Ashley Raibick is familiar with the weight loss yo-yo. She’s played with prominent names: Weight Watchers, Jenny Craig, etc. She sheds 10 pounds and then falls off the diet plan only to watch her weight rise again.
A day at the local med spa, where she receives treatments like facials Botox and fillers, has changed everything for the hairstylist of 28, who was looking to shed 18 pounds.
During one visit, she observed that the spa’s owner was a bit thinner. When Raibick asked what she was doing, the owner said she was taking semaglutide. She also explained the procedure to Raibick. Raibick was utterly convinced. On the same day, she received an appointment with a doctor in the spa and received the first dose.
“Are people going to think I’m crazy for doing this?” she thinks.
At 5 feet 4 inches, her initial weight before taking the drug was 158. This would place her into the obese, however not obese, category determined by BMI or body mass index (BMI). She would like to lower her weight to 140 before stopping.
Wherever you read the news, you’ve likely heard about the name of the drug that Raibick was prescribed: Ozempic. It’s part of a growing collection of GLP-1 receptor antagonists, which have semaglutide, a peptide that is the primary ingredient. Though initially designed to combat type 2 diabetes, Ozempic’s popularity and its brothers grew after celebrities who were already slim were accused of taking injectable drugs to get thinner.
The FDA approved Ozempic’s close relative, Wegovy, for “weight management” for patients suffering from overweight a couple of years ago. However, Ozempic is currently accepted for the treatment of diabetes. Patients who do not meet the requirements can receive off-label medications if they can afford to pay for them out of pocket, typically at more than $1,400 per month. But do you think Ozempic is worth the price, especially when you have only a minimal amount of weight to shed?
For many, mainly people who have been taking the drug for several months and have shed weight due to it taking Ozempic hasn’t only helped them shed the stubborn weight. Still, it has removed them from the constant internal conversations about eating, also known as “food noise.” But experts aren’t all on the same page that semaglutide is a good option for people who aren’t considered obese, particularly in the long run.
After the first nine weeks on semaglutide, Raibick already lost 18 pounds. She decided to write about her experience in TikTok, and her video on GLP-1s was received many times.
At present, there are no data on the number of semaglutide users who are taking the drug to treat obesity or diabetes and the percentage of people who are taking it for weight loss off-label on its own. However, the company that manufactures Ozempic, Novo Nordisk, has disclosed rapid growth in sales and anticipates higher profits in the future.
Raibick has heard of other people like her who took the medication for less minor weight loss but aren’t open about their experiences. There is a stigma attached to the necessity of using an appetite-reducing drug to reduce obesity instead of achieving their goals through the help of diet and lifestyle changes alone.
Another reason for keeping the information secret is the shame that some patients who use Ozempic experience using their financial privileges to purchase a medication that was a significant shortage. It made it more difficult for those who require the drug to treat obesity or diabetes to obtain their doses.
This is the kind of thing Diana Thiara, MD, the medical director of the University of California, San Francisco’s weight-management program, has been seeing in the field.
“It’s one of the most depressing things I’ve experienced as a physician,” she declared. Within her clinic, she’s observed patients who have found GLP-1s and have begun losing weight, but then they recover the weight within the time required to get another prescription through their insurance.
“It’s absolutely awful, patients are spending the whole day contacting dozens of pharmacies. I’ve never experienced an experience like this in my entire career,” said Thiara.
Ann, 48, the mother of an unborn daughter who works at home full-time, has been using Ozempic since the close of January. (Ann isn’t her real name, but she wanted us to create a pseudonym for her to speak freely about her usage of Ozempic). Like Raibick, she’s been paying out of pocket to receive her injections. Initially, she had to spend $1,400 per month, but she discovered an online pharmacy in Canada that offered the drug at $350. It’s available globally, as she explained, and often, the Ozempic box will come in Czech or another language that needs to be added to the list.
Like many people, Ann never had any doubts about her weight or how her body appeared. She wasn’t a fan of exercising, but it wasn’t until the outbreak that she began losing weight. She noticed modifications in her physique when the areas started opening up, and her clothes were no longer fitting.
She pushed herself to move more often and eating healthier. She was a former Real Housewives of Beverly Hills cast participant in Teddi Mellencamp’s controversial weight loss program. It was famous for its rigorous diet and overly exercise suggestions. The program only worked once a mother at her daughter’s school told her she was taking Ozempic.
Ann began to notice hot flashes and missed her menstrual cycles. Her doctor that prescribed Ozempic, confirmed she was perimenopausal. For women at this stage, losing weight is much more complicated than ever.
Ann, 5’7″ tall, began her journey at 176 pounds (considered overweight) and is now at 151 pounds, weighed an average weight according to BMI measurements. The drug is still in her system, but she struggles with her guilt over owning the medicine from someone else who may need it. And she’s not sure when she’ll have to remain on Ozempic to keep up the weight reduction.
Ann has cause to be concerned. A study in 2022 discovered that the majority of people will regain the weight they lost within one year after the end of Ozempic.
After Raibick had reached her goal weight, she was confident she could continue to lose a little. However, it wasn’t until after she was at the 120-pound mark that she realized it was the right time to get off the dosage of semaglutide she was taking.
“I reached a moment when my mom said, “All right, you’re not quite enough. However, I’m extremely content where I am. I’m not worried about being able to fit in a bathing suit,” said Raibick, who has lost about 30 pounds since taking the pills.
Ultimately, she stopped using the medication entirely, and all the food cravings and hunger noise semaglutide suppressed resurfaced on the surface. She claimed that the weight she gained was not significant during the month, but the internal commotion about food was enough to cause her to restart on an edgier dose targeted toward weight loss.
There’s also the matter of adverse side adverse effects. Raibick said she’s never experienced the overwhelming nausea and digestive issues that many patients taking the medication, such as Ann, who has reported it. However, Thiara stated that despite these common adverse negative effects, there are many other issues, including the lasting impacts on reproductive health and thyroid, particularly in females – which we do not know enough about. Recently, CNN reported that certain Ozempic users have experienced stomach paralysis because of the drug’s ability to slow the process of food passing through the digestive tract.
For Raibick, the out-of-pocket price for the drug is approximately 600 dollars per month. This is a cost she’s willing to pay, not just for the medication’s security. There’s no plan to stop taking semaglutide anytime soon.
“There is nothing stopping me from – a year from now, when I’ve put a little weight back on – looking back at photos from this time and thinking I was way too skinny.”
Dan Azagury, MD, an expert in bariatric surgery and the associate Professor of Surgery at Stanford University School of Medicine, is a patient who tests GLP-1s for those with obesity before considering the possibility of bariatric surgery. In his patients’ population, it is possible that medications such as Ozempic could be an integral part of their treatment strategies.
“We’re not doing it for the cosmetic part of it, we’re doing it for health,” he explained. “What I tell my patients is, if you’re planning to start on this medication, you should be OK with the idea of staying on it forever.”
For doctors such as Thiara, who are experts on weight control, there are better methods than utilizing Ozempic long-term to treat patients with a healthy weight.