This article is intended to inform. It is not an endorsement or an opinion. It is not intended as medical advice; always discuss any medications with your doctor.
As we head into the holiday season, talk of Ozempic, the diabetes medication touted as the “miracle” weight loss drug, is louder than ever.
Always wary of miracle meds, we turned to one of the country’s top plastic surgeons, Westport-based Dr. O’Connell, to learn more about how it works and its side effects.
According to Dr. O’Connell, Ozempic, Wegovy and Rybelsus are all versions of the generic “semaglutide” which belong to a class of drugs known as GLP-1 agonists. Ozempic and Wegovy are administered as weekly injections while Rybelsus is a daily pill.
GLP-1 is a peptide hormone naturally made by our body that, in response to a meal, enhances insulin secretion thus helping your body regulate blood sugar levels. This is why drugs that mimic GLP-1 (like Ozempic) are useful in treatment of Type 2 diabetes.
These drugs delay stomach emptying and communicate with the appetite control center in the brain to reduce appetite. The result is weight loss that can exceed 10% of your body weight, hence its popularity among those wishing to easily shed some pounds.
Ozempic and Rybelsus are approved to treat Type 2 diabetes. Wegovy is a higher dose version of semaglutide specifically to treat weight loss.
Let’s throw another drug on the script: the increasingly popular Mounjaro (tirzepatide). This is a different drug that mimics a second hormone called “glucose-dependent insulinotropic polypeptide” (or GIP) that stimulates both insulin and glucagon secretion, helping to control Type 2 diabetes and result in weight loss.
But nothing’s ever that simple. First, up to 39% of the weight lost with these medicines can include lean muscle, so Dr. O’Connell recommends adding weight training to the program. Second, about two-thirds of the weight tends to come back after stopping a GLP-1 agonist, which means you should have a diet and exercise plan for when you stop taking it.
Third - and this is serious - it may interfere with anesthesia should you require surgery. How? A recent study in Brazil showed “about a quarter of patients taking semaglutide had residual food in their stomachs during procedures requiring sedation — even after stopping the drug for 10 days.” With food in the stomach, an individual risks vomiting perioperatively, which can lead to pneumonia and even death. Doctors are now recommending at least three weeks without injections for surgery patients.
Not as serious but still a concern, you’ve probably heard of “Ozempic face.” Dr. O’Connell explains the skin on our face is supported by the underlying fat. If this fat disappears too quickly, such as with rapid weight loss, the skin doesn’t have time to contract properly. The result is loose, saggy skin, a hollowed-out appearance, and more lines and wrinkles.
Now, none of this touches upon the greatest gating factor: a price tag of, typically, $1,000 a month.
Due to cost and the increasing demand for the drug, some compound pharmacists are creating their own cheaper versions. However, Novo Nordisk, the maker of semaglutide, does not sell this product for compounding purposes. Which means these pharmacists are using generic brands that are not FDA-approved and mixing them with ingredients that may or may not cause negative interactions.
States are cracking down on these imposter drugs, some of which don’t work, others of which could be contaminated or dangerous, so “get your medication from your internist, trusted family physician or endocrinologist and I’d stick with the actual name brands.”
Granted, this is all a bit daunting. However, weight loss and sugar control has many health benefits, so don’t let bootleg meds or “Ozempic face” deter you from maintaining a healthy lifestyle. Any havoc wreaked on one’s face or body can be addressed.
Dr. O’Connell works with “patients in need of various nips and tucks [and facelifts] following weight loss” on a daily basis. “We can address all of this but stick with a board-certified plastic surgeon – and do your homework first.”
As with any changes one decides to make to their body, consider it a multi-step process that must be maintained, and embark on the journey with all of the information.
PlasticSurgeryCT.com
"These drugs delay stomach emptying and communicate with the appetite control center in the brain to reduce appetite."