• Posted February 1, 2023

Ozempic: Dieters Who Use Scarce Diabetes Drug Could Face Side Effects

Mila Clarke started taking Ozempic in 2020 to help manage her diabetes, but was pleasantly surprised to find herself soon shedding pounds.

"I was like, this is really weird because I'm not having to try very hard to do this,"said Clarke, who has been diagnosed with both type 1 and type 2 diabetes and chronicles her diabetes journey on her Hangry Woman blog. "And as I kept going on, I kept noticing that the weight was falling off."

Then the side effects started -- most worryingly, a racing and palpitating heartbeat.

"I could be laying down in bed and my heart rate, like resting heart rate, would be 120 beats per minute,"the sort of rate associated with exercise, Clarke said in an interview with HealthDay Now. "It was really having an effect on my heart rate, and that was really terrifying."

First approved to treat diabetes under the brand name Ozempic, the drug semaglutide received federal approval in June 2021 to also be prescribed as a weight-loss medication -- with the brand name Wegovy.

People interested in dropping pounds -- either for their health or for vanity's sake -- flooded the market for semaglutide, making it difficult to impossible for people with diabetes to fill prescriptions needed to manage their condition.

But semaglutide comes with some troubling side effects that people might not have considered in their search for the perfect body, experts say.

These can range from nausea and vomiting to premature aging of the face, as well as heart problems.

The drug is a synthetic form of a naturally occurring gut hormone, Dr. Holly Lofton, an obesity medicine specialist with NYU Langone Health in New York City, told HealthDay Now.

"It goes to different areas of the brain and blocks hunger signals, it goes to your stomach and slows down the rate your stomach empties, and it hormonally helps your body be more sensitive to the insulin that you produce, thus helping your fat cells shrink,"Lofton explained.

Because of the way it works, semaglutide's most commonly reported side effects involve the gastrointestinal system, Lofton said.

Those were the first that Clarke experienced.

Scary side effects, like a racing heartbeat

"You start out on a very low dose to have your body get used to it,"Clarke said. "You can get a lot of nausea, diarrhea, you can feel dizzy."

When Clarke advanced to the therapeutic dose of semaglutide, she developed heart palpitations and tachycardia (racing heartbeat).

"It got to a point where it was like I could feel my heart beating out of my chest,"Clarke said. "It would wake me up in the middle of the night, and I was kind of panicking because I was like, this doesn't feel right. It feels very scary."

Clarke didn't mention it, but other people who take semaglutide appear to develop what's becoming known as "Ozempic face,"in which rapid weight loss causes a person's face to look gaunt, saggy and prematurely aged.

"When you lose weight so acutely and quickly, you see more of a global facial wasting,"Dr. Paul Jarrod Frank, a New York City dermatologist, told NBC's TODAY show.

"It's not just a wrinkle we're seeing in one area or a heaviness around the eyes,"Frank continued. "We're seeing it in the temples, the jaw line, around the mouth, under the eyes."

Despite her side effects, Clarke stuck with Ozempic for about a year because the drug was very effective in controlling her diabetes and helping her lose weight.

Clarke dropped about 10 pounds within a month. By the time she decided to stop taking Ozempic a year later, she'd lost 35 pounds.

"It was really tempting to continue it because it's such an easy medication to take,"Clarke said. "It's once weekly, it's an injection, it does not hurt that badly at all, barely feels like a pinch."

"I just felt like, I kind of want to continue this because I'm seeing really good results on it. But then for the flip side, it was like, even though I'm seeing these great results, I feel awful all the time,"Clarke added. "I don't feel good, I don't have any energy, I feel sick and nauseous. And that's not quality of life."

Clarke was worried that she'd regain the weight she lost after she stopped taking Ozempic, but that wasn't what happened.

"I actually ended up maintaining my weight for a little while and then even losing a little bit more. So total, I lost about 50 pounds,"Clarke said.

As demand exceeds supply, some with diabetes go without

Clarke has described the semaglutide shortages as "really frustrating"on her blog, particularly for people who need the drug to manage their diabetes.

Wegovy contains a higher dose of semaglutide, because that's the dose needed to treat obesity as approved by the U.S. Food and Drug Administration.

Ever since Wegovy arrived on the market, manufacturer Novo Nordisk has struggled to meet demand, prompting off-label prescription of Ozempic for weight loss.

"There are people who are using it for weight loss for health purposes, and I think that is amazing,"Clarke said. "Especially with my own experience, I know how helpful it can be."

But social media has spurred demand by promoting semaglutide as a miracle weight-loss drug, Lofton said.

Wegovy is meant to help people with weight problems so bad that the extra pounds are harming their health, but semaglutide is instead being used to help people achieve the "perfect body."

Clarke noted an "Ozempic challenge"circulating on TikTok.

"It's people who are at a pretty normal weight,"Clarke said of the TikTok videos. "Maybe they have like 10 pounds that they want to lose because of some reason. From what I've seen, it's usually vanity purposes."

"And so they're using Ozempic, and I think that has a really big impact on people with diabetes because we're not able to get the drug at this point,"Clarke said. "There are so many shortages, and there's a lack of production for Ozempic with this increased demand because people are seeing that it works for weight loss very well."

Lofton said that both uses of the drug are legitimate, and what's really needed is for Novo Nordisk to resolve its production bottleneck and for insurers to cover semaglutide treatment.

Novo Nordisk has promised to resolve the semaglutide shortages within the first few months of 2023, Lofton said.

"We have about 40 million people with obesity/overweight, and we have about 11 million people in the U.S. with diabetes,"Lofton said.

"If the companies can't meet the demand -- which I'm glad the demand is great and people know about these drugs -- then we really need to reevaluate how these pharmaceutical companies are allowing us, as well as insurance companies are allowing us, to have access to these much-needed drugs for multiple conditions,"Lofton said.

More information

The U.S. Food and Drug Administration has more on shortages of Wegovy and Ozempic.

SOURCES: Mila Clarke, blogger and activist; Holly Lofton, MD, obesity medicine specialist, NYU Langone Health, New York City