Ozempic
Semaglutide has been a very controversial topic nowadays. Its use is for people with type 2 diabetes, but lately, celebrities and people all over the world have been using it to lose weight. While this seems wonderful, it is actually extremely dangerous. Have you heard the ad with the catchy song that goes “Oh-oh-oh-ozempic~?” This is ONLY for people
Semaglutide
Semaglutide, more commonly referred to as Ozempic, is the “skinny pen” that can help an individual decrease their body weight and risk of major cardiovascular events. Semaglutide takes effect by helping the pancreas to release the proper amount of insulin when blood sugar levels are high. Insulin helps with moving sugar from the blood into other body tissues, where it is utilized for energy. By imitating GLP-1 (Glucagon-like peptide 1), a naturally occurring hormone in the body, semaglutide can help with decreasing blood sugar levels by enhancing the secretion of insulin. Ozempic is able to imitate by binding to the GLP-1 receptors on pancreatic beta cells, which increases cyclic adenosine monophosphate (cAMP). cAMP activates a protein called kinase A (PKA), which releases insulin from the beta cells. In addition, the binding of Ozempic to GLP-1 receptors allows for regulation of hormones that control appetite. As the GLP-1 levels reduce, the glucose levels in the liver decrease too. Last but not least, Ozempic also slows down digestion of food, which decreases blood sugar even more.
Oral Semaglutide
Oral semaglutide is a tablet that is absorbed in the stomach. This tends to be a more preferred method for multiple reasons. First of all, oral medications are simply easier to take, and they are not as much of a hassle. It is convenient. In addition, oral semaglutide is formulated with an absorption enhancer, so it has a higher solubility and protection against proteolytic degradation. Especially for patients with diabetes, oral semaglutide is preferred over injections because it increases comfort. It is a very patient-friendly alternative to the injection.
Chemistry of Ozempic
Ozempic is a protein, composed of 187 amino acids, and contains a peptide called GLP-1 (glucagon-like peptide-1), which is very similar, having a 94% sequence homology (similarity rate) with the naturally occurring GLP-1 in our bodies. This gives us feelings of satiation so that we don’t eat any more.
The backbone of the peptide is produced through yeast fermentation (using organisms to turn carbs into alcohol or an acid). This process generates impurities as a byproduct. We make 3 amino acid substitutions inside the backbone so that we can have more stability, and we attach albumin-binding C-18 fatty di-acids with hydrophilic spacers (through a process called acylation). Stability is achieved by attaching the enzyme DPP-4 so that it is safer to use. Lastly, the impurities mentioned before are detected through a process called high resolution liquid chromatography mass spectrometry (a technique that combines chromatography, where you isolate different components in a mixture, and spectrometry, a method of measuring relative abundance of isotopes in a substance).
Dosage & Administration
Dosage of semaglutide is extremely important as this hormone can create drastic changes within the body. Typically, 0.25 milligrams (mg) of semaglutide is injected under the skin once a week for 4 weeks. After, depending on the individual, the doctor may increase their dose as needed. However, the dose is usually not more than 2 mg once a week because that can put the body at extreme risk of danger. There are different areas that semaglutide can be injected into. These include but are not limited to the upper arm, stomach, or thigh. Patients should change between locations each week so that the semaglutide is not being injected into the same place every time. Equal spread of area allows for less pain and a lower chance of complexities/altercations. As for all other typical injections, patients should use an alcohol wipe to disinfect the area of injection beforehand. The injection process is the same as other basic injections. These self-injections need to be done precisely and without fear. Simply hold the pen firmly in your hand and press it into the injection site. Slowly, inject the hormone in and slide the needle out.
Ozempic Differentiation
Of course, semaglutide is a prescription medication, but it also requires constant supervision of a healthcare provider. It is consumed or injected by the individual themselves, but a healthcare provider will need to consistently monitor its effects on weight, blood sugar control, and potential side effects. It can only be used for people with a BMI of 27 or higher, and it is NOT an over-the-counter solution for weight loss. This has become very popular recently, and it’s not in the least bit healthy to use Ozempic as a tool for weight loss. While other weight loss medications work through mechanisms like appetite suppression or fat absorption inhibition, semaglutide works by causing the hormones to reduce blood sugar, which leads to a lower calorie intake and a suppressed appetite. This results in weight loss. Once again, Ozempic is not used for weight loss; weight loss is a side effect. In fact, the FDA did not approve Ozempic for weight loss. This is why weight loss is an off-label use, which is not the original intention. Instead, there are other medications like orlistat, phentermine, or liraglutide that have FDA approval for usage for weight management. It is unwise and unsafe to rely on Ozempic for weight loss.
Sustain Trials
All of the SUSTAIN trials are compared with glycated hemoglobin, which is used to lower body weight. They all come to the same conclusion that semaglutide reduces body weight more than any other placebo or drug like sitagliptin, exenatide, insulin, etc.
Ozempic Trials
The Semaglutide Treatment Effect in People with Obesity (STEP) clinical trials were designed to see the efficiency semaglutide has on weight loss. By comparing placebos or other medications, these studies evaluated different dosages. STEP 1 reported that the group that received 2.4 mg of semaglutide weekly for 68 weeks lost much more weight than all the other groups it was compared to. STEP 2 did the same process but with a lifestyle intervention and this increased the percentage of weight lost from 15% (in STEP 1) to 17%. STEP 3 reported that people who received semaglutide had better blood sugar control and more weight loss. STEP 4 looked at the long-term effects of semaglutide through a period of 104 weeks. Another trial is the PIONEER 6 Trial, which focused on people with type 2 diabetes.
Side Effects
Ozempic is generally safe if it is taken for type 2 diabetes; its safety is still not completely known for weight loss. The most common Ozempic side effects are nausea, vomiting, diarrhea, abdominal pain, and constipation. In addition to these, there are more serious side effects, including allergic reactions, changes in vision (diabetic retinopathy), gallbladder problems (acute gallbladder disease), kidney failure (acute kidney injury), pancreatitis, and a risk for thyroid C-cell tumors and medullary thyroid carcinoma (MTC). It can cause abnormalities in the fetus stage, and it can possibly cause depression and recurring suicidal thoughts. There are also possible chronic effects, and it can cause the skin to sag too. One of the most serious effects is pancreatitis. This inflammation of the pancreas changes the way the organ and tissue work.
Affordability
Ozempic prices vary. If you are in a savings program, the price can be as little as $25 a month, but without savings it is around $900 a month. There are many ways to reduce the cost. You can use an Ozempic savings card from Novo Nordisk, the manufacturer of Ozempic, to get a 90-day supply. That same company also has patient assistance programs for people with a household income under 400% of the federal poverty line so that they can get Ozempic for free as long as they’re a US citizen or legal resident. If an individual does not have insurance, Medicare, or other cost-reducing programs, prices can be quite high. Either way, Ozempic is typically not covered by insurance.
Staying Educated and Looking for the Signs
It is always important for healthcare workers to inform their patients of why they are using semaglutide in order to confirm the true intentions of usage. In addition, all patients must be aware of ALL potential side effects. If symptoms are life-threatening, the patient must call 911. Ozempic can be taken until the healthcare worker recommends an individual to stop usage.
Many people often want to use Ozempic to lose weight, but they tend to be unaware of the side effects. The potential risks are not worth the purpose. This is why healthcare workers should be cautious around people who do not want to use Ozempic for its original intentions. Ozempic is not made for fat loss, so it can be very harmful for a patient who only cares about weight loss. Instead, healthcare workers can point these individuals to making lifestyle changes like changes in diet so that they can reach their goal.