It all started with the Netflix show Fabulous Lives vs Bollywood Wives where Maheep Kapoor criticised people for using Ozempic for weight loss, leading to a shortage of the drug for diabetic patients who rely on it to control their blood sugar levels. A user was quick to tweet, “Maheep (Maheep Kapoor) rightly called out people for using Ozempic for fast weight loss and driving it out of stock for people with diabetes. Hope she calls out Karan Johar too, the producer of Fabulous Lives vs Bollywood Wives (sic).”

Celebrity and social media influences largely shape aesthetic trends in today's society. While Karan Johar denied using the medication, many other celebrities from Amy Schumer to Elon Musk and Kathy Bates have been open about using Ozempic or similar drugs to lose weight quickly. Unsurprisingly, the idealisation of thinness and the stigmatisation of fatness often lead people to participate in various diets and weight-loss trends.

What is Ozempic drug?

In an interview with HT Lifestyle, Prachi Chandra, Lead Clinical Nutritionist at Sakra World Hospital in Bengaluru, shared, “From juice cleanses to the Atkins Diet to fen-phen, people have relentlessly searched for the magic solution to weight loss. While many of these diet trends produce short-term results, they are often unsustainable due to costs, time constraints, or extreme dietary restrictions. Ozempic offers something new to the world of dieting because it is not only effective in terms of helping people lose weight but it does not require individuals to change their behaviours.”

She revealed, “The drug, injected once a week into the stomach, thigh, or arm, has gained attention for its appetite-suppressing effects. Ozempic belongs to a class of medications known as glucagon-like peptide 1 (GLP-1) agonists. They are most often used for the treatment of type 2 diabetes (T2DM) by way of suppressing glucagon secretion and enhancing the satiating effects of the naturally occurring GLP-1 hormone. This drug class includes Semaglutide (Ozempic and Wegovy), tirzepatide (Mounjaro), liraglutide, exenatide, and many others. Semaglutide, is only FDA-approved for the management of Type II diabetes mellitus. Later, its indications have expanded over the years to also include long-term weight management for adults with obesity or who are overweight and have at least one weight-related comorbidity. In recent developments, the FDA further expanded semaglutide’s indication to include reducing the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease who are either obese or overweight.”

How does it work:

Prachi Chandra explained, “GLP-1 receptor activation in the stomach delays gastric emptying, meaning food moves more slowly through the digestive tract, enhancing digestion and extending feelings of fullness. Secondly, since GLP-1 receptors were also found in the brain, particularly in areas that control food-related cues, in studies it was found that these receptors drive signaling from the brain to the gut to feel satiated more quickly. As a result, GLP-1 RAs have become recognized for their effectiveness in suppressing appetite, helping individuals consume fewer calories and achieve weight loss. Their dual action on both metabolic and appetite-regulating systems makes them a compelling option for managing weight and metabolic health.”

Bringing his expertise to the same, Dr Rajiv Kovil, Head of Diabetology at Zandra Healthcare and Co-Founder of the Rang De Neela Initiative, pointed out, “Semaglutide is the active ingredient in Ozempic, Wegovy and Rybelsus. Semaglutide is used for weight loss in specific patients, and also to lower blood sugar levels, and to reduce the risk of major cardiovascular events such as heart attack or stroke in certain patients. Semaglutide is a GLP-1 agonist that works by increasing insulin release, lowering the amount of glucagon released, delaying the movement of the stomach and reducing appetite.”

He elaborated, “Semaglutide injections (Ozempic and Wegovy) are given as subcutaneous injections once a week. Rybelsus is a tablet that you take once a day in the morning, 30 minutes before eating, drinking, or taking any other medicines. You may eat, drink, or take oral medicine 30 minutes after taking Rybelsus. Semaglutide is not available as a generic medicine. Each of the different brands of semaglutide (Wegovy, Ozempic, Rybelus) is made by Novo Nordisk and are FDA-approved for different conditions.”

Semaglutide side effects

Talking about the common semaglutide side effects, Dr Rajiv Kovil said, “Common semaglutide side effects may include low blood sugar (in people with type 2 diabetes), upset stomach, heartburn, burping, gas, bloating, nausea, vomiting, stomach pain, loss of appetite, diarrhea, constipation, stomach flu symptoms, headache, dizziness, tiredness.” He recommended to tell your doctor if you have ever had -

• a stomach or intestinal disorder
• Pancreatitis
• Kidney disease or
• Eye problems caused by diabetes (retinopathy) or family history of thyroid tumours

Dr Rajiv Kovil cautioned, “In animal studies, semaglutide caused thyroid tumors or thyroid cancer. Semaglutide cannot be used by pregnant ladies and lactating mothers. It can be used by adults more than 18 years of age. Keep out of the reach of children and pets.”

According to Prachi Chandra, common side effects of the injectable Ozempic drug include nausea, vomiting, abdominal pain, dehydration, fatigue, changing bowel movements, reduced muscle mass, hypoglycemia, kidney damage, gastroparesis, SIBO, GERD, sarcopenia, nutrient deficiencies and pancreatitis. She asserted that the following individuals may not be candidates for Ozempic:

• Age over 65,
• Family history of thyroid cancer,
• BMI below 27,
• Children below 18 years,
• People suffering from kidney stones, gallstones, type-I diabetes etc.

Foods to Avoid on Semaglutide:

Prachi Chandra cautioned against high-calorie, low-nutrient foods and drinks as these foods contribute to weight gain without providing much nutrition. Examples include highly processed foods, fast food, baked goods and alcoholic beverages. Talking about fatty and fried foods, she said, “While healthy fats are necessary, excess intake of them can lead to digestive discomfort. Since fat slows down digestio and the drug already causes longer gastric emptying, eating a large amount of fat at one meal can cause things like nausea and abdominal pain.”

She added, "Limit foods like fried items, butter, and high-fat dairy products. Focusing more on plant-based fats and limiting unhealthy saturated fats can also have benefits for your heart health. Sugary snacks and beverages can significantly increase calorie intake with or without satiating hunger. Portion control is important. The diet should focus on incorporating nutrient-packed meals, ensuring that the body receives essential vitamins and minerals.

Prachi Chandra concluded, “Many individuals are told to remain on these drugs indefinitely due to the possibility of gaining all the weight back once they come off. As of now, we currently do not have sufficient data to say for sure whether these medications are safe for long-term use.”

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