Ozempic: Decoding the buzz behind the new weight loss treatment

Navigating weight loss has become increasingly complex as a myriad of quick fixes emerge. Pills promising miraculous results flood the market, offering tempting solutions with minimal effort for those embarking on a weight loss journey.

From appetite suppressants to fat-burning supplements, these shortcuts promise rapid transformations without committing to a healthy lifestyle. Additionally, unconventional techniques like extreme detox diets, crash fasting and unregulated herbal concoctions have gained popularity, further complicating the weight loss arena.

Parallelly, a relatively new drug in the Indian market - Ozempic has become a buzzword in weight loss conversations. Meant to reduce hunger, by giving saturated signals to your brain - the injection induces less consumption of food which ultimately kicks off weight management. However, is it a sustainable way to shed those extra kilos?

To decode its efficacy, side effects and long-term impacts, Midday.com spoke to Dr Rajiv Kovil, Head of Diabetology, Zandra Healthcare and Co-founder of Rang De Neela initiative, Mumbai who sheds light on this novel pill.

Here are the edited excerpts from the interview:

What is Ozempic, and how does it work in the context of weight loss?
Kovil: Ozempic is the brand name for injection semaglutide which is injected once-a-week. It has a labelled indication for the treatment of type 2 diabetes at a lower dose which is 0.25mg to 2 mg and has a labelled indication of weight loss in overweight people for 0.25mg dose once a week to 2.4 milligrams once a week.

Ozempic works in multiple ways to reduce the movement of the stomach. The doctors define it as the reducing gastric emptying or ileal (the third part of the small intestine) brake phenomenon. It works on the brain by giving you satiety signals at lesser food or it makes you eat food as per your requirement. So, a person ends up eating less food as GLP 1 is a signal to the brain to reduce the food intake. These are the mechanisms for the weight loss of Ozempic.

Can you elaborate on the efficacy of using Ozempic for weight management?
Kovil: Obesity is recognised as a medical disorder, analogous to conditions like high blood pressure, elevated cholesterol levels or diabetes. In addressing this health concern, pharmacotherapy, involving the use of drugs for obesity management, becomes a viable option, especially for individuals requiring long-term solutions.

It's essential to acknowledge that the effectiveness of weight management drugs is often contingent on their consistent, extended use. Discontinuing medication may result in a significant weight rebound, with studies indicating up to a 50 percent regain within the first-year post-treatment cessation. Therefore, a prolonged, sustained approach is often necessary to achieve and maintain targeted weight loss successfully.

In the realm of obesity treatment, the focus extends beyond mere weight loss; it encompasses the broader goal of fostering overall health and well-being. This holistic perspective emphasises the importance of extended pharmacotherapy to not only attain the desired weight but also to promote sustainable health outcomes.

In your opinion, how sustainable is the use of Ozempic in the pursuit of overall well-being?
Kovil: Excess weight poses a significant barrier to the overall quality of life, impacting various facets of health. Leveraging drug molecules such as semaglutide, alongside behavioural and lifestyle modifications, has shown promising results in facilitating weight loss of up to 10 per cent. This approach not only aids in shedding excess pounds but also contributes to an enhanced overall quality of life.

Obesity, being a major driver of prevalent health issues like diabetes, heart disease and several types of cancers on a global scale, underscores the urgency of addressing this health concern.

Recognising that obesity serves as a primary catalyst for non-communicable diseases (NCDs), including diabetes, heart ailments and certain cancers, emphasises the pivotal role of weight management in preventing and mitigating these health conditions.

Stemming the tide of obesity holds the potential to substantially reduce the burden of NCDs, marking a proactive step toward fostering a healthier population. It is noteworthy that India, with a population of more obese individuals than the entire populace of the United States, faces a critical need for targeted interventions and comprehensive strategies.

By prioritising weight management through a multi-faceted approach, there exists an opportunity to significantly improve public health outcomes and diminish the prevalence of obesity-related NCDs in the Indian context.

Are there specific populations or individuals for whom Ozempic might be more or less suitable?
Kovil: Ozempic is indicated for the treatment of diabetes. For weight loss, the same injection has been marketed worldwide under a different name which is Wegovy. It is the same product. So, for diabetes management it is Ozempic and for obesity management, it is called Wegovy. GLP1 and semaglutide are indicated for patients with cardiovascular disease.

So, anybody with cardiovascular disease should be on a drug like GLP1 semaglutide as they are overwhelming and have robust evidence of reducing heart disease. Ozempic and Wegovy have not been launched in our country. But, for a BMI of 25 with other comorbidities related to obesity, obstructive sleep apnea and osteoarthritis of the knee then consider using these drugs. If you have a BMI of 27.5 without any comorbidity you can consider using GLP1 RA.

Particularly both Ozempic and Wegovy have not been marketed in India though have been approved by the drug controller of India. Oral Semaglutide, Inj Dulaglutide and INJ Liraglutide are marketed in India and can be used.

What are the known side effects of Ozempic, and how do they impact an individual's overall health?
Kovil: The primary considerations associated with the use of Ozempic involve upper gastrointestinal (GI) side effects, primarily linked to nausea and vomiting. These effects arise due to the medication's impact on reducing stomach movement, potentially leading to discomfort for some individuals. Additionally, Ozempic may contribute to constipation, a condition that may be exacerbated in individuals with pre-existing chronic constipation, gastritis or upper GI symptoms.

It is crucial for those with a history of such conditions to exercise caution and consult with healthcare professionals before considering the use of Ozempic to ensure that the potential side effects are carefully evaluated and managed appropriately based on individual health profiles. As with any medication, a thorough understanding of potential side effects and their implications is essential for making informed decisions regarding its usage.

Are there any hidden dangers associated with relying solely on drugs like Ozempic for weight loss?
Kovil: Obesity is a multi-factorial behavioural problem. Hereditary and genetics decide the distribution of fat in the body and circumstances and behaviour amplify the hereditary and genetic risk. So, weight loss cannot only be due to the drug and a multifactorial intervention is necessary. Pharmacotherapy like Ozempic will need to be there but cognitive behaviour therapy, lifestyle changes and exercise all need to be there for weight loss. Weight loss cannot be induced with the usage of drugs only.

What role should lifestyle changes, such as diet and exercise, play in conjunction with medications like Ozempic for weight loss?
Kovil: Lifestyle changes and behavioural changes like diet and exercise continue to be the cornerstone of treatment when it comes to weight management and diabetes, blood pressure, cholesterol and other NCDs. Diet and exercise need to be followed irrespective of whether you are going to take a drug for weight loss or not. So, these factors play a larger role in weight loss management.

What alternative or complementary approaches do you recommend for sustainable and holistic weight loss?
Kovil: The alternative or complementary approach we don't recommend. Lifestyle changes, behavioural therapy, diet and pharmacotherapy will remain the pillars of weight management.

Note:
The oral semaglutide by the brand name of Rybelsus is available in our country and can be used to treat blood sugars and weight in people with type 2 Diabetes.

Although Ozempic, the injectable semaglutide, has obtained approval for sale in India, it has not yet been introduced to the market.