A trend from the USA ensures that diabetes medication is currently difficult to obtain in Germany. It helps to lose weight - and quite effectively. Elon Musk and Kim Kardashian did it. However, experts warn of side effects and skyrocketing costs.
Women film themselves injecting a special drug into their stomachs. "I'm down nine pounds now. There's a constant one kilo per week. I think it's super good," reports a Tiktok user. Videos like this are currently being uploaded and clicked on a lot on social media.
Many celebrities who are said to have lost weight are also to blame for this: tech billionaire Elon Musk or influencer and entrepreneur Kim Kardashian, for example. The drug is called Ozempic, but is also sold under the name Wegovy, with the active ingredient semaglutide, manufactured by the Danish pharmaceutical company Novo Nordisk.
Actually, it is intended for diabetics with type 2 diabetes to lower their blood sugar levels. In a study, however, it was found that the drug also helps to lose weight, says diabetologist Andreas Pfeiffer from the Berlin Charité in the ntv podcast "Again what was learned". "You then tried to understand more precisely how it works, because it's just one of many hormones that help regulate it. But then you saw that it's very effective."
The active ingredient semaglutide regulates appetite and increases the feeling of satiety, "regardless of whether you are fat," says Pfeiffer. You're less hungry. "Of course, it's also very interesting for diabetics, because they have good blood sugar regulation if they have enough insulin of their own. And they also reduce their weight." Long-term studies have shown that patients with diabetes have fewer heart attacks, strokes or kidney problems as a result of the drug, according to Pfeiffer.
It's not the first weight loss drug. The active ingredient liraglutide has been on the market for several years. The associated diabetes drug is called Victoza, the drug Saxenda is approved for weight loss. Overweight people can lose about six kilos with it.
But semaglutide has a stronger effect, explains the diabetologist: "Liraglutide is a third as effective as semaglutide." According to a study, patients can use the active ingredient to lose around 15 kilos in just over a year. Elon Musk is said to have lost 13 kilos with the help of the drug Wegovy. In addition, semaglutide only has to be injected once a week instead of once a day as with liraglutide.
Semaglutide is intended for overweight and obese people. That's 60 percent in Germany. In the USA it is even around 73 percent. If you are overweight, you have a greater risk of getting cancer, a heart attack, a stroke - or diabetes, says Andreas Pfeiffer.
The preparation is particularly useful for people with obesity, says the expert in the “Learned again” podcast. "People who weigh 100 kilograms or more have a very small chance of permanently losing weight without help. With medication, it's already very good."
But semaglutide is being used more and more frequently as a lifestyle drug to get rid of annoying but not harmful rolls of fat. "There is concern that anorectics could also use it. Of course, that's not indicated," estimates Pfeiffer. He himself treats patients from countries where there is very strong pressure to be slim. Semaglutide inhibits appetite, the patients would not even notice that they are eating less.
The manufacturer Novo Nordisk is benefiting from the high demand for the weight loss syringe, which has been making more sales for years. The hype ensures that the prescription drug - even for diabetics - is currently not available.
With Ozempic, the lower-dose drug, there have been delivery problems for a long time. According to the list of the Federal Institute for Drugs and Medical Devices, it should not be available again until next week. The newer remedy Wegovy has also been approved in Germany for a year, but has not yet come onto the market.
As with other medicines, the reason for the supply bottlenecks are global factors such as interrupted supply chains. For diabetics that means: wait and see. "The pharmacies don't have it regularly available," says the expert. "Right now we're giving patients a prescription for three months and they put it there."
Users on Tiktok celebrate semaglutid as the "miracle cure" for obesity and show before and after pictures as proof of how many pounds they have lost with it.
However, experts recommend that specialized doctors should prescribe the drug - and only if it is medically necessary. Also because it has side effects. "It inhibits gastric emptying. That means the food stays in the stomach for a long time. It can be so pronounced that people spill over. Often there is nausea, a feeling of fullness and such a feeling of discomfort at the beginning," explains Pfeiffer in the podcast.
That's why you have to increase the dose very slowly, the diabetologist knows. Only very few people would have to struggle with side effects. But some break off the therapy because of this - up to seven percent in the approval studies.
Another problem is that if you want to lose weight sustainably with semaglutide, you probably have to inject it for the rest of your life. However, long-term use has not yet been researched. And it could also be that the effect wears off over time, experts fear.
In the beginning, the joy may still be great when the body is slimmer. But for most people who then no longer take the injection, the yo-yo effect sets in. "With all previous anti-obesity drugs, it was always the case that when you stopped taking them, people went back to their starting weight," says Pfeiffer.
The expert explains this phenomenon by programming the body. "The brain strives for the highest weight that we had. And if you don't have that, you're not quite happy."
Anyone who gets a prescription for semaglutid has to pay for it themselves. That can get really expensive. Depending on the dose, around 80 to 200 euros can be due every week. The statutory health insurance companies have not yet covered the costs. Because obesity is not formally recognized as a disease in Germany. Health insurers are not allowed to reimburse the costs for medicines that are intended for "slimming".
Nevertheless, research into obesity drugs is in full swing. The substance tirzepatid, among other things, will be important next, Andreas Pfeiffer promises. The drug Mounjaro from the US pharmaceutical giant Eli Lilly is also said to lower blood sugar and weight, it is "more effective than semaglutide". It is already approved in the European Union.
(This article was first published on Wednesday, February 01, 2023.)
