Are you still looking for the miracle method that promises fast weight loss with minimal effort? You’re not alone. According to the World Obesity Atlas, slightly more than half of the world’s population (51%) will be overweight or obese by 2035. This trend is driven by factors like junk food, malnutrition, a sedentary lifestyle, and lack of physical activity. But recently, a new trend has emerged: injectable anti-diabetic medications. The promise? Lose several pounds quickly by simply injecting doses of Ozempic, Mounjaro, or Wegovy.

Oprah Winfrey, Rebel Wilson, Whoopi Goldberg, and Tori Spelling all openly use these products. That was enough to ignite interest among numerous influencers, to the point that the hashtag #ozempic has amassed over 500 million views on TikTok. So, how do drugs intended for diabetes work for weight loss? And are there any health risks to this off-label use? We discuss this with Dr. Kanza Benomar, an endocrinologist in Casablanca.

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Ozempic, Mounjaro, Wegovy… What are they?

Though they have different names, these medications belong to the same family: GLP-1 (Glucagon-Like Peptide 1) analogs, which are intestinal hormones. Essentially, they mimic GLP-1 by regulating blood sugar levels and controlling appetite. “There are two types of these analogs on the market: liraglutide, sold under the names Victoza and Saxenda, and semaglutide, known as Ozempic and Wegovy. Mounjaro, on the other hand, is a tirzepatide, which contains two hormones that activate both GLP-1 and GIP (Glucose-Dependent Insulinotropic Polypeptide) receptors,” explains Dr. Benomar.

But which one should you choose for weight loss? “They all  work similarly and benefit both diabetes and weight loss. However, the dosages vary depending on the condition,” she clarifies. To put it simply, Ozempic and Wegovy both contain semaglutide, but Ozempic has a lower dosage for diabetes. Conversely, Wegovy has higher doses, making it more suitable for overweight or obese individuals. “It’s the same with Victoza and Saxenda. The former is used only for diabetes, as it doesn’t exceed 1.8 mg of liraglutide. Saxenda, however, can reach up to 3 mg, which is better suited for weight loss,” Dr. Benomar adds.

Finally, the main difference between semaglutide and liraglutide lies in their duration of action. The former lasts several days in the body, requiring a weekly injection, while the latter is shorter-acting, thus requiring  daily injections. The choice of active ingredient depends on the patient’s history, goals, and more.

Not for cosmetic weight loss

These drugs act in several ways on the metabolism: by slowing stomach emptying, regulating insulin secretion via the pancreas, and promoting a feeling of fullness in the brain. The result? The body feels satiated more quickly, leading to reduced food intake and thus, noticeable weight loss. In fact, it’s possible to lose 10-22% of one’s excess weight. However, these drugs aren’t meant for people simply looking to shed a few pounds.

“That’s precisely the issue. While the molecule isn’t inherently dangerous, these medications have specific indications and restrictions. There’s always a benefit-risk balance to consider. To be eligible for these treatments, one must have a BMI over 30 without comorbidities, or over 27 with conditions like sleep apnea, hypertension, prediabetes, diabetes, etc. So, they’re not meant for individuals looking to lose just 3 or 4 kilos. In such cases, the risks outweigh the benefits,” warns Dr. Benomar.

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Beware of side effects

Aside from misuse dangers, the popularity of these drugs is also affecting availability. Due to this trend, pharmacies in Europe and the U.S. face Ozempic shortages, with some people even forging prescriptions. Each drug has a different dosage of the active molecule, so while someone with obesity can use Ozempic, a diabetic cannot use Wegovy. Recently, on October 8, 2024, Wegovy became available in France under strict regulations.

Like any treatment, these drugs have side effects, primarily digestive, tied to their action mechanisms. Slowed stomach emptying can lead to stomach pain, acid reflux, abdominal pain, constipation, nausea, vomiting, fatigue, and muscle loss from reduced food intake.

“Before prescribing these drugs, it’s essential to be aware of possible contraindications. For instance, I would never prescribe it to someone with a history of pancreatitis or a family history of pancreatic cancer. I also screen for thyroid nodules, as patients with malignant conditions like thyroid cancer should not use these treatments,” Dr. Benomar says.

Avoid self-medication!

These treatments require a prescription and should not be self-administered. Only endocrinologists, gastroenterologists, cardiologists, pulmonologists, and sometimes nutritionists can prescribe these medications. “It’s crucial to be guided by a knowledgeable doctor to prescribe it safely, monitor the side effects, contraindications, and ensure proper protocol follow-up,” she explains.

Be wary of dietitians who prescribe these drugs. “They’re not specialists and aren’t equipped to conduct the necessary evaluations. Proper care includes specific dietary and sometimes psychological support,” Dr. Benomar cautions.

Once again, the protocol varies with each patient’s condition and background. And these drugs won’t work miracles without dietary and fitness efforts. “I believe these treatments can be seen as a starting point for a lifestyle change. They give overweight or obese patients in a therapeutic impasse the motivation to increase physical activity as they begin to feel lighter. So, they can truly encourage a healthier lifestyle,” concludes the endocrinologist. Note that in Morocco, only Victoza (containing liraglutide) is available, costing approximately 1,000 dirhams per month for a 6-12 month treatment.

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