Dr. Housefather Vs. Ozempic

Dr. Housefather Vs. Ozempic

Is Ozempic* Worth the Shot?

A question I constantly raise with my patients is one that we must ask all the time in medicine: are the benefits greater than the risks?

Over the last 6 months I’ve received many questions about Ozempic and other prescribed medications that are known to help people lose weight. This escalating interest in weight loss is good insofar as people want to get healthier, lose weight, and become stronger. But if a medication is considered the answer to a patient’s interest in losing weight and healthy living then I’m concerned.

Very recently I had a patient who has complex medical issues who was also struggling with being overweight. According to Styku, their body fat percentage is at 50%. A person of their age, gender, height and body type would be healthy with a body fat percentage of about 30%. So their other medical issues were being exacerbated by their overweight condition. Moreover, their blood-sugar levels are in the pre-diabetic range. And, so, upon being asked if Ozempic was right for them, I asked them the question: are the benefits of Ozempic greater than the risks?

Ozempic was designed as a way to help people with diabetes. That it also suppresses a person’s appetite means that there are other kinds of applications for this drug, but it was not meant to be used as a weight-reduction tool for people without diabetes.

It is concerning to me, then, that it is people who do not have diabetes who are using Ozempic the most these days. What most don’t know is that, aside from the well-publicized impacts on weight loss, there are significant risks associated with using Ozempic. 

Pros: 

1) Helps treat diabetes by lowering blood markers (A1C) and blood sugar in people diagnosed with diabetes.

2) Many people with diabetes are at high risk for heart-related issues and diseases, and Ozempic reduces risk of non-fatal strokes and, to a lesser extent, non-fatal heart attacks in those people diagnosed with diabetes.

3) Helps people to lose weight by suppressing a person’s appetite. A 40-68 week study showed that study participants had 4-6% weight loss of initial body weight. Put another way, people in the study lost an average of 12.8 pounds with the average starting weight of 211 pounds – as long as people remained using Ozempic. 

Cons: 

1) Studies found that weight loss due to taking Ozempic was dose-dependent, meaning that once a person stopped taking the shot then they regained the weight they had just lost. Unfortunately, the lowered blood markers and sugar levels, and the lowered risk of non-fatal strokes and non-fatal heart attacks also returned to previously elevated levels of risk.

2) The cost is usually between $270-$300/month ($3,200-$3,600 each year), which, for most patients who are not diabetic or obese, is not covered by OHIP.

3) Studies have linked Ozempic to a variety of other medical issues such as thyroid cancer, pancreatitis gall bladder disease, and the worsening of diabetic retinopathy.

4) Hypoglycemia especially if used in conjunction with insulin or a sulfonylurea  

5) Gastro-intestinal side effects including diarrhea, nausea, vomiting… which could lead to  dehydration and acute renal failure. These can be minimized by starting with a low dose and very slowly increasing it.

6) Contra-indicated if any family history of MEN-2 (multiple endocrine neoplasia type 2, a rare genetic disorder) or Medullary thyroid cancer. 

7) Allergic reactions

So, now, we return to the question we must always ask in medicine: do the benefits outweigh (pardon the pun) the risks?

In my opinion, Ozempic and similar medications are a useful tool in our battle against diabetes with some benefits to those people with diabetes who are also overweight. Ozempic is especially helpful for people with diabetes who also have cardiovascular risks. 

However, this diabetes drug should not be viewed as a solution to obesity, nor should it be taken without a discussion with your health care professional who can help navigate whether the benefits for you individually are greater than the risks.

If you truly want to lose weight and get healthier in the process, diet and exercise cannot be overlooked. 

We would be honoured to help you on your journey to becoming  “Medically Fit”.

~ Dr. Leslie Housefather

 

If you wish for more information then please book an appointment for a FREE CONSULT AND DISCOVERY with our Medically Fit Dietitians or Exercise Physiologists.

 

More information about Ozempic and its properties:
Semagludide is a Glucagon-Like Peptide Receptor Agonist (GLP-1 RA) sold under the brand names:  Ozempic, Wegovy (higher dose) Rebelsus (oral pill) Dulaglutide (Trulicity) Liraglutide (Victoza) and soon  to be released, a new player Tirzepatide (Mounjaro) offering even greater weight loss promise. Drugs  mimicking the effects of GLP-1 hormones are naturally secreted after we eat. Tirzepatide offers the  addition of GIP hormone (Glucose-dependent insulonotropic Peptide, or Gastric Inhibitory peptide) to  add on to the GLP-1 effects.  
GLP-1 or Glucagon-like peptide is a hormone that stimulates insulin release from the pancreas and reduces glucagon release after eating, both of which help lower blood sugar. Hence the development of GLP-1 receptor agonists in the treatment of diabetes for which they can be very effective tools. In addition, these medications help slow gastric (stomach) emptying and promote a feeling of satiety (feeling full) at a central level in the brain, which, naturally, makes these medications an important tool in the world of weight loss.

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