December 9, 2023

Ozempic, a diabetes medication turned off-label obesity drug, has enjoyed a meteoric rise in popularity, sparking unprecedented demand across the globe.

Ozempic is the brand name of an injectable form of the drug semaglutide that stimulates insulin secretion when blood sugar is high. It imitates the hormone GLP-1 that also lowers glucagon secretion in the liver and slows the rate food leaves the stomach. As a result, patients tend to eat less and feel full longer, mimicking the effects of bariatric surgery.

Wegovy, developed by Danish health-care company Novo Nordisk, is also semaglutide but at a higher dosage. Health Canada has approved the higher dose semaglutide as a treatment for obesity, but many physicians have been prescribing Ozempic off-label in its place due to Wegovy’s ongoing supply issues and lack of availability in Canada.

This new class of drugs are much more effective than previously existing obesity medications. A landmark clinical trial published in 2021 found that the drug led to a 15 per cent reduction in body weight on average.

Many researchers, advertisers and people on social media have hyped Ozempic as a “miracle drug” for its effectiveness in aiding weight loss. Some, like Weight Watchers CEO Sima Sistani, have even gone as far as to say that drugs like Ozempic could mark “the end of diet culture.”

Ozempic’s popularity has led to shortages of the drug in countries like the United States, causing concern among those who rely on it to manage diabetes. In June, Health Canada stated that “while shortages have been reported in some countries, supply is meeting current demand in Canada.”

Despite the drug’s widespread popularity, critics have expressed their reservations. Semaglutide does have side effects, notably nausea and diarrhea but also more serious side effects like low blood sugar and kidney failure.

Ozempic is also not a cure. Patients who stop taking it can regain some or all of the  weight they lost. There is also the issue of affordability: Ozempic isn’t cheap. Although less expensive than in many other countries, in Canada Ozempic costs about $200 to $300 per month.

But questions around Ozempic’s rise to mainstream popularity extend beyond the drug’s medical impacts.

Obesity in our society is incredibly stigmatized and biases likewise exist within the medical system. Although obesity is correlated with several comorbidities such as heart disease and diabetes, critics highlight the complexity of using weight to define concepts like “health,” as well as the fallibility of metrics like Body Mass Index (BMI).

Further, when a drug is in high demand and has proven to be as relatively safe and effective as Ozempic, what role do physicians have to play as gatekeepers? What responsibility do doctors have in determining who should and should not be able to access it? And how might prescribers’ own biases around weight influence their willingness to prescribe these medications?

We asked a panel of experts what are the most important factors to consider when prescribing Ozempic for weight loss.



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