Heavy demand for weight reduction ‘miracle’


YOU’VE seen them on TV advertisements and TikTok, or heard them joked about on the Oscars — Ozempic, Wegovy, and Mounjaro.

Due to movie star endorsements from the likes of Kim Kardashian and Elon Musk these so-called “marvel” medication have been hijacked by a technology of customers who’re flooding social media with posts and movies boasting their properties as a “miracle” weight reduction hack.

In consequence, demand has soared resulting in a worldwide scarcity, although they’re prohibitively costly, or as is the case in Eire, they’ll solely be prescribed for the remedy of diabetes and never for weight reduction. Or at the very least not but.

Within the US alone, about 130m adults are eligible for these so-called GLP-1s due to their weight and different well being situations.

If only a third of People with extreme weight problems took them, US gross sales of weight reduction medication would swell greater than 30 occasions, into an $80bn trade, in accordance with knowledge analytics firm, Airfinity Ltd.

Analysts at Jefferies Monetary Group predict that GLP-1s for diabetes and weight problems may turn into the largest blockbusters of all time, bringing in as a lot as $150bn (€137bn) a 12 months globally.

The growing demand for that 'quick-fix' weight loss is already evident here with some diabetes patients forced to switch from Ozempic because of shortages. Picture: Mario Tama/Getty Images
The rising demand for that ‘quick-fix’ weight reduction is already evident right here with some diabetes sufferers pressured to change from Ozempic due to shortages. Image: Mario Tama/Getty Pictures

The impression for well being methods and insurance coverage corporations internationally is also enormous with the medication costing within the area of $10,000 per affected person within the US a 12 months, doubtlessly for the remainder of somebody’s life. (The medication primarily work as urge for food suppressants, and if individuals cease taking them, they could achieve a lot of the load again.)

The rising demand for that “quick-fix” weight reduction is already evident right here with some diabetes sufferers pressured to change from Ozempic due to shortages.

Ozempic has been permitted by the HSE solely to deal with type-2 diabetes. The injectable drug regulates blood sugar ranges and insulin. Greater than 260,000 individuals in Eire have type-2 diabetes, in accordance with Diabetes Eire.

Producer Novo Nordisk has warned the drug is just for adults with type-2 diabetes, and “will not be a weight-loss drug” — however that hasn’t dampened demand, forcing some nations to take extra dramatic motion.

Australian authorities have known as on well being professionals to keep away from initiating new prescriptions of Ozempic and, when treating sufferers with weight problems, to think about alternate options to semaglutide [generic name of Ozempic] “till provide stabilises”.

France’s nationwide drug security company issued related directions in September when it urged docs to solely provoke new GLP-1 drug prescriptions for sufferers with type-2 diabetes with a historical past of stroke or coronary heart illness.

Final month, the regulator stated current estimates steered that over the course of a 12 months, some 2,185 sufferers in France got Ozempic although they weren’t diabetic. Which means round 1% of Ozempic prescriptions coated by state medical health insurance had been “misused”, it stated.

The company confused that these off-label prescriptions had been squeezing out diabetic sufferers who actually wanted the drug, and it warned of “doubtlessly critical” side-effects corresponding to gastrointestinal issues, pancreatitis, and low blood sugar.

Authorities within the UK have additionally issued warnings to influencers selling these medication on-line.

Provide strains below strain

Whereas using these medication right here is way extra restricted, provide strains are below rising strain.

Pharmacists have warned it will possibly take months for shares to be replenished — with Well being Minister Stepehen Donnelly telling the Dáil lately that it will likely be properly into subsequent 12 months earlier than the provides of Ozempic cool down.

That’s chilly consolation to sufferers right here who’ve been pressured to change medication or go weeks with out.

Corkman, Pat Murphy, was advised 4 weeks in the past he wouldn’t obtain a refill prescription for Ozempic as a result of it wasn’t in inventory in his native pharmacy.

“I obtained a name on Tuesday saying that they had my refill, and after I went in, I used to be chatting with my chemist who stated they had been discovering it very onerous to get the availability in.

“However it’s not simply the one chemist in Cork that’s seeing this drawback, as a result of I’ve tried others, to see if I may get the prescription. And I couldn’t get it.

Mr Murphy was identified with type-2 diabetes 15 years in the past however has solely been taking the drug for a 12 months.

The remedy helps regulate his blood sugar ranges. Nevertheless, the longest he can go with out Ozempic is 4 weeks earlier than switching to a different drug.

“If it’s not there subsequent month it should imply I might be with out it for a month once more,” Mr Murphy stated.

“Which implies then I in all probability should go and alter from the Ozempic to one thing else which suggests I’d be beginning once more from scratch.

“And I will probably be sick once more for a few months as a result of my physique is getting used to this new drug and I don’t actually wish to do this. But when should, I’ll should.”

So how do these medication work?

The medication which have drawn essentially the most consideration are a category of medicines that activate a hormone often known as GLP-1. They embody Ozempic and Wegovy, that are model names of the identical remedy, semaglutide.

Tirzepatide targets GLP-1, but additionally impacts a second hormone, known as GIP, which builders say contributes to its elevated effectiveness. Mounjaro was permitted to deal with diabetes in Might 2022. Saxenda was the primary new-generation drug for the remedy of weight problems.

The medication are delivered via once-weekly injections. Customers are suggested to comply with a healthful, reduced-calorie weight loss plan and to train recurrently whereas utilizing the medication.

The HSE began reimbursing Saxenda for the remedy of weight problems final January.

Ozempic was permitted by the HSE in 2018 however just for treating type-2 diabetes.

The medication work by mimicking the actions of hormones, discovered primarily within the intestine, that kick in after individuals eat. The hormones assist regulate blood sugar by triggering the pancreas to launch insulin, one other hormone, and slowing the discharge of sugar from the liver. 

People who find themselves obese or have weight problems can turn into insulin-resistant, which suggests the physique doesn’t reply to insulin correctly.

The weight problems medication decrease blood sugar and decelerate digestion, so individuals really feel full longer. Additionally they have an effect on alerts within the mind linked to emotions of fullness and satisfaction, tamping down urge for food, food-related ideas, and cravings.

As a result of individuals really feel full longer, they eat much less and drop some pounds.

In a trial, adults who took Wegovy noticed a weight lack of practically 35lb, or about 15% of their physique weight. Adolescents misplaced about 16% of their physique weight.

The newest research of tirzepatide studied the drug in additional than 900 sufferers with diabetes who had been obese or had weight problems over practically 17 months. It confirmed weight lack of as much as 16% of physique weight, greater than 34lb, when utilizing the very best dose of the drug. Sufferers who obtained placebo, or dummy injections, misplaced about 3% of their physique weight, or seven kilos.

An earlier trial of tirzepatide confirmed weight lack of between about 15% and about 22% of physique weight, or about 35lb to about 52lb, relying on the dose.

The medication seem efficient for persistent weight administration over many months. Along with weight reduction, additionally they scale back well being issues related to weight problems, corresponding to excessive blood sugar and markers of coronary heart and metabolic illness.

Nevertheless, it seems that if individuals cease taking the medication, they regain the load they misplaced — and the well being issues that got here with it.

In a typical weight-loss programme the place members rely solely on weight loss plan and train, analysis exhibits solely a couple of third of individuals will lose 5% or extra of their physique weight. Many individuals discover it troublesome to drop some pounds due to the physique’s organic reactions to consuming much less, he stated. There are a number of hormones that reply to decreased calorie consumption by ramping up starvation to keep up physique mass.

The commonest negative effects are short-lived gastrointestinal points corresponding to nausea, vomiting, constipation, diarrhea, and abdomen ache. Different potential results embody critical points corresponding to irritation of the pancreas, kidney, gallbladder, and eye issues.

Individuals with a historical past of sure thyroid cancers or a uncommon, genetic endocrine dysfunction ought to keep away from the medication, as a result of it’s not clear if tirzepatide causes thyroid issues, together with most cancers.

In line with Professor Carel le Roux, an Weight problems Specialist at St Vincent’s College Hospital, who spoke to the Irish Examiner lately, using Ozempic or different medication utilizing semaglutide for the remedy of weight problems might be “revolutionary”, however you undoubtedly shouldn’t take this drug for weight reduction causes.

“It’s very, crucial that we focus this remedy for the illness of weight problems and never for weight reduction,” he stated.

“There’s the illness of weight problems, after which there’s what we seek advice from because the cultural need for thinness.

“For those who deal with individuals [with Ozempic] with the illness of weight problems, you may management the illness, however it means they should take this remedy for the remainder of their lives.

“For individuals with the cultural need for thinness, in the event that they take this remedy, what’s going to occur is they may lose some weight initially but when they cease the remedy, they may regain all the load and so they’ll really be heavier after than they had been earlier than. So it’s actually, actually unhealthy concept to [use this drug] for weight reduction.”

To outline weight problems, Prof le Roux factors to the World Well being Group’s definition: “Irregular or extreme fats accumulation that presents a danger to well being.”

“Your BMI doesn’t actually matter, what issues is whether or not or not the surplus adipose tissues or an excessive amount of fats cells are inflicting you to be much less wholesome proper now.

“For instance, in case you’ve obtained extra fats that causes you to have diabetes, then you’ve the illness of weight problems.”

We don’t deal with individuals for weight reduction, we deal with individuals for well being achieve.”

Prof le Roux says he would urge the Irish public to not take Ozempic until they’ve the illness of weight problems, and until they’re ready to take it for the remainder of their lives.

“Apparently, even individuals that actually, actually actually wish to drop some pounds. For those who say to them, ‘do you’ve the illness of weight problems and are you ready to take this for the remainder of your life? 9 out of 10 individuals will say no’.”

Extra reporting Bloomberg



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YOU’VE seen them on TV adverts and TikTok, or heard them joked about on the Oscars — Ozempic, Wegovy, and Mounjaro.

Because of superstar endorsements from the likes of Kim Kardashian and Elon Musk these so-called “marvel” medicine have been hijacked by a era of customers who’re flooding social media with posts and movies boasting their properties as a “miracle” weight reduction hack.

Because of this, demand has soared resulting in a worldwide scarcity, despite the fact that they’re prohibitively costly, or as is the case in Eire, they’ll solely be prescribed for the therapy of diabetes and never for weight reduction. Or no less than not but.

Within the US alone, about 130m adults are eligible for these so-called GLP-1s due to their weight and different well being circumstances.

If only a third of People with extreme weight problems took them, US gross sales of weight reduction medicine would swell greater than 30 instances, into an $80bn trade, in keeping with information analytics firm, Airfinity Ltd.

Analysts at Jefferies Monetary Group predict that GLP-1s for diabetes and weight problems may change into the largest blockbusters of all time, bringing in as a lot as $150bn (€137bn) a yr globally.

The growing demand for that 'quick-fix' weight loss is already evident here with some diabetes patients forced to switch from Ozempic because of shortages. Picture: Mario Tama/Getty Images
The rising demand for that ‘quick-fix’ weight reduction is already evident right here with some diabetes sufferers compelled to change from Ozempic due to shortages. Image: Mario Tama/Getty Photos

The affect for well being programs and insurance coverage firms the world over is also enormous with the medicine costing within the area of $10,000 per affected person within the US a yr, probably for the remainder of somebody’s life. (The medicine basically work as urge for food suppressants, and if individuals cease taking them, they might acquire a lot of the burden again.)

The rising demand for that “quick-fix” weight reduction is already evident right here with some diabetes sufferers compelled to change from Ozempic due to shortages.

Ozempic has been authorised by the HSE solely to deal with type-2 diabetes. The injectable drug regulates blood sugar ranges and insulin. Greater than 260,000 individuals in Eire have type-2 diabetes, in keeping with Diabetes Eire.

Producer Novo Nordisk has warned the drug is just for adults with type-2 diabetes, and “is just not a weight-loss drug” — however that hasn’t dampened demand, forcing some nations to take extra dramatic motion.

Australian authorities have referred to as on well being professionals to keep away from initiating new prescriptions of Ozempic and, when treating sufferers with weight problems, to contemplate alternate options to semaglutide [generic name of Ozempic] “till provide stabilises”.

France’s nationwide drug security company issued related directions in September when it urged medical doctors to solely provoke new GLP-1 drug prescriptions for sufferers with type-2 diabetes with a historical past of stroke or coronary heart illness.

Final month, the regulator mentioned current estimates steered that over the course of a yr, some 2,185 sufferers in France got Ozempic despite the fact that they weren’t diabetic. Which means round 1% of Ozempic prescriptions lined by state medical insurance have been “misused”, it mentioned.

The company pressured that these off-label prescriptions have been squeezing out diabetic sufferers who actually wanted the drug, and it warned of “probably critical” side-effects equivalent to gastrointestinal problems, pancreatitis, and low blood sugar.

Authorities within the UK have additionally issued warnings to influencers selling these medicine on-line.

Provide strains underneath strain

Whereas using these medicine right here is way extra restricted, provide strains are underneath rising strain.

Pharmacists have warned it will possibly take months for shares to be replenished — with Well being Minister Stepehen Donnelly telling the Dáil lately that will probably be nicely into subsequent yr earlier than the provides of Ozempic cool down.

That’s chilly consolation to sufferers right here who’ve been compelled to change medicine or go weeks with out.

Corkman, Pat Murphy, was advised 4 weeks in the past he wouldn’t obtain a refill prescription for Ozempic as a result of it wasn’t in inventory in his native pharmacy.

“I acquired a name on Tuesday saying they’d my refill, and after I went in, I used to be talking to my chemist who mentioned they have been discovering it very arduous to get the provision in.

“However it’s not simply the one chemist in Cork that’s seeing this drawback, as a result of I’ve tried others, to see if I may get the prescription. And I couldn’t get it.

Mr Murphy was identified with type-2 diabetes 15 years in the past however has solely been taking the drug for a yr.

The medicine helps regulate his blood sugar ranges. Nevertheless, the longest he can go with out Ozempic is 4 weeks earlier than switching to a different drug.

“If it’s not there subsequent month it would imply I may very well be with out it for a month once more,” Mr Murphy mentioned.

“Which implies then I in all probability must go and alter from the Ozempic to one thing else which suggests I’d be beginning once more from scratch.

“And I shall be sick once more for a few months as a result of my physique is getting used to this new drug and I don’t actually wish to do this. But when must, I’ll must.”

So how do these medicine work?

The medicine which have drawn probably the most consideration are a category of medicines that activate a hormone referred to as GLP-1. They embrace Ozempic and Wegovy, that are model names of the identical medicine, semaglutide.

Tirzepatide targets GLP-1, but additionally impacts a second hormone, referred to as GIP, which builders say contributes to its elevated effectiveness. Mounjaro was authorised to deal with diabetes in Might 2022. Saxenda was the primary new-generation drug for the therapy of weight problems.

The medicine are delivered by means of once-weekly injections. Customers are suggested to observe a healthful, reduced-calorie food regimen and to train often whereas utilizing the medicine.

The HSE began reimbursing Saxenda for the therapy of weight problems final January.

Ozempic was authorised by the HSE in 2018 however just for treating type-2 diabetes.

The medicine work by mimicking the actions of hormones, discovered primarily within the intestine, that kick in after individuals eat. The hormones assist regulate blood sugar by triggering the pancreas to launch insulin, one other hormone, and slowing the discharge of sugar from the liver. 

People who find themselves chubby or have weight problems can change into insulin-resistant, which suggests the physique doesn’t reply to insulin correctly.

The weight problems medicine decrease blood sugar and decelerate digestion, so individuals really feel full longer. Additionally they have an effect on alerts within the mind linked to emotions of fullness and satisfaction, tamping down urge for food, food-related ideas, and cravings.

As a result of individuals really feel full longer, they eat much less and drop some pounds.

In a trial, adults who took Wegovy noticed a weight lack of almost 35lb, or about 15% of their physique weight. Adolescents misplaced about 16% of their physique weight.

The most recent research of tirzepatide studied the drug in additional than 900 sufferers with diabetes who have been chubby or had weight problems over almost 17 months. It confirmed weight lack of as much as 16% of physique weight, greater than 34lb, when utilizing the very best dose of the drug. Sufferers who acquired placebo, or dummy injections, misplaced about 3% of their physique weight, or seven kilos.

An earlier trial of tirzepatide confirmed weight lack of between about 15% and about 22% of physique weight, or about 35lb to about 52lb, relying on the dose.

The medicine seem efficient for persistent weight administration over many months. Along with weight reduction, additionally they scale back well being issues related to weight problems, equivalent to excessive blood sugar and markers of coronary heart and metabolic illness.

Nevertheless, it seems that if individuals cease taking the medicine, they regain the burden they misplaced — and the well being issues that got here with it.

In a typical weight-loss programme the place members rely solely on food regimen and train, analysis exhibits solely a few third of individuals will lose 5% or extra of their physique weight. Many individuals discover it tough to drop some pounds due to the physique’s organic reactions to consuming much less, he mentioned. There are a number of hormones that reply to decreased calorie consumption by ramping up starvation to take care of physique mass.

The most typical uncomfortable side effects are short-lived gastrointestinal points equivalent to nausea, vomiting, constipation, diarrhea, and abdomen ache. Different potential results embrace critical points equivalent to irritation of the pancreas, kidney, gallbladder, and eye issues.

Individuals with a historical past of sure thyroid cancers or a uncommon, genetic endocrine dysfunction ought to keep away from the medicine, as a result of it isn’t clear if tirzepatide causes thyroid issues, together with most cancers.

In accordance with Professor Carel le Roux, an Weight problems Specialist at St Vincent’s College Hospital, who spoke to the Irish Examiner lately, using Ozempic or different medicine utilizing semaglutide for the therapy of weight problems may very well be “revolutionary”, however you positively mustn’t take this drug for weight reduction causes.

“It’s very, essential that we focus this therapy for the illness of weight problems and never for weight reduction,” he mentioned.

“There’s the illness of weight problems, after which there’s what we confer with because the cultural need for thinness.

“For those who deal with individuals [with Ozempic] with the illness of weight problems, you possibly can management the illness, however it means they must take this therapy for the remainder of their lives.

“For individuals with the cultural need for thinness, in the event that they take this therapy, what is going to occur is they are going to lose some weight initially but when they cease the therapy, they are going to regain all the burden and so they’ll really be heavier after than they have been earlier than. So it’s actually, actually dangerous concept to [use this drug] for weight reduction.”

To outline weight problems, Prof le Roux factors to the World Well being Group’s definition: “Irregular or extreme fats accumulation that presents a threat to well being.”

“Your BMI doesn’t actually matter, what issues is whether or not or not the surplus adipose tissues or an excessive amount of fats cells are inflicting you to be much less wholesome proper now.

“For instance, when you’ve acquired extra fats that causes you to have diabetes, then you’ve the illness of weight problems.”

We don’t deal with individuals for weight reduction, we deal with individuals for well being acquire.”

Prof le Roux says he would urge the Irish public to not take Ozempic until they’ve the illness of weight problems, and until they’re ready to take it for the remainder of their lives.

“Apparently, even individuals that actually, actually actually wish to drop some pounds. For those who say to them, ‘do you’ve the illness of weight problems and are you ready to take this for the remainder of your life? 9 out of 10 individuals will say no’.”

Further reporting Bloomberg



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We will be happy to hear your thoughts

Leave a reply

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