Weight-loss wonder drugs: Mass. doctors explain who should really be taking them

WORCESTER, Mass. — It’s the time of year when most people want to see the numbers on the scale going down as weight comes off.

Now there is a new way to help people drop those pounds. Move over diet and exercise, and make room for semaglutide. Thanks to omnipresent TV commercials, you probably know it better by its brand name, Ozempic.

“It was actually introduced for diabetes and approved for diabetes and we saw that it suppresses the appetite and causes weight loss”, said Dr. Samin Malkani, an endocrinologist from Umass Memorial Health in Worcester.

Dr. Malkani has been treating his patients with Ozempic, a drug a patient injects once a week. While he said it works very well for diabetics, doctors quickly noticed another benefit from the drug. 

“People were losing between twenty and forty pounds,” he said. “So, they became popular for the weight loss aspect of things.”

Ozempic did wonders for Dale, a diabetic from Worcester, who didn’t want us to use her last name. She first started using Ozempic last May and not only did it control her diabetes, she lost a significant amount of weight. It even allowed her to get off of insulin. 

“(I) lost about 35 pounds, that is a lot for a short person,  you know, it is a lot. I went down like three sizes,” she said.

Dr. Malkani added, “The drugs are incredibly effective, so they could reduce the incidents of obesity dramatically.”

Noting the remarkable effect it had on weight loss, drug maker Novo Nordisk decided to market the same drug, but with different packaging and a different name. The weight loss drug is called Wegovy, which is made with the same semiglutide.

“So, if someone wants it for weight loss, you have to get approval from the insurance company for weight loss,” Dr. Malkani explained. “If they want it for diabetes, you get approval to use Ozempic for diabetes.”

Even at a cost of about $1,000 a month, these drugs are flying out of pharmacies. According to data compiled by Trilliant Health, prescriptions for the drug (including the pill form called Rebelsus) have gone up 300 percent since the year 2020. 

Nine million prescriptions for these drugs were written in the last three months of 2022. With demand overwhelming supply, some doctors think diabetics should be first in line for it. 

“I think, that person, again, has a greater need for the drug than someone who is slightly overweight and has no associated health conditions,” Dr. Malkani said. “But again, who should decide who gets it and who doesn’t.”

With the popularity of these drugs for weight loss, doctors are concerned about who may want them.  

Dr. Amin Sabat, also an endocrinologist at Umass Memorial, is concerned about people using these drugs for vanity purposes. There are many with no serious health concerns who use this drug only for cosmetic reasons. 

“It does concern me. All of these medications have risks and potential side effects,” Dr. Sabat said.

Those short-term side effects include things like nausea, stomach paralysis, and gastric discomfort. There are potential long-term side effects as well, according to Dr. Malkani. 

“Most of the weight loss is fat mass, but you do lose muscle mass and you do lose bone mass, and I’ve seen people who lost bone to the point they became osteoporotic,” Dr. Malkani explained.

Still, obesity presents its own health complications. However, the benefits of these drugs could far outweigh the other side effects.

“I don’t have a hesitation of prescribing it as long as the person really understands what it’s all about and what the effects could be,” Dr. Sabat said. “It’s a very exciting field. People who didn’t have a lot of great options before, we’re seeing great options for them.”

That includes patients like Wendy Titchen. These drugs did for her what gastric bypass surgery could not -- helped her lose weight.

“I have steadily lost a significant amount of weight, about 122 pounds,” she said.

Doctors are excited about the potential to combat obesity in the coming years.  

Drug maker Eli Lilly claimed it is seeing the same results from its drugs Trulicity and Mounjaro. The FDA just approved Mounjoro as a weight loss drug last year. 

Dr. Sabat is also excited about the impact of the drug Zepbound.

“I would say these are game-changing drugs,” Dr. Sabat said.

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