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Wednesday, October 4, 2023
Oct. 4, 2023

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National weight loss trend prompts diabetes drug shortage in Washington


TACOMA — America’s search for weight-loss treatment has come to a head, resulting in a drug shortage that’s depriving diabetic and obese patients from getting proper medical treatment.

Ozempic is one of several anti-diabetic and weight-management medications that has skyrocketed in popularity since fall 2022. The hashtag #ozempic has more than 618 million views on TikTok and more than 48,000 posts on Instagram.

Ozempic is the brand name for semaglutide, an injectable drug intended for people with Type II diabetes. Semaglutide is a type of GLP-1 receptor agonist, or glucagon-like peptide 1, which is a type of hormone, according to the Mayo Clinic. Other popular hormone drugs include Wegovy, another semaglutide brand, and Mounjaro, the brand name for a different drug called tirzepatide. These medications are also intended to treat diabetic and obese patients.

The hormone drugs have received attention in recent months for their weight loss effectiveness. In March, the Wall Street Journal reported that the American Diabetes Association updated its guidelines to put Wegovy and Ozempic as its preferred treatment for Type II diabetes.

However, legacy media organizations like Variety and the Wall Street Journal have reported on the medication’s popularity among people who don’t medically need it, specifically its widespread use among the wealthy and Hollywood elites. Since then, other sources have written about adverse side effects associated with the medications.

“They’ve been so effective in helping people to lose weight that … it’s been taken advantage of by people who are trying to lose weight,” Ronald Graf, an endocrinologist with MultiCare in Tacoma, said to The News Tribune in an interview.

Graf has practiced endocrinology, the study of the body’s hormones, in Tacoma for more than 40 years. He says that Ozempic has been in short supply in Tacoma and nationwide. Graf explains what you need to know about how these drugs function and the current shortage.

How do Ozempic and Wegovy differ?

Wegovy is another semaglutide brand, but it provides the strongest dose of the drug, Graf says.

Wegovy is mostly intended to treat obesity, while Ozempic is suited specifically for people with Type II diabetes, according to medical organization GoodRx. In June 2021, the Food and Drug Administration approved Wegovy for patients in need of chronic weight management treatment. The drug was approved specifically for people who are obese, or for overweight adults who also have another weight-related condition, such as high blood pressure, Type II diabetes, high cholesterol, bad arthritis or gallbladder disease. Because of these differences, Wegovy contains a higher dosage than Ozempic.

Most recently, the FDA approved Mounjaro (tirzepatide) in May 2022 as treatment for Type II diabetes.

GLP-1 receptor agonists are especially beneficial for people with Type II diabetes in a few ways:

  • Helps the pancreas release insulin, in turn decreasing blood-sugar levels.
  • Decreases the amount of glucagon the liver secretes to prevent blood-sugar levels from rising.
  • Helps the stomach retain food longer.
  • Modifies the brain’s hunger signals to make one have a sense of fullness, also called satiety, for longer.
  • Minimizes chances of developing cardiovascular complications.

Graf says that the medications work wonders for people who have a hard time losing weight and keeping their blood-sugar levels low. This has made the shortage all the more worrying for them.

“I have patients who get, you know, they get frantic because they their blood sugars have been doing very well on this medicine,” Graf says. “They lost weight, they’re feeling great. And all of a sudden, they can’t get it. … Within a week or two of stopping the medication, your blood sugars — if you have diabetes — may tend to rise right back up to where they were supposed to be.

A month’s worth of Ozempic, Wegovy or Mounjaro can range anywhere from $800 to $1,400, according to prices from telemedicine platform GoodRx.

How do Ozempic, Wegovy cause weight loss?

The drugs themselves don’t produce weight loss. Instead, they cause people to feel full faster and stay satiated for longer periods of time. In effect, this modified people’s eating habits, causing them to eat less and therefore be in a caloric deficit, which results in weight loss.

When people take the drug, they tend to lose anywhere between 10-20% of their body weight, Graf says.

Graf says that the drug doesn’t alter metabolism. This means that people aren’t losing weight because their bodies are burning more calories, but because they’re eating less than they typically would. So when a person stops taking the drug, their hunger level return to normal.

Why is there a shortage?

Graf says his patients have had difficulties getting hormone treatments at their pharmacies. Currently, the FDA lists semaglutide and tirzepatide as “currently in shortage.”

“I tell [my patients] to try a different pharmacy,” Graf says. “Maybe there’s just a shortage in that particular distribution chain. But it’s become more and more and more universal.”

He believes the shortage is being driven by people who want to lose weight but don’t meet the medical requirements to be prescribed any of the hormone drugs.

“I understand people’s frustration, and they’re wanting to lose weight,” Graf says. “But I think folks should not take away an essential medication for people who need it purely for selfish, cosmetic reasons.”

Pharmacies may be choosing not to stock these hormone drugs at all. NBC News reported in March that some pharmacies haven’t bothered to order any of the medication because they’re too expensive to justify selling.

Side effects of GLP-1 agonists

Graf says the hormone drugs elicit side effects that some people can’t handle. In addition, a more recent study has linked a serious adverse side effect to GLP-1 receptor agonists.

According to the FDA, people who regularly use these weight-management and anti-diabetic medications can expect to experience:

  • Nausea
  • Vomiting
  • Abdominal pain
  • Diarrhea
  • Constipation
  • Headache
  • Fatigue

There are other potentially serious health complications associated with these hormone medications. For example, Ozempic may lead to gallbladder problems, kidney problems and Inflammation in the pancreas, according to the drug’s official website. Graf also notes that when the drug was tested on rats and mice, the drugs can cause tumors in their thyroid glands. Ozempic’s website also lists thyroid tumors and cancer as a potentially serious side effect.

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Additionally, a study published in March found that taking GLP-1 agonist receptors increases the chances of developing intestinal obstruction.

Another side effect has been dubbed “Ozempic face.” The health information website Healthline characterizes the phenomenon as a sagging of facial skin. This is because people taking the drug experience fat loss across the entire body, including the face. This isn’t too dissimilar from loose skin, which can occur if someone sheds a large amount of body weight in a short amount of time.

In January, the New York Times reported on Ozempic face and how fat loss resulted lead faces to appear more deflated, gaunt and aged. The publication reports that for older people, volume-restoring fillers may be necessary.