Over the past year, Ozempic has secured its place as a household name and frequent topic of conversation, an impressive feat for a drug originally created to treat those with type 2 diabetes. Since the discovery of the drug’s ability to mimic the feeling of fullness and reduce appetite, Ozempic has become known as a weight-loss drug frequently used by Hollywood’s elite, despite never having been approved for use purely to treat obesity. Attitudes towards Ozempic seen in the media vary wildly; some criticise its use by non-diabetics, some say that it has damaged the body-positivity movement, and others are critical of the drug’s politicisation in the first place. Students at the University of Exeter share this range of opinions on the drug. When surveyed, some students described the drug as ‘horrific’, while others described it as ‘game changing’. Some expressed a wish to try Ozempic and others said they had not heard of the drug beyond celebrity usage. As pharmaceutical companies race to patent new and innovative anti-obesity drugs, there has never been a more important time to discuss the history and impact of Ozempic.
When surveyed, some students described the drug as ‘horrific’, while others described it as ‘game changing’. Some expressed a wish to try Ozempic and others said they had not heard of the drug beyond celebrity usage.
In 2008, the Danish pharmaceutical company Novo Nordisk launched a stage II clinical trial investigating the safety and efficacy of semaglutide to treat type 2 diabetes. Semaglutide binds to GLP-1 receptors found in the pancreas and works to regulate insulin secretion and appetite. Following its success in early-stage trials, the drug Ozempic was manufactured as a once-weekly treatment for diabetes and gained approval for use in the USA and Canada in December 2017 and January 2018 respectively. The EU approved the drug one month later. In 2021, a clinical trial was run investigating the drug’s potential as an anti-obesity drug, and the drug Wegovy, also produced by Novo Nordisk, was approved for weight loss later that year. Thus, a new generation of weight-loss drugs was born. Novo Nordisk’s market cap currently stands at $528.76 billion, making it the world’s 14th most valuable company.
Despite being frequently referred to as a weight loss drug, Ozempic is not currently approved as a treatment to manage weight, only the drug Wegovy is; Wegovy contains a larger dose of semaglutide than Ozempic. So why has Ozempic gained a name as a ‘skinny jab’ while Wegovy is often mentioned second? Weight loss was always a side effect of Ozempic, it was just not the primary target of the drug. Once the drug’s ability to make you ‘forget to eat’ became common knowledge, doctors say they had patients requesting a prescription purely for the weight-loss side effect, which is legal. It may also be due to the availability of the drugs; Ozempic is typically covered by American health insurance while Wegovy is not, which could explain why Ozempic is more well known. In the UK, Ozempic is usually available via the NHS and through private providers for type 2 diabetes, when shortages don’t affect availability. The same is true for Wegovy, which is available to treat obesity.
So why has Ozempic gained a name as a ‘skinny jab’ while Wegovy is often mentioned second?
One impact of the popularity of Ozempic and Wegovy has been worldwide shortages. In December 2023, the European Medicines Agency released a statement predicting worsened shortages throughout 2024 due to increased demand. In September 2023, the Australian Therapeutic Goods Association advised prescribers to not issue any new patients with Ozempic prescriptions and to try and offer alternative prescriptions for current users. The consequences of shortages can be life-threatening for diabetics; complications from high blood sugar can lead to periods of hospitalisation, and some blame the shortages on semaglutide’s popularity among those wanting, but not medically needing, to lose weight. Earlier this year, Novo Nordisk announced the acquisition of New Jersey-based drug company Catalent in order to expand Wegovy production, but it is unknown if this expansion can meet the demands for Ozempic and Wegovy. Shortages aren’t the only danger associated with Ozempic demand: fake Ozempic jabs have been identified for sale in the UK, and the internet has flooded with horror stories of those hospitalised after taking unlicensed semaglutide.
As with many novel drugs, alleged side effects and adverse effects are coming to light; as of February 2023, there are 13 lawsuits consisting of 55 cases in the USA over side effects caused by Ozempic. The headline side effect outlined by the plaintiffs is gastroparesis, a condition in which the nerves and muscle in the wall of the stomach weaken, causing intestinal blockages or disruption. As the condition can’t be cured, only managed, plaintiffs are facing a lifetime of medical management, and therefore medical bills. Other alleged side effects include links to suicidal ideation and gallbladder disease. Novo Nordisk released a response restating the side effects listed on Ozempic’s warning packages, and stating that gastrointestinal side effects were mild at low dosages. The lawsuits are further complicated by counterfeit Ozempic pens, as plaintiffs will have to prove they were using genuine Ozempic.
Although predominantly taken by older generations, Ozempic is also familiar to the student population, although primarily as a social phenomenon rather than as a medical intervention. When surveyed, 67% of the University of Exeter students say they first became familiar with Ozempic through social media, compared to only 17% who say they first learned about it through news outlets. No students reported first hearing about Ozempic in a medical setting. This is not surprising, as social media has given Ozempic a life of its own, coining terms such as ‘Ozempic face’ to describe the look of celebrities rumoured to have taken the drug.
Student opinions regarding Ozempic are also deeply polarised; some see the drug as beneficial for public health. A second-year Economics student described Ozempic as ‘a game changing drug that has the ability to alleviate the high personal and societal costs of obesity and other related illnesses. A third-year Economics student had a similar positive attitude to the drug, ‘as the costs of obesity are probably greater than the medication’. Others were critical of the use of the drug to lose weight, describing it as ‘cheating weight loss.’
‘It’s setting a dangerous precedent and highly unrealistic body standards.’
Some students expressed concern over the implications for body image and the potential for misuse of the drug. One third-year English student commented that ‘I think it is quite dangerous that it is being used to increase weight loss. It promotes very unrealistic body image’. A third-year Medical Science student described Ozempic as ‘a great drug for those who need it if they are type 2 diabetic and pre-type 2 diabetic’, but criticised its off-label uses ‘as it increases the body dysmorphia of young people through seeing celebrities use it for impossible natural beauty standards’. Another student worried that ‘it’s setting a dangerous precedent and highly unrealistic body standards.’
Some also expressed concern over the potential misuse of a drug intended for diabetics being used by non-diabetics to lose weight. A second-year history student commented ‘I think it’s horrific that a diabetes medication is being used as a weight loss injection. It’s just taking resources away from people that need it.’ Others were critical of the pharmacological method of treating obesity as a whole, arguing that ‘there needs to be a shift in mindset from looking at obese individuals as standalone medical cases and instead focus efforts on whole system approaches to preventing obesity.’ The concern expressed by some students was not shared by all, with two students admitting that they would not be against trying Ozempic.
‘I think it’s horrific that a diabetes medication is being used as a weight loss injection. It’s just taking resources away from people that need it.’
Weight loss drugs similar to Ozempic are rapidly being developed by pharmaceutical companies across the world. In January 2024, Eli Lilly’s new weight loss injection Mounjaro was approved to treat type 2 diabetes in the UK and is likely to be approved to treat obesity in the near future. The drug’s active ingredient, tirzepatide, works similarly to semaglutide through binding to GLP-1 receptors, with additional binding action to GIP receptors which also aids insulin production. The drug will soon be available for purchase in the UK, and is hoped to reduce the impact of Wegovy shortages. Amgen, a California-based biotech company, recently found success in clinical trials with their new weight-loss drug MariTide, a monoclonal antibody-based therapeutic which would only have to be taken once a month.
The sudden rush from pharmaceutical companies to design the next block-buster weight loss drug indicates the growing profitability of treating lifestyle-related illnesses as we live longer lives with unhealthy lifestyles. The range of attitudes towards Ozempic shown by Exeter students is reflective of the discourse within wider society; to some, Ozempic is a step towards treating growing global health issues, while to others the drug highlights the stigma towards obesity and the long-standing pressure to be thin. Despite the controversy, the demand for the drug is staggering, with 1.7% of Americans prescribed a semaglutide medication in 2023. As this demand is only expected to grow, the issues of drug shortages, potential life-changing side effects, and misuse associated with the drug will likely grow too.
