Although Ozempic isn’t a new drug, the recent buzz around it is undeniable. This attention is causing a shortage, which can seriously affect people with Type 2 diabetes.

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Why Is There an Ozempic Shortage?

Celebrities trying to lose weight is one reason behind the global Ozempic shortage. Originally approved for Type 2 diabetes, Ozempic also leads to significant weight loss.

On TikTok, hashtags like #Ozempic and #OzempicChallenge have over 400 million views. People rave about their weight loss with the drug. This fall, Andy Cohen criticized celebrities using Ozempic for weight loss, tweeting, “Everyone is suddenly showing up 25 pounds lighter. What happens when they stop taking #Ozempic?”

It’s a crucial question. Content creator and model Remi Bader, who used Ozempic for prediabetes and insulin resistance, stopped taking it in 2020 and said it worsened her binge eating. She gained double the weight back after stopping the drug, as reported by People magazine.

BuzzFeed News consulted medical professionals and the manufacturer to understand why Ozempic has become a weight-loss hit and what happens when it’s unavailable.

Dr. Archana Sadhu, an endocrinologist and director of the diabetes program at Houston Methodist, said the impact depends on why you’re taking it.

For those using Ozempic for weight loss, whether needed or not, the drug will leave your system, and you’ll return to your previous state. There’s no withdrawal or need to taper off, but you may feel hungry again and regain the weight.

However, for managing Type 2 diabetes, the shortage could be life-threatening. Blood sugar levels can spike almost immediately, leading to severe complications like heart attacks, strokes, kidney damage, and even death. Dr. Sadhu has been receiving panicked calls from patients with Type 2 diabetes running out of the medication.

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What is Ozempic?

Ozempic, the brand name for semaglutide, is an injectable medication first approved by the FDA in 2017 to treat Type 2 diabetes and related heart complications. It quickly became a staple in managing blood sugar levels due to its potency. “It’s much more effective than existing drugs,” Sadhu said.

In clinical trials, a side effect of Ozempic was weight loss, making it attractive to those without Type 2 diabetes who wanted to lose weight.

Initially used “off label” for weight loss, it was FDA-approved under the brand name Wegovy in June 2021 for people who are overweight or obese. This includes two-thirds of Americans, many of whom also have Type 2 diabetes.

Strict criteria exist for using Ozempic and similar drugs for obesity. “You need a BMI of 27 with chronic conditions like heart disease or fatty liver disease or a BMI of 30 and above,” Sadhu explained. For perspective, someone 5’5’’ tall would need to weigh about 160 pounds to have a BMI of 27 and 180 pounds for a BMI of 30.

“For someone with a BMI of 24 wanting to be 22, the risks don’t outweigh the benefits,” Sadhu said.

How Do Ozempic and Wegovy Work?

Ozempic belongs to a class of medications known as GLP-1 receptor agonists, which work in multiple ways.

“They target the brain’s appetite center to suppress appetite,” Sadhu said. They also delay food emptying from the stomach, keeping you feeling fuller longer. Most importantly for Type 2 diabetes, Ozempic mimics a gut hormone called incretin, helping the pancreas release the right amount of insulin when blood sugar levels are high.

Most people take the shot once a week in dosages ranging from 0.25 milligrams to 2 milligrams per week, according to Dr. Andrew Kraftson from the University of Michigan.

Wegovy Versus Ozempic

The only difference between Wegovy and Ozempic is their maximum dosage levels and approved uses, explained Dr. Jamy Ard from Atrium Health Wake Forest Baptist Medical Center.

Both drugs are semaglutide. Ozempic treats Type 2 diabetes, while Wegovy treats obesity. Ozempic’s maximum dosage is 2 milligrams weekly, while Wegovy’s is 2.4 milligrams.

“Although Wegovy and Ozempic both contain semaglutide, they have different indications, dosages, titration schedules, and delivery devices,” said a Novo Nordisk spokesperson. “The products are not interchangeable and should not be used outside of their approved indications.”

Experts say these differences in the medications are negligible.

Why Is Ozempic So Popular, and Why Is There a Shortage?

The Ozempic shortage is driven by various factors.

Novo Nordisk anticipated growing demand for Ozempic, just not at this pace. Usage of the drug grew 69% globally year to date, and its weight management medications, including Wegovy, grew 75%.

The main driver of Ozempic’s popularity is its effectiveness, leading to high demand for semaglutide medications. Society’s anti-fat bias and the weight loss industry’s influence also contribute.

“Before Wegovy, weight loss drugs caused 7% to 10% of body weight loss, whereas Wegovy achieves 15% to 17%,” Ard explained.

A more effective drug, Mounjaro (tirzepatide), approved by the FDA in May 2022, can lead to 20% body weight loss, similar to bariatric surgery results. But it’s also headed for shortages.

Medications that cause weight loss create a word-of-mouth effect, said Dr. Daniel Bessesen from the University of Colorado. When people see others lose weight, they may ask their doctor for the same medication. Many older weight loss meds didn’t have this impact because they weren’t as effective.

A Shortage from the Start

Soon after Wegovy’s release, it was clear demand exceeded supply, Kraftson said. There was also a supply issue with the injection device for Wegovy, Ard added.

Once the Wegovy shortage began, doctors and patients turned to Ozempic as an alternative, quickly leading to an Ozempic shortage.

The Insurance Factor

The Ozempic shortage can’t be explained without discussing insurance.

Many health plans don’t cover weight-loss medications but do cover diabetes medications like Ozempic.

Doctors can prescribe Ozempic for obesity off label, allowing patients to get coverage for a medication they otherwise couldn’t. When companies require evidence for diabetes treatment, doctors can provide blood tests showing poorly regulated blood glucose levels or prediabetes.

Off-label prescription use is common in many medical areas. But due to the high demand for weight loss medications, this case has gained more attention, Kraftson explained.

Why Don’t Insurance Companies Cover Weight Management Medications?

Insurance companies often don’t cover weight management medications because they’re expensive, Bessesen explained. The most widely prescribed weight management drug, phentermine, has remained popular since the late 1950s due to its low cost despite only causing 3% to 5% body weight loss.

“Phentermine costs around $10 to $20 a month, whereas semaglutide medications cost about $1,200 a month,” Bessesen said.

Ozempic Versus Other Weight Loss Drugs

Older weight management drugs were generally less effective or had risky side effects, leading to the belief that these medications aren’t worth the risk for insurance coverage, Bessesen described. But newer anti-obesity medications like Wegovy are effective and safe, experts say.

Despite their efficacy, these drugs are extremely expensive. With 42% of US adults having obesity and needing these drugs indefinitely, it’s nearly impossible for insurance companies to cover everyone who qualifies, Bessesen concluded.

How Are Shortages Affecting Patients?

Experts had mixed responses on whether Wegovy and Ozempic shortages affect their patients.

Ard described dealing with these shortages as a daily hassle. “I probably have several emails in my inbox right now asking where to find it, which pharmacies still have it, and how to get a refill when it’s on backorder.”

Bessesen felt the shortages were more pharmacy-dependent and payment method-dependent. “But it’s clear that the production capacity compared to the demand has been exceeded,” he said.

For people with Type 2 diabetes, doctors are switching to older, less effective drugs to control blood sugar, Sadhu said.

How Long Will the Shortages Last?

Novo Nordisk stated that 1- and 2-milligram doses of Ozempic are now available across the US. However, due to high demand and global supply chain constraints, there are still intermittent supply disruptions for 0.25- and 0.5-milligram doses.

Ozempic continues to be manufactured and shipped, but patients in some areas will experience delays. The company is making both short- and long-term investments to solve these temporary challenges.

While some healthcare providers prescribe Ozempic for weight loss, it’s up to each provider’s discretion to choose the best treatment approach. Novo Nordisk doesn’t encourage off-label use of its medicines and is committed to complying with all applicable US laws and regulations.

What Do Experts Think About Celebrities and TikTokers Promoting Ozempic for Weight Loss?

When asked about his secret to looking “fit, ripped, and healthy,” Elon Musk replied, “Fasting … And Wegovy.”

(Novo Nordisk said it does not currently work with any celebrities to promote Wegovy.)

Ard said celebrity and influencer use drives demand for Wegovy and Ozempic. “As an obesity medicine specialist, I really cringe at this thought,” he said.

Using these drugs for cosmetic purposes can worsen disparities in medication access. People who don’t need these medications but can afford them create supply issues for those who need them but can’t afford to pay outright.

Sadhu urged people without diabetes to forgo the drug temporarily in favor of those who are desperately sick.

As for the safety of basing weight-loss treatment decisions on social and celebrity advice, it’s important to remember to treat obesity as a medical condition, Ard said.

“You wouldn’t seek advice on treating heart disease or cancer from a celebrity or influencer without medical training,” Ard said. “You really shouldn’t turn to these sources for advice on how to lose weight healthfully.”

When people hear about celebrities using weight management medications, they might think it’s just for cosmetic purposes. This can further the misconception that weight is only a cosmetic or lifestyle issue, Bessesen added.

Many believe that a good diet and exercise can cure health issues related to weight, but this isn’t always true. “Weight is regulated by a complex biological system, and in most cases, people don’t choose what they weigh. The body has its own idea of what it wants to weigh and will work to maintain or return to that weight,” Bessesen said. This means once you stop taking weight loss medications, you’re likely to regain all the weight you lost.

Bessesen sees obesity as a biological weight regulation problem and wishes more people, including clinicians, would view it this way.

How to Get Help

For those looking to treat obesity or lose excess weight, a good first step is to talk with your family doctor.

Even with medication or bariatric surgery, diet and exercise still play a crucial role in weight management. “The effect of these medications goes away immediately when you stop them,” Sadhu said. “You have to build long-term healthy lifestyle habits.”

If you’re not getting the support or advice you need from your doctor, look for a provider who specializes in treating obesity, Ard said. Many family doctors don’t get special training in how to treat the condition.

If you’re having trouble finding an expert, you can search for specialists in your area using a portal provided by the Obesity Medicine Association.

Final Thoughts

The popularity and subsequent shortage of Ozempic highlight the complex issues surrounding weight management and diabetes treatment. While the drug offers significant benefits, its demand has created challenges for those who rely on it for medical reasons. Balancing effective treatment with equitable access remains a critical concern.

Remember, always seek advice from medical professionals for health-related decisions and consider the long-term implications of any treatment.

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