Pharmaceuticals such as Ozempic, intended for weight reduction, have elicited heavily divided perceptions, leading to much uncertainty among patients. While many regard them as miraculous solutions, others are distinctly cynical. They are at times interpreted as manifesting a lack of will and moral fibre to shed weight solely through lifestyle modifications.
However, in dealing with life’s intricacies, the solution seldom lies on either end of the spectrum but somewhere in between. As a heart specialist, my advice to my patients is simple. These are drugs. They ought to be consumed only when surplus fat poses health risks and when the consequences of not taking them outweigh those associated with their use. Each side of this balancing act involves risks—this is true for every life decision. That said, these are not ‘cosmetic injections’ offering an easy path to a perfect beach body. They cannot replace regular exercise and a balanced diet, but should instead be used adjunctively with such healthy lifestyle habits.
Utilising these drugs to shed harmful fat is not any more indicative of a moral shortfall than taking a medication to reduce dangerously high blood pressure that could lead to a stroke. Those criticising the use of weight reduction drugs often emphasise the need for focusing on diet and exercise. Although these do indeed facilitate weight loss over short durations and under carefully controlled conditions. If one were confined in a room with scarce food supply, they would lose weight. However, the more pertinent question is the long-term impact of dietary and exercise habits on individuals—given we live in the real world and not in isolation.
Numerous individuals embarking on a weight loss journey through diet and exercise witness results within half a year. Two years down the line however, 50% of these individuals return to their original weight. After five years, this figure increases to 80% indicating that only 20% manage to maintain their weight reduction successfully. Although possible, it’s just not as likely.
Regrettably, standard strategies like proper diet and routine exercise often prove inadequate for the majority of individuals aspiring to shed extra kilos and maintain their achieved weight. Numerous research studies have indicated an average weight reduction through these means to be a mere 2.45kg after three years. Though it seems a step in the right direction, if you’re weighing 110kg, this trivial change does not do enough to decrease the health hazards correlated with obesity. This leads to a pattern of weight reduction and gain – the notorious “yo-yo” effect. As a consequence, an arduous and seemingly infinite battle ensues with yearly progress being offset by setbacks.
There exist weight loss pharmaceutical therapies as alternatives for patients endeavouring to lose burdensome weight that poses a threat to their wellbeing. Clinical trials for Ozempic (semaglutide) and other novel treatments demonstrated a 15% decrease in body weight compared to lifestyle adjustments alone. More recent treatments, like tirzepatide (Mounjaro), have recorded even higher decreases, with upward of a 25% reduction in body weight. Drug therapies currently under clinical testing have manifested reductions reaching 30% in body weight, equating to a 27kg weight reduction for many.
Post two years of treatment, the majority of the patients reportedly maintain their weight loss, compared to the 50% who did so using just lifestyle adjustments.
What is the outcome if one discontinues these medications? It’s generally the case that most people’s weight reduction nearly disappears in the same way as stopping a blood pressure reducing drug after six months, would shoot up their blood pressure back to its original value. Therefore, it is unrealistic to anticipate different results from weight loss drugs as they are, essentially, ones for treating a medical situation and not a fleeting diet.
Additionally, it often implies that therapy with such medicines could ultimately turn out to be a perennial treatment – analogous to a medication for lowering blood pressure.
Like any medicinal drug, weight loss medicines too have their own set of potential side effects. Most individuals do not experience any adverse effects from these medications, but around one in five individuals may undergo mild nausea for the first few months. Other less common effects include vomiting, constipation and diarrhoea. Severe adverse effects, such as acute inflammation of the pancreas, are extremely rare.
The potential long-term consequences of new medications such as Ozempic are still being studied due to their recent introduction. However, our understanding of the far-reaching effects of obesity spans a significantly longer period. Long term exposure to obesity is known to cause diabetes, stroke, heart problems, dementia, and many different types of cancer. While the repercussions of weight-loss medications will become clearer with time, it’s unequivocal that obesity has a devastating long-term impact. Ozempic forms an integral part of the pioneering generation of anti-obesity treatments, with upcoming candidates showing even more potential. As of now, medications like these are administered through injection, but oral alternatives will be introduced soon.
Obesity is among the largest global public health crises. The dramatic transformation of our environment over the years plays a pivotal role in the obesity epidemic. We must, therefore, take necessary measures to mitigate the environmental aspects contributing to obesity and also encourage lifestyle changes to avert obesity from the outset. For the time being, weight loss treatments such as Ozempic provide a powerful and sustainable answer for many, though this is not to say there are no difficulties with these treatments.
In Ireland, the usage of Ozempic is restricted to diabetes treatment. A prescription of Ozempic for weight reduction purposes only costs approximately €160 each month. In the US, the monthly cost can reach $1000 (€898) or more. Over time, these issues will get addressed. Nevertheless, for individuals wrestling with obesity, the introduction of these new tools offers a promising shift in their struggle.
Dr. Paddy Barrett, the author of “Heart An Owner’s Guide,” is a preventive cardiologist at the renowned Blackrock Clinic.