At least once a day, Nancy Rahnama’s clinical nutrition practice in Beverly Hills, Calif., gets a call from a patient looking for a diabetes drug that they’ve heard can help them lose weight fast.
“They specifically say, ‘How much is it to get Ozempic?’” Dr. Rahnama said.
Ozempic, which is taken by injection in the thigh, stomach or arm, was approved by the Food and Drug Administration in 2017 to help lower blood sugar in people with Type 2 diabetes. One Ozempic injection pen typically lasts about a month and costs about $900 before insurance, though coverage can be hard to come by.
The brand is not approved by the FDA for weight loss. But recently, Ozempic and other drugs of its kind have become the subject of conversations about weight loss, thinness and so-called biohacking in Hollywood, the tech industry and beyond.
Ozempic, made by Novo Nordisk A/S, is one of several brand-name drugs on the market containing an antidiabetic ingredient called semaglutide. Semaglutide stimulates insulin production and also targets areas of the brain that regulate appetite, according to the FDA. The federal agency has approved semaglutide for weight loss under the brand name Wegovy, which Novo Nordisk sells at a higher price than its cousin Ozempic.
Elon Musk, the Tesla and SpaceX CEO who has more than 100 million followers on Twitter, tweeted this month that he was taking Wegovy in combination with fasting to lose weight. Mr. Musk could not be reached for comment.
In late September, Andy Cohen, the Bravo host and “Real Housewives” executive producer, tweeted: “Everyone is suddenly showing up 25 pounds lighter. What happens when they stop taking #Ozempic ?????” Through a representative, Mr. Cohen declined to be interviewed.
Ozempic isn’t meant to be taken as a get-thin-quick treatment. Doctors use medical discretion to prescribe it to people who are obese or overweight—an off-label use given the drug’s similarity to Wegovy. However, in some cases, patients who meet neither of those criteria are still getting their hands on Ozempic.
“This is the Hollywood drug,” said Patti Stanger, star and executive producer of the reality show “The Millionaire Matchmaker” who has also tweeted about Ozempic, in an interview.
“It’s nationwide,” Ms. Stanger said. “I have friends in Miami, I have friends in New York who are doing it.”
Cat Marnell, a writer in New York City, said she first heard about Ozempic over the summer, while gossiping with friends about celebrities. “It’s definitely a dinner conversation in the Hamptons,” she said.
“Everybody I know is on it,” Ms. Stanger added, noting that she paused her own semaglutide treatment due to side effects, but plans to soon restart with some changes to dosing. She first heard about Ozempic from Shamsah Amersi, a Santa Monica-based gynecologist, but consulted with her functional-medicine doctor for a prescription.
Dr. Amersi, whose clientele includes celebrities, said she prescribes the drug to some people who have exhausted other avenues for weight loss, including women who have underlying hormonal issues that may contribute to difficulties losing weight.
“I tell my patients to use this to retrain the way we eat,” Dr. Amersi said.
A New Class of Drugs
People have long sought a way to lose weight by taking a drug, and pharmaceutical companies have long aimed to capitalize on that demand. Yet drug researchers have struggled for years to find medicines that accomplish that goal. Ozempic and Wegovy belong to a new class of drugs, called GLP-1s, that some studies indicate may significantly reduce weight when combined with other lifestyle changes—at least in certain people.
Ozempic’s embrace among relatively healthy people isn’t supported by scientific evidence, however. Wegovy itself isn’t approved to treat all those seeking weight loss. The drug’s 2021 weight-loss approval was for people who are obese or overweight with a coexisting condition related to weight, such as high blood pressure, Type 2 diabetes or high cholesterol. It is priced at $1,350 for a month’s supply, which includes four injection pens. (Novo Nordisk has also introduced a once-a-day semaglutide pill called Rybelsus. A 30-day supply, without insurance coverage, costs $850.)
Cost might be one reason people seeking to lose weight are flocking to Ozempic, rather than Wegovy. Supplies might be another. Wegovy was on the market for barely six months before Novo Nordisk announced it was in short supply, in December 2021. The company has attributed the shortage to an issue with its contracted manufacturer. Both Wegovy and Ozempic are on the FDA’s shortage list, which makes information publicly available about drug supply issues.
Under the terms of their approvals, neither drug should be taken for casual weight loss.
Though Ozempic and Wegovy contain the same active ingredient, Novo Nordisk’s executive director of medical affairs, Jason Brett, says they are not interchangeable. He cited differences including dosage amounts and escalation schedules for the drugs. Because the drugs are intended for people with chronic conditions, they are not meant to be used as short-term treatments.
“From our standpoint, we don’t promote or suggest or encourage any off-label usage at all,” Dr. Brett said, further noting that “we’re not looking at weight loss for cosmetic purposes or episodic weight loss for people who don’t fit those criteria from the FDA-approved label indications.”
Doctors are generally able to prescribe medications off-label as they see fit, a fact that FDA spokeswoman Chanapa Tantibanchachai pointed to in an emailed statement.
Ms. Tantibanchachai continued: “It is important to note that the FDA approval (or clearance) of a medical product for one intended use does not assure its safety and effectiveness for other uses.”
Ozempic and Wegovy are not the only new GLP-1s used off-label—some doctors say Mounjaro, a different formula approved by the FDA in May for diabetes treatment, is also being prescribed for weight loss. Maker Eli Lilly & Co. said the drug is only promoted “consistent with its FDA indication and label for Type 2 diabetes,” per a spokeswoman.
‘Everyone Wants a Quick Fix’
Rupal Mathur, an internist in Houston whose practice specializes in weight loss, said three of her patients developed pancreatitis while taking Wegovy or Mounjaro and had to come off the medications. Other side effects Dr. Mathur warns patients about, and which are also listed on the labels for these drugs, include gastrointestinal issues such as gallbladder disease. Those with a family history of thyroid cancer are advised against taking the drug.
Allison Schneider, director of media relations for Novo Nordisk, said, “to date, the safety data from trials and post-marketing safety surveillance have not identified any risks that outweigh the benefit of treatment,” adding that the company is continuing to monitor the drug’s safety.
Dr. Mathur said the drugs are meant to be taken long-term and that people who withdraw from them may gain back weight they have lost.
The drugs have only been studied in people who met certain criteria, including a minimum BMI threshold, she added.
“Ozempic is really hard on the stomach,” said Julie Fredrickson, a startup investor who has been open about losing weight on the drug. Ms. Fredrickson, who lives in Montana and considers herself a biohacker, was first prescribed the medication in 2020 to help her shed unwanted weight she gained as a result of other prescription drugs she takes for a medical condition. She said she lost nearly 25 pounds in six months.
Since posting about her experience online, more than two dozen women have asked her how they could qualify for it, she said, adding that some have asked to discuss the injection over Signal, an encrypted messaging app, for privacy reasons.
Ms. Fredrickson, who bought stock in Novo Nordisk around the time she began taking Ozempic, said that after she stopped taking Ozempic, she regained much of the weight she had lost. She cautioned that due to other medications she takes, it is hard to pinpoint the cause. She has since restarted Ozempic.
The rise of off-label use is being monitored by organizations such as the American Diabetes Association and Mutual Aid Diabetes, whose representatives expressed concern about shortages affecting patients. Robert Gabbay, chief scientific and medical officer for the American Diabetes Association, said he has seen some of the patients in his own practice struggle to fill prescriptions at their local pharmacies.
While Ozempic’s website clearly states that it is “not a weight-loss drug” but may help those who take it lose weight, third-party companies are using its name to advertise virtual-weight loss programs and discounted prescriptions. People are turning to social media for tips about how to get the drug.
“Everyone wants a quick fix,” said Lisa Moskovitz, a registered dietitian and CEO of NY Nutrition Group. She believes some doctors are prescribing Ozempic too liberally—and in some cases, she said, giving samples to patients who can’t afford to continue taking the drug once the free doses run out.
“When you stop taking it, you lose that feeling of fullness, that benefit of not being as hungry,” Ms. Moskovitz said. “And now your hunger signals and cues can become a lot stronger.”
I think MQ mentioned this drug a few weeks back, and here is the WSJ treatment.
NOTE: A doctor has been prescribing +$150,000 worth of ozempic for weight loss for 15 members of a small 150 life self-funded group, increasing the PEPY medical costs by $1,080. Mos doctors have no idea what things cost or the financial impact expensive drugs can have on a group health plan.