Battle Of The Bulge: Are semaglutides the answer?

While each of us should aim to be fit as a fiddle, how we achieve our fitness goals is the real question. With Ozempic and Wegovy becoming a global rage, here’s what experts have to say about using semaglutides for weight loss

Hyderabad: In the winter of 1944, Nazi Germany unleashed its final major offensive to stop the Allied forces from using the strategic Belgian port of Antwerp and to split enemy lines. It was called The Battle of The Bulge — a key turning point in World War II.

Today, our world is living through two major wars — Russia-Ukraine and Israel-Gaza-Lebanon. And, it is on the brink of a full-blown escalation that many fear may manifest in World War III.

While top diplomats, leaders of State and geopolitical analysts are yet again in a huddle to save humankind, this time from ballistic missiles and drones, another ‘Battle of The Bulge’ is ensuing far, far away from the frontlines — in the glistening urbanscapes where vanity is up against wellness and cosmetic against health in the race to look like a million bucks.

With every passing day, as lifestyle changes for the worse — blame it on technology, sedentary work culture, lack of discipline or arrogance — our world is spending every waking moment fighting OBESITY. According to a recent study published in Lancet, 70 per cent of India’s urban population is obese, which puts the country in the midst of a global obesity crisis. More than one billion people worldwide are obese, which makes them prone to several diseases such as heart ailments, diabetes and cancer, the study states.

While each of us should aim to be fit as a fiddle, how we achieve our fitness goals is the real question. Today, many believe that the wait to rid ourselves of weight has ended. Enter Ozempic and Wegovy!

The Global Rage

Formulated to manage blood sugar levels in type-2 diabetics, Ozempic is the new buzzword. It is a semaglutide subcutaneous injection that has caught the fancy of celebs and influencers for its rapid weight-loss properties. With many in the West — notably Elon Musk and Oprah Winfrey — drastically shedding those pounds due the injectable, it’s being touted as a ‘miracle drug’, a ‘gamechanger’. The drug has become an internet sensation; people are jabbing themselves with it even if it is just to lose those last few extra kilos.

Drugs with semaglutide as their active ingredient trick your brain into making you feel full. They mimic the role of Glucagon-like Peptide-1 (GLP-1), which is a hormone that is secreted when we eat. It signals the body that there’s food entering and to get ready to convert the nutrients into energy. Drugs like Ozempic do just that — they suppress appetite and induce satiety.

The success of Ozempic in terms of attaining weight loss has been such that drug maker Novo Nordisk came out with Wegovy — another semaglutide injection that it markets purely as a weight-loss drug. While these two are not yet available in India, people either import them or procure them from the grey market, wherein they run the risk of using counterfeit products.

“Ozempic, which is a Type-2 diabetes medicine and also used off-label for weight loss, and Wegovy, the first USFDA-approved medicine for weight management, are both semaglutide injection products from Novo Nordisk. These may be imported for personal use by submitting an application in Form 12A to the Central Drugs Standard Control Organisation (CDSCO) and obtaining permission in Form 12B from the CDSCO. However, the instances of Ozempic injections being sold in the grey market were detected by the Drugs Control Administration, Telangana. Stocks of Ozempic were seized at a medical shop in Nampally, Asha Medical Hall, in September 2023. A case was filed against the offenders,” says VB Kamalasan Reddy, Director General of
Telangana State Drugs Control Administration (TSDCA).

These come at a steep price. A month’s supply can set you back by over Rs 80,000, according to reports. For example, Ozempic has to be taken weekly once, with each dose, if imported, costing around Rs 20,000. Meanwhile, manufacturer Novo Nordisk sells the same semaglutide medication for type-2 diabetics in a pill form in the country under the brand name Rybelsus, which needs to be taken every day. A Rybelsus strip of 10 costs around Rs 3,000, each pill costing Rs 300.

Conditions Apply

But experts warn that semaglutides are not for all. “All drugs come with side effects. Weight loss is a side effect of Ozempic, which has gained prominence. If one has to take a weight loss drug, it has to be done under strict medical supervision by a doctor. Additionally, drugs like these are not prescribed to anyone, the patient must fit the criteria. These drugs are usually administered to those with a Body Mass Index (BMI) higher than 27, when the body needs extra assistance to lose weight. But there are riders to this. Just taking the medication doesn’t do it, one has to back it up with eating right and exercising regularly,” says Mumbai-based celebrity wellness and nutrition specialist Dr Namita Jain. She also insists against self-administering these drugs.

As miraculous Ozempic is being made out to be, the rapid weight loss it causes shows up on the face. Many users have shared how they started to look aged after taking the injectable. They call it the ‘Ozempic Face’. But it would be unfair to blame this solely on the ‘top selling diabetic drug’. Doctors say when the body loses mass drastically through any means — be it diet, exercise, illness or
medication — it sheds facial fat too. When that happens, the skin begins to sag, the face looks gaunt and the areas around the eyes turn hollowed. But for those who can afford it, there are always dermal fillers to the rescue.

Growing Addiction

Dr Jain warns that weight-loss drugs can be addictive. When one starts taking them and begins to see the quick results, it’s just hard to stop. “Patients lose 5-8 per cent body weight in about six months. But, this is not the cure to obesity,” she says. Dr Jagadeesh Kumar V, a senior physician, diabetologist and internal medicine specialist at KIMS–Secunderabad, strongly believes that
Ozempic is no gamechanger in diabetes. “It’s a new molecule that needs more studies. One major side effect is sarcopenia, wherein the patient loses muscle mass. But we need more authentic trials to ascertain the side effects,” he says, adding that if the goal is to treat diabetes effectively, there are many other safer and tested options in the market, which are cheaper too.

He points out that most people, amidst all this hype, have overlooked the fact that Ozempic comes with a black box warning by the US FDA — the drug could cause thyroid malignancy, i.e., thyroid tumours and thyroid cancer. “There are no shortcuts to weight loss. It’s all about discipline. In cases wherein one has to opt for medical weight loss, it has to be done under close supervision of a doctor. And, as far as possible, surgeries for weight loss should be avoided,” he concludes.

If you want that ‘perfect bod’, you have to sweat it out, eat clean, stay away from processed foods and get a good night’s sleep.