Patients
As more South Africans turn to medical interventions for weight loss, Ozempic – originally developed as a treatment for type 2 diabetes (T2D) – has gained rapid recognition. But is this so-called wonder drug effective and, more importantly, is it safe for those without diabetes?
Dr Marius Wasserfall, a Specialist Physician at Mediclinic, says medications like Ozempic can be valuable adjuncts to lifestyle changes like diet and exercise. “These medications are not a silver bullet,” he notes, “but they can help patients battling obesity make real progress when combined with healthy habits.”
Obesity is a growing concern worldwide, with predictions indicating that by 2030, half of the world’s population will be overweight or obese. In South Africa, this figure has already been reached, with more than 50% of adults classified as overweight or obese.
“The challenge with obesity is complex. It involves not just willpower, but changes in the brain’s appetite regulation and metabolic processes that make long-term weight loss difficult,” says Dr Wasserfall. “Ozempic works by addressing this challenge at the root. It affects hunger and satiety hormones in the brain, helping people feel fuller for longer and reducing their appetite.”
Ozempic, also known as semaglutide, belongs to a class of drugs called Glucagon-like peptide-1 (GLP-1) receptor agonists that help to regulate blood sugar levels. While Ozempic was only officially approved for the treatment T2D in 2017, a secondary effect became apparent during clinical trials: patients were experiencing significant weight loss. This discovery led to the drug quickly being prescribed off-label for weight management.
In 2021, the US Food and Drug Administration (FDA) approved a higher dose version, marketed as Wegovy, specifically for chronic weight management in individuals with obesity or related health conditions. Since then, interest in the drug has skyrocketed, driven by glowing endorsements from celebrities and widespread attention on social media platforms.
The appeal is understandable. Studies show that participants using semaglutide lost up to 15% of their body weight – a figure unmatched by most other weight-loss treatments. But experts warn that using Ozempic without a prescription, or for reasons other than diabetes management, comes with risks.
“Side effects can include nausea, vomiting, and diarrhoea, and long-term safety for non-diabetic users remains unclear,” warns Dr Wasserfall. “While serious adverse effects are very seldom seen, they include acute pancreas inflammation and gallbladder problems. Some studies involving rodents found that this medication resulted in medullary cancer of the thyroid.”
Despite its effectiveness, there are also concerns about the long-term sustainability of weight loss achieved through Ozempic. Dr Wasserfall cautions that this is a lifelong treatment: “Stopping the medication will result in the majority of the weight lost being regained.” Studies have backed this up, showing that patients tend to regain most of the weight after discontinuing semaglutide or other GLP-1 receptor agonists.
The reason for this lies in how these medications work. Ozempic and similar drugs improve the brain’s regulation of appetite and alter the body’s biology. However, as Dr Wasserfall points out, “once you stop using it, your brain biology reverts to its previous state, and you will likely regain the weight.”
Dr Wasserfall notes that affordability is therefore a major factor: “The reality is that these medications are expensive, and many medical schemes will not cover them for weight management, only for diabetes.” This makes it essential for individuals considering Ozempic or similar drugs to weigh the costs carefully and recognise the commitment required to maintain results.
“Availability is another concern,” he adds. As demand grows among those seeking weight loss, shortages of the drug are making it difficult for diabetics, who rely on Ozempic to manage their condition, to access the medication. This has led to calls for caution and more stringent regulations to ensure the drug remains accessible for those who need it most.
Ozempic’s rise as a weight-loss quick-fix speaks to a broader societal issue – the pressure to conform to ideal body standards. While the drug may offer a solution for some, healthcare professionals stress that any weight-loss treatment should be approached with careful consideration of the risks, and in consultation with a medical professional. Medications like Ozempic are just one piece of the puzzle and weight management remains a multifaceted issue that requires long-term lifestyle changes to achieve and maintain results.
While GLP-1 receptor agonists show promising results in weight loss, Dr Wasserfall believes that focus should shift to prevention. “We need to prioritise preventing obesity, especially in our youth, to reduce our reliance on costly, lifelong medications like Ozempic. Encouraging healthy habits is crucial. Ultimately, it comes down to this: you’ll face either the pain of self-discipline or the pain of regret – the choice is yours,” he concludes.