At the 2022 Met Gala, Kim Kardashian dazzled in Marylin Monroe's iconic dress that the late actress and singer famously wore to wish then-president John F. Kennedy a happy birthday in 1962. The dress, which was several sizes too small for Kim, took some work to fit into.
On the red carpet, Kim said she had been eating clean, using “sauna suits” and had taken up running to fit into the dress. At the back, it had not been zipped up all the way. Rumours began flying that Kim had also used another method to help her lose over 7kg in a month - a type-2 diabetes drug called Ozempic.
What is Ozempic?
Ozempic, made up of the drug semaglutide, is an injectable medication for type-2 diabetes patients, developed by Danish medicine giant Novo Nordisk. The drug mimics human glucagon-like peptide 1 (GLP-1), a hormone that regulates appetite. Most importantly, it helps insulin-resistant patients by prodding the body to produce insulin when eating and lowering blood sugar levels.
The drug is not new and has been used for decades. But since Kim’s rumoured use made headlines, Ozempic and its sister drug, similar-acting Wegovy, have been in heavy demand in Hollywood and beyond, helping overweight people and A-list celebrities lose weight. That is because the drug, administered via weekly injections at home, can create a sense of fullness in the stomach and prevent overeating.
Depending on how much is taken, people report losing a lot of weight within months. But with its overwhelming demand came critical shortages.
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High demand
In South Africa, where the burden of diabetes is almost as deadly as TB, Ozempic shortages have affected many.
While the drug can only be given to patients by a registered doctor, they’re also able to prescribe it “off-label”, a designation for patients who are not diabetic but rather overweight.
“If you are obese, with a BMI over 30 and have high cholesterol levels, you’re not yet diabetic but you are having increased fasting glucose... that’s where Ozempic works amazingly well,” says Nicola Mostert, a registered dietician at 4 Life Living Dieticians.
However, the South African Health Products Regulatory Authority will not have reviewed the efficacy of this drug for the use of treating obesity, since its designation is for diabetes treatment. For Dr Niel du Plooy, a specialist physician who works in the diabetes and obesity space, Ozempic should not be prescribed immediately.
“Prescribing a GLP-1 RA (Ozempic), or any other medication for obesity, should not be a knee-jerk reaction,” he says.
“One must appraise your patient holistically, screen for associated comorbid diseases, explore their diet and exercise, explore their feelings towards their obesity, ask about the stigma they may experience and discuss treatment outcomes and goals.”
For obese and overweight patients, the drug will have to be paid in cash since Ozempic is not on the list of Prescribed Minimum Benefits for obesity, but rather for diabetes. It costs anywhere from R1 200 to R1 500, with each pen lasting around one month.
Mostert prescribes her patients Ozempic for three months, coupling the treatment with diet and lifestyle changes to maintain results. The results speak for themselves, with most patients losing between 10 percent to 15 percent of their body fat, says Mostert.
The results
One scroll through TikTok reveals stunning weight loss progress using Ozempic, and reported side-effects.
One noticeable knock-on effect is nausea, which many users report after taking injections. Others report gastric problems such as constipation or diarrhoea, loss of facial volume (called Ozempic face) and even a negative change in taste and smell.
Mostert says these side-effects are short-lived and usually go away on their own or with a dosage adjustment. Additionally, one important caveat to consider about Ozempic is that once you’re off it, the weight comes back.
In one study, participants without diabetes, but who were overweight, were given the drug for 20 weeks. Then, half of them were given a placebo for 48 weeks and also undertook lifestyle changes. After the 48 weeks, participants on placebos gained two thirds of the weight back, despite lifestyle interventions.
“If you’re in the three-month trial period [of using Ozempic], then whatever lifestyle adjustments you’re going to make with regards to diet as well as exercise, you want to make sure that you’re going to be able to continue with those adjustments even after you’ve stopped the medication,” says Mostert.
“People regain the weight if they haven’t done any efforts to adjust their lifestyles and become healthier versions of what they were before they initialised the drug.”
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Is it safe to use?
The drug has been around for decades and is deemed safe for use in the long term, with diabetics relying on it as a life-saving treatment.
“Lifestyle modification is key,” says Mostert. “But it’s just there to help. Metabolically, it makes sure that your body releases just the right amount of insulin together with what you’re eating. The unfortunate part is the cost; there are better ways to spend your money if you want to lose weight, by investing in good, healthy food as well as making sure that you move about. This is just an aid.”
To that end, Dr Du Plooy agrees.
“I am not too worried about the side-effects, but rather that it is considered the alpha and omega of weight loss. It is merely a single tool in an extensive and highly individualised toolbox.”
Celebrities rumoured to be on Ozempic
