Doctors share their biggest concerns about Ozempic, from muscle loss to hollowed faces
The weight loss medication semaglutide has skyrocketed in popularity — but so has misinformation.
Doctors worry that patients could be harmed by misleading claims about the drug and its results.
Side effects like weight regain and muscle loss could be consequences of using the medication improperly.
The weight loss medication semaglutide has exploded in popularity, showing up everywhere from Oscars punchlines to the SNL cold open — but doctors worry that the hype could have health consequences as misinformation runs rampant.
Semaglutide was FDA-approved for weight loss in 2021 under the brand name Wegovy, manufactured by Novo Nordisk. The same medication is sold to treat type 2 diabetes under the brand name Ozempic, and can be prescribed off-label for weight loss, too.
While medical experts across different fields recognize the drug's potential for health benefits, many are worried that misleading claims circulating online could cause concerning side effects and a lack of access to the drug by patients who need it most.
A gastroenterologist says semaglutide is generally safe, but social media myths are rampant
One of the biggest problems with semaglutide's popularity isn't the drug itself, but the widespread false claims about it online such as exaggerated side effects and misleading success stories , according to Dr. Christopher McGowan, a board-certified physician in internal medicine, gastroenterology, and obesity medicine.
"Semaglutide is a legitimately effective medication. It provides health-altering weight loss," he told Insider. "It has an overall excellent safety profile and is generally well tolerated."
While the medication does have side effects, the most common are mild cases of diarrhea, constipation, and nausea, which can usually be managed by starting patients on a smaller dose and gradually increasing it over time.
McGowan said that cost and lack of insurance coverage are major issues, but that misleading and inaccurate claims about the drug are also worrying, since it can prevent patients from understanding how it works and how to use it safely and effectively.
"My biggest concern is that there's misinformation everywhere," he said. "People are seeing on social media it's a quick fix or a way to lose a few pounds. That's not how they're studied or intended to be used."
An endocrinologist fears patients getting the drug online don't have proper supervision
As semaglutide becomes increasing popular, it's become apparent that a growing number of people are obtaining it via online prescriptions with little or no follow-up or care from a medical team, endocrinologist and obesity medicine specialist Dr. Scott Isaacs told Insider.
"The perception is that you can take it, lose weight, and stop taking it, and that's not the case at all. Most of the weight be will regained," he said. "Anything you do temporarily, you're going to get temporary results."
The medication is intended to be used in combination with healthy lifestyle changes and doctor supervision to monitor the effective and minimize side effects, according to Isaacs. And, similar to other medications for chronic conditions, like high blood pressure, patients need to continue taking it to maintain the benefits.
"It's almost criminal to give someone a drug and not tell them they need to change their diet to lose weight. It's wrong on so many levels," he said.
A healthy weight can help fertility, says an OB-GYN — but people who stop taking semaglutide can regain the weight
Semaglutide may also be relevant to reproductive health, according to Dr. Mary Jane Minkin, practicing gynecologist and clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Business.
Minkin told Insider that she knows relatively little about the drug and would defer to bariatric specialists, but that it's important to consider that the medication needs to be taken long-term to keep working.
"The major concern I have about it are the reports of people regaining their lost weight, and sometimes even more, when they go off the drug," she said.
That's important because weight can be an important aspect of fertility, according to Minkin.
"We do know that fertility is enhanced by being as close to the ideal body weight — being both significantly overweight 0r underweight can contribute to difficulties with ovulation — alas, it's sometimes hard to get there," she said.
The FDA warning label for semaglutide also cautions against using the drug while pregnant, and advises patients trying to become pregnant to stop taking it at least two months prior, since animals studies found a link to possible developmental issues.
Minkin said she was aware of the warning, but did not know enough about the data to comment on it.
Longevity specialists worry the drug can cause muscle loss
Not all weight loss is created equal — the health benefits of losing weight come from reducing fat tissue while maintaining muscle mass, which is important factor in health as we age, according to doctors who specialize in longevity.
But some evidence suggests semaglutide doesn't discriminate, and patients lose significantly more muscle than they do via other weight loss methods, according to Dr. Peter Attia.
"They've lost muscle mass at a rate that alarms me," he said in a recent clip of his podcast "The Drive."
Dr. Mark Hyman, a specialist in healthy aging and author of "Young Forever," expressed similar concerns.
"It's not a benign compound. You have patients losing muscle and slowing their metabolism, it's unrealistic and you have to stay on it for life," he told Insider. "We need to address the cause of systemic problems in the food system instead."
A cardiologist said semaglutide could reduce heart health risks, but may distract from the importance of healthy eating
Maintaining a healthy weight is important for cardiovascular health, so semaglutide could be a valuable tool to stave off cardiovascular disease, but it's not a substitute for eating right, according to cardiologist Dr. Elizabeth Klodas.
A nutritious diet is a major factor in preventing cardiovascular disease, and Klodas said she worries patients may rely too much on the medication without making other lifestyle changes that could protect their hearts.
"It's important to recognize that weight itself is not the problem, it's the marker of the problem," she told Insider. "People are looking at this drug as the miracle weight-loss solution when it truly isn't. In many ways it's just another fad diet – except that comes in a very expensive syringe."
The high price point — listed $1,349 a month, sometimes more — also makes it hard for people to access, and its popularity could distract from crucial conversations about healthy eating, said Klodas, whose company Step One Foods has researched how to make popular foods like pancakes that can help lower cholesterol.
"When we're successful at helping people lose weight through pharmaceuticals we are far less likely to focus the dysfunctional food environment that enabled and even encouraged that weight gain in the first place," she said. "$1,500 per month buys a lot of healthy food."
Rapid weight loss from the meds can cause telltale gaunt appearance of the face, according to a dermatologist
With the rise of people using semaglutide for aesthetic weight loss, a certain group of patients are also facing a superficial side effect known as "Ozempic face," according to a cosmetic dermatologist who has worked with celebrities.
The phrase reference to a gaunt, hollow or "deflated" look around the cheeks, Dr. Paul Jarrod Frank previously told Insider's Allana Akhtar.
It's particularly prevalent in people 40 and older, according to Frank, since younger people have more elasticity in their skin which allows it to shrink and adjust as they lose underlying fat.
"I think a combination of age and the rapidity of the weight loss is what's causing what I call 'Ozempic face,'" he said. "When you meet someone that you saw not too long ago and they've [suddenly] lost a lot of weight, particularly in that area, it's kind of like a telltale sign."
Frank said it can be treated with fillers, which have the same possible side effects (such as bruising or swelling) as similar cosmetic procedures.
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