Be careful taking Ozempic

Most of us have spent a significant amount of time trying to shed off those extra kilos that have left 23% of Kenyan adults overweight, but most of us have terribly failed while at it.

We have had over 40 years of relentlessly promoting diet and exercise as the only solution for significant weight loss, but only a small fraction of people manage to achieve this objective in the long run.

As one writer opined, the reality is that people don’t fail diets, diets fail people. Most of the time, the desire to lose weight is often because of external societal pressure for those who feel ridiculed by those in their surroundings.

Unlike when we were growing up, when body size was associated with wealth or well-fedness, our society today is facing a real moral issue where the culture discriminates against people based on their body size. Unfortunately, we live in an obesogenic environment where excessive ingestion of processed foods is highly promoted and readily available, whereas healthy organic foods are scarce and expensive.

According to the world obesity atlas, Japan has the lowest number of people who are obese at only 4.5%, while America has over 45% adult obesity, and 45% of women and 26% of men in Africa are likely to be overweight or obese by 2030.

There is a lot of evidence that obesity can predispose an individual to a myriad of other conditions and complications. Some anecdotal evidence shows that Ozempic could reduce or reverse obesity by reducing up to 15% of their body weight within a year, which is still below the bariatric surgery outcome.

In 1984, the Canadian Endocrinologist Prof Daniel Drucker, together with his team of researchers, discovered that the Glucagon gene chain present in the pancreas had a GLP-1 molecule at its tip, which, when combined with insulin more insulin was produced. These drugs reduce blood glucose by stimulating insulin secretion and lowering glucagon secretion by selectively binding to and activating the GLP-1 receptor.

Physiologically, in the gut it reduces the feeling of hunger by up to 80% for a prolonged period by reducing the frequency and the meal portions one usually consumes while psychologically in the brain, it primarily changes what one wants to eat and how much you want to eat via the satiety system in the brain.

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There are different types of GLP-1 receptor agonist Medications, including Ozempic, Mounjaro, Wegovy, and Zepbound are marketed for weight loss.

Ozempic is literally the hottest drug in the world right now, and as one social media influencer called it, the new miracle drug. These days, social media is awash with bunter and buzz, celebrities, including Oprah Winfrey, are documenting their journeys and outcomes while others are injecting themselves live on Instagram and TikTok, showing others how to DIY.

This is quite concerning because not everyone requires, or not everyone has met the criteria (BMI greater than 27 kg/m² of fat mass) to take Ozempic. Some just want to lose vanity weight so that they can fit into their tiny outfits for showbiz, which is contrary to the core indication and benefit of this drug.

Hollywood, Bollywood, Nollywood, you name it, have found a personal trainer in these drugs. We are likely to see an explosion in the number of thin/skinny people, and gym membership is likely to take a hit or vice versa. This can only be possible if the drug becomes easily available and affordable, which is currently far from it.

Ozempic offers hope for patients struggling with obesity, a condition associated with cardiovascular disease, diabetes, cancer, and reduced quality of life.

Diabetic patients have been taking these drugs for more than 19 years, and if there were any detrimental effects, they would have been discovered by now. However, there are some reported risks and concerns that the public should be cautious about, even as they consider injecting Ozempic and other GLP-1 receptor agonists

These drugs contribute greatly to eating disorders by suppressing the pleasure of enjoying a delicious meal, which could be quite dreadful and socially depressing, leading to mental health deterioration, including suicidality.

After a year of discontinuation, one can gain over 60% of their body weight if they don’t maintain a proper diet and an active lifestyle. This may lead to cycles of psychological distress and unhealthy re-use.

The regulator (PPB) must ensure that the importation of these medications into the country is strictly controlled, particularly regarding counterfeit versions.

Ozempic is a prescription-only medication, so the regulator should also make certain that it is not easily accessible for over-the-counter (OTC) purchase and that individuals handling it are licensed, capable of weighing the benefits and risks, and that authorized institutions adhere to good distribution and storage practices (GDSP).

Healthcare providers should strictly stick to the prescribing and treatment guidelines to guarantee the safe and effective use of GLP-1 receptor agonist medications. Additionally, healthcare professionals and policymakers need to ensure that these drugs are utilized ethically, equitably, and safely.

Dr Reuben Mogoi is a Clinical Pharmacy Consultant