Unmasking the Dark Side of the Ozempic Craze

Unmasking the Dark Side of the Ozempic Craze

By Gary M. Pepper, M.D. Ozempic, Rybelsus, Trulicity, Wegovy, Saxenda are the central players in the weight loss craze sweeping across the globe. Metabolisim.com has been monitoring this phenomenon from its beginnings in 2008 with its report “Lizard Spit Reduces Blood Sugar and Appetite”, regarding the first drug in this class, Byetta (exenatide). Caught In the middle of the current chaos are the medical experts who treat diabetes and have been prescribing these medications for more than a decade. Here is a brief commentary from one such board certified endocrinologist; “I started treating Type 2 diabetics with GLP-1 agonists more than 10 years ago. In some respects, these medications have revolutionized the treatment of diabetes by lowering blood sugar effectively and promoting weight loss at the same time, a unique combination of benefits. Not everyone benefits from these drugs to the same degree unfortunately, and I have seen lots of patients experience unacceptable side effects from them. Nothing though, has prepared me for what is happening now. Too often, I find myself confronting someone who expects me to prescribe one of these drugs just so they can lose weight. Sadly, one extreme example was someone who, despite battling a life threatening medical condition, was insistent on getting a prescription. At the same time my diabetic patients are scrambling to find a place to buy their medications if they can even afford it. It is disheartening, to say the least, and I dread the negative interactions with some of my patients I now face almost daily.”

Off- Label Use

The FDA is the U.S. government’s department tasked with evaluating and approving drugs for specific medical conditions. When a new medication is approved for treating a medical condition by the FDA the agency will, at the same time, set strict guidelines for exactly which patients may use the newly approved drug. When a medication is used “off-label” it means that these limitations are being overridden by the provider for a potential benefit which outweighs the drugs risks. It is a general misconception that off-label means illegal; it does not. This practice has been going on for ages and more than 20% of prescriptions in the United States are prescribed off-label. A common example is the use of beta-blockers (approved for heart problems) for the treatment of performance anxiety.

GLP-1 agonist drugs, as discussed recently by metabolism.com. were originally approved for the treatment of Type 2 diabetes in adults. In the past few years most of these same medications have gained unprecedented popularity for their “off-label”  weight loss benefit. Of the 5 GLP-1 agents presently in U.S. pharmacies only Wegovy (semaglutide) and Saxenda (liraglutide) are FDA approved for treating obesity. Of these two, Wegovy is the newer and had been much more popular that its sister drug Saxenda, probably due to being dosed only once weekly compared to daily for Saxenda and less likely to cause side effects. Due to Wegovy’s soaring popularity, its manufacturer, Novo Nordisk, increased the price of Wegovy two times since its initial release. (more…)

Lizard Spit Reduces Blood Sugar and Appetite

By Gary Pepper, M.D., August 18, 2008

Gila Monster



I just returned from a conference on the latest wonder drug to be launched in the battle against diabetes Type 2  diabetes (the kind treated with pills, not insulin injections). The drug, brand named Byetta,(exenatide), is a derivative of a compound in the saliva of the Gila Monster. These ugly and venomous lizards eat 3 times per year. How about that for metabolism? Helping them accomplish that is a chemical in their digestive tract that turns insulin production on when needed. The scientific name of this naturally occurring substance is glucagon-like-peptide 1, or GLP-1, for short. Since diabetics don’t make enough insulin this wonder drug is ideal for helping them get more of what they need.

As if that isn’t enough, Byetta (the synthetic version of  the compound in Gila Monster spit) turns off feelings of hunger. What is the result in humans? You guessed it,… weight loss. Not just routine weight loss but a weight loss that keeps on going and going and going. In one preliminary study the weight loss continued for up to 82 weeks.

Is there a downside to all this? Certainly. First of all, the medicine must be self administered as an injection twice a day. Second, some people experience nausea or constipation using Byetta.  The degree of unpleasant gastro-intestinal symptoms produced by this novel medicine will likely determine how wide spread its use will be. One wonders if it could become the next blockbuster drug.

Byetta is marketed by Amylin Pharmaceuticals and Eli Lilly Company and is available by prescription only. If you suffer from Type 2 diabetes you may want to ask your doctor if artificial lizard spit is right for you.

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