’s 95th Academy Awards ceremony, the host Jimmy Kimmel spoke out in a teasing tone the unspoken secrets of Hollywood stars-many of them are using Ozempic to lose weight. With the growing celebrity push, people seem to forget that semaglutide is also a diabetes drug.
　　After the explosion of semaglutide, diabetic patients who need the drug are at risk of drug shortages, and some of them have had to reduce their doses or switch to other drugs.

　　”Daily Mail” quoted data from third-party companies as saying that 5 million prescriptions for semaglutide were issued in the United States last year, but only 230,000 prescriptions were issued in 2019, an increase of more than 2,000% in just a few years.
　　Since April last year, the FDA has included semaglutide in the drug shortage list, and as of May this year, the drug is still on the list. According to the European Medicines Agency (EMA), semaglutide will face a long-term shortage, and it is not expected that this situation will be alleviated within this year.
　　Under such a situation, many unqualified merchants began to think wrongly, and there was a “black market” in the United States for reselling semaglutide or selling so-called “generic drugs” of semaglutide.
　　The FDA has nothing to do about it, and can only issue a warning to patients not to use the non-branded version of semaglutide. According to relevant FDA officials, the so-called semaglutide sold online for “for laboratory research” or self-prepared by pharmacies has not been approved, and its drug safety and effectiveness cannot be guaranteed.
Be wary of the Ozempic face

　　Objectively speaking, compared with traditional weight-loss drugs, semaglutide is indeed superior, but in this wave of spontaneous amrismeglutide, its side effects and adaptability are often overlooked.
　　The first is the applicable crowd. The World Health Organization recommends the use of body mass index (BMI) to measure the degree of obesity in a population. Judging from the general practice of multinational agencies including the FDA, generally only patients with BMI ≥ 27 and accompanied by high blood pressure, high cholesterol, heart disease, etc., will be allowed to use drugs for intervention, and if there is no accompanying disease, they need to use drugs to intervene. BMI≥30.

　　The vast majority of people who clamor to lose weight in their lives are far from meeting this standard.

　　According to the “Report on the Status of Nutrition and Chronic Diseases of Chinese Residents (2020)”, the average height of men and women aged 18-44 is 169.7 cm and 158 cm, respectively. This means that people of average height can only reach the threshold for using weight loss drugs when they are ≥86.4kg for men and ≥74.9kg for women without disease. From the actual observation, the vast majority of people who clamor to lose weight in their lives are far from meeting this standard.
　　In terms of side effects, the aforementioned study published in the New England Journal of Medicine showed that the most common adverse reactions were nausea and diarrhea. In other studies, there have also been reports of severe headaches, acute kidney injury, etc., so it is not recommended for patients with gastrointestinal problems.

　　In an April report, the EMA noted that studies in rodents suggest that tesiparatide, another GLP-1 drug, may increase the risk of thyroid cancer. UK health chiefs have called for studies to monitor any potential link between the drugs and cancers of the thyroid and pancreas.
　　”Daily Mail” expressed concern about this, Wegovy’s clinical trials have only been carried out for 16 months, which means that this significant long-term side effect may have been ignored.
　　For most weight loss methods, rebound is a severe test that has to be faced. In April, a University of Liverpool study found that patients using Wegovy lost 18% of their body weight over 68 weeks. But after giving up the weekly injections, the 336 participants in the trial gained two-thirds of their body weight the following year.
　　In addition, rapid weight loss can also lead to obvious physiological changes such as hair loss and emaciation. Weight loss will reduce facial fat, and it will not look as “full” as when you are heavier. Once you lose weight too fast, the face will not be able to keep up with the progress of weight changes, and the ability to adapt and adjust will be worse, resulting in a “facial sunken” feeling will become more obvious.
　　This kind of facial expression with sunken face and obvious wrinkles, which is more serious than “thin and out of shape”, is also dubbed “Ozempic face” by American netizens.
　　Zhaoping Li, professor of medicine and chair of the Department of Clinical Nutrition at UCLA, said in an interview with The Washington Post that semaglutide is not effective for everyone, “These new drugs are important tools in the doctor’s ‘toolbox’ , but not a panacea.”
　　There is no “magic bullet” in this world, and the same is true for weight loss. At present, semaglutide has not been allowed to be used as a weight-loss drug in China. Only one drug, orlistat, has been approved in China for the treatment of obesity or overweight. Butt leaking oil” was complained about.
　　When fantasizing that you can “ly lie thin” by relying on drugs, don’t forget Zweig’s famous saying that all the gifts given by fate have their prices secretly marked. Those who are completely out of the scope of semaglutide but want to rely on it to lose weight, may wish to ask themselves first, insert a needle into their abdomen once a week, after weight loss, bald, sunken face, loose skin, this is really what you want of it?