Weight loss, Wegovy and how the drugs work
The metabolic syndromes Type-2 diabetes and obesity have boomed in the United States. There are about 30.6 million people living with Type-2 diabetes and about 36% of people in the United States are considered obese.
Obesity is a risk factor for developing Type-2 diabetes and other metabolic syndromes, but up until recently, the treatments for this disease were limited. That’s why endocrinologists and obesity medicine specialists everywhere were excited about the approvals of Ozempic and Wegovy.
But the conversation around these medications hasn’t been on target. Ozempic has been at the center of controversy in Hollywood, where its rumored use has gotten a lot of attention, particularly by already thin celebrities. Physicians are also frustrated by the difficulty in getting these medications approved by insurance companies.
We go over everything you need to know about Ozempic.
How does Ozempic work for diabetes?
Semaglutide is the generic name for both Wegovy and Ozempic, which are made by Novo Nordisk. Wegovy is approved for weight loss, while Ozempic is used to treat people with diabetes.
Dr. Judy Korner, an endocrinologist and the founder and director of the Metabolic and Weight Control Center at Columbia University, says that Ozempic mimics the hormone GLP-1, which helps the pancreas release insulin.
“GLP-1 goes to the pancreas, and helps the pancreas make insulin – but only when the body needs insulin. So when glucose levels rise, the body needs more insulin, and GLP-1 or Ozempic (its mimicker) helps the pancreas release insulin,” Korner explains.
How does Ozempic work for weight loss?
It acts on the brain.
“Semaglutide (Ozempic or Wegovy) sends signals to the appetite center in your brain to reduce hunger and increase fullness,” according to Dr. Deborah Horn, an associate professor in the Department of Surgery at McGovern Medical School at UTHealth Houston. “This helps you feel full with smaller meals and decreases the need for snacks.
“Many of us eat to manage emotions like stress or boredom. Wegovy decreases what we call ‘food noise’ so that we aren’t thinking about food as much or using food to try and solve other problems. Many individuals also report decreased interest in alcohol, which reduces calories from both the alcohol and the food that we usually eat with it.”
What is the downside of Ozempic?
Common side effects of these so-called GLP-1 receptor agonists – nausea, diarrhea, vomiting and constipation – can be significant.
Dr. Waj Mehal is a professor of medicine at Yale School of Medicine, an obesity medicine doctor and the director of the Fatty Liver Program and Yale Metabolic Health and Weight Loss Program. He says, “Almost everyone has nausea when they start but this improves after a week or so. There is a low risk of pancreatitis and gallstone disease, and the drug needs to be continued to maintain benefits.”
Why is Ozempic not covered by insurance?
Even though these medications have been approved by the FDA, that doesn’t mean your insurance company will approve the expensive cost of the medications.
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Most insurance plans, including Medicare, do not cover the cost of weight loss treatments other than some sessions with a nutritionist.
There is a misconception that these medications are simply about vanity, or that obesity is simply about willpower.
“It’s horrifying for us as physicians. It puts us in a very awful situation of wanting to do the best for our patients based on the evidence. It feels like having to treat our patients with our hands tied behind our backs.”
Insurance coverage may change because of the new medications, which seem safe and effective, and under pressure from drug makers and the public. But the cost of these drugs make it hard for people – or insurers – to afford them.
Contributing: Karen Weintraub, USA TODAY
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