Do They Work? Are They Safe?
Elon took semaglutide to get leaner. Kim K. supposedly took it to whittle down that dump truck of a butt. Should you? Info here.
Semaglutide: A Diabetes Drug That Rips Off Body Fat?
Elon Musk was large. Now he’s not. Kim Kardashian was large, or at least a part of her was. Now she (it) isn’t.
Similarly, socialite brides-to-be are lately slipping into their waifish wedding dresses without breaking so much as a moist upper lip in the gym. Recovering Wall Street Peloton addicts who’d put on an extra 10 or 20 post-Peloton pounds are suddenly getting back to their fighting weights without the whole hamster-on-a-wheel thing. Post-partum baby weight, for many well-to-do mothers, has become a non-existent problem.
And it’s all because of semaglutide, a relatively new diabetes drug that’s been appropriated for the off-label purpose of fat loss by financially secure people, along with some resourceful, less deep-pocketed people who’ve gotten their insurance companies to cover it, even if they don’t have diabetes.
So, what is this stuff, and, more importantly, should regular folk who quickly want to drop a wheelbarrow of fat use it?
Oh-Oh-Oh Ozempic
Semaglutide is an insulin regulator that was developed by Danish pharmaceutical giant Novo Nordisk in 2012 and was approved for the treatment of Type II diabetes (and heart disease since it lowers the risk of heart attack and stroke) five years later.
If you own a television and you’ve turned it on any time in the last few years, you’ve no doubt had your senses assaulted by a cheery chorus singing “Oh-Oh-Oh Ozempic…”
Yeah, that’s the trade name for semaglutide.
The drug is typically injected subcutaneously once a week and it lowers blood sugar levels by stimulating the release of insulin, which is hugely helpful for people with Type II diabetes. Semaglutide also mimics a hormone called glucagon-like-peptide 1 (GLP-1) that tells our stomachs that we feel full, along with prompting the stomach to slow down the transit of food.
Those things, of course, are a recipe for weight loss, one that rivals bariatric surgery, the procedure where they surgically reduce the size of your stomach to about the size of the pouch your AirPods come in.
When Novo Nordisk saw what was happening to the waistlines of Ozempic users, they felt a big dose of that hygge stuff you hear about, and it apparently filled them with entrepreneurial inspiration. “We’ve got the diabetics’ money, but what if we make semaglutide for fatties too?”
Genius! The only trouble was, semaglutide/Ozempic had only been approved by the FDA for the treatment of Type II diabetes and related or non-related heart problems.
That didn’t mean some completely healthy but chubby people weren’t getting semaglutide for its off-label use by finding doctors with flexible ethics. Regardless, Novo Nordisk decided to make it easier for people who wanted to be svelte by developing an injectable semaglutide specifically designed for weight loss. Enter Wegovy, which the FDA quickly approved.
It’s the same damn drug as Ozembic, only Wegovy is available in higher dosing to facilitate weight loss more efficiently. Each comes in nifty pre-loaded syringes (a 4 mm, 32-gauge needle), but Ozempic is available in 0.25 mg, 0.5 mg, and 1.0 mg pens, while Wegovy is available in 0.25 mg, 0.5, 1.0 mg, 1.7 mg, and 2.4 mg pens.
Enter an Oral Version, Rybelsus
Obviously, a lot of people aren’t comfortable jabbing themselves with a needle. It’s too invasive, too medical, too ucky. Enter Rybelsus, an oral form of semaglutide. Unfortunately, it has to be taken in a very specific way: a half hour before eating and with 4 ounces of water.
Unlike Ozempic, it’s only approved for the treatment of Type II diabetes, but there are ways around that for those who want to use it for weight loss (like sweet talking your doc into writing the script anyways).
Novo Nordisk also has at least a fourth variant of semaglutide in the works, but little is known about it. Given that the earliest entry for any generic semaglutides to appear is December 5th, 2031, I half-expect Novo Nordisk to take full advantage and churn out a cascade of different semaglutide products in the meantime – gummies, tinctures, nasal sprays, who knows? Maybe even some semaglutide products for adipose adolescents, tubby tots, or porcine pets.
How Much Weight Loss is Typical?
Users of any of the semaglutide products typically lose up to 15% of their body mass in just a few weeks, without making any modifications at all to their diet or exercise habits. Whether most of this weight loss is comprised largely of fat with a modicum of muscle loss would of course be dependent on the user’s protein intake and type and intensity of exercise.
Side Effects
As with any drug, there are some side effects associated with the use of semaglutide:
- Redness or itching at injection site (Ozempic and Wegovy)
- Nausea and vomiting
- Dehydration
- Diarrhea
- Stomach pain
- Constipation
- Gas
- Fatigue
- And of course, weight loss.
These side effects shouldn’t be taken lightly, as just about everybody who uses the drug experiences debilitating nausea for the first two or three days. Most savvy doctors, however, will often prescribe the anti-nausea pill Zofran at the same time.
There are also some more serious possible side effects that can occur with semaglutide:
- Allergic reaction
- Hypoglycemia (low blood sugar)
- Cholelithiasis (gallstones)
- Kidney problems
- Thyroid C-cell tumors (in animal studies, at least)
The drug’s only been around a short time, so no one knows what the really long-term effects might be. Still, that’s likely more of a concern with diabetic patients or heart patients who’d presumably stay on the drug for a long time, or for the rest of their lives.
The risks to the dieter who only stays on the drug for a short time would of course be less, or even minimal. Of course, any fat loss that occurred from using any of the forms of semaglutide would come back with a vengeance after cessation of the drug unless appropriate lifestyle modifications were made.
Financial Side Effects
The executives at Novo Nordisk have taken to mixing their Kartoffelsalat with caviar and buying their kids solid gold Legos because, justifiably or not, they’re charging an arm and a leg, or given their original demographic, and arm and a pancreas for semaglutide.
A monthly supply of Ozempic, depending on the dosage, is around $900, while the cost for an equal supply of Wegovy is around $1,300. However, if you’re a Type II diabetic, have heart problems, or are clinically obese (have a BMI over 30), you should be able to use insurance to get the cost down to around $25.
There exists kind of a loophole, though, provided you have flexible morals. A lot of people are allegedly getting the drug through video chats with their doctor. The apparent secret is to lie about your body mass index (BMI). If you qualify as obese (a BMI over 30), you’re supposedly in. Whether this lie requires you to shove your cheeks full of cotton balls, a la’ Marlon Brando in “The Godfather” and have the camera aimed solely at your face, I don’t know.
Other Considerations and Alternatives
I can see semaglutide having an impact on bodybuilders. It may bring back the discredited practice of off-season bulking. Lifters can eat their lungs out during winter, gain an appreciable amount of fat and muscle, and then painlessly Ozempic or Wegovy their way down to a much more muscular body come springtime.
Still, there’s that price thing to contend with. Of course, given that pro bodybuilders often spend as much as 10 grand a month on anabolics, a few more dollars probably wouldn’t be a deterrent.
Those of us with less financial means might just want to go the supplement route. Hot-Rox Extreme can respectably emulate some of semaglutide’s effects (e.g., appetite suppression) while also stimulating production of thyroid hormone and blocking andrenergic receptors that predominate in “trouble areas” like the abs, love handles, and lower back.
Combine it with Indigo-3G for its positive effects on insulin sensitivity and you’ve got a respectable alternative to semaglutide without needles and at a fraction of the cost.
