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Success of Weight-Loss Drugs May Depend on Exercise

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Introduction: The Issue of Weight Regain

A long-term study has revealed that exercise may be key to preventing weight regain after stopping weight-loss drugs. Despite the effectiveness of drugs like Ozempic, many users quit within a year due to cost, side effects, or other reasons, leading to weight regain that is predominantly fat, not muscle.

Effectiveness and Real-World Challenges

The new weight-loss drugs that suppress appetite and reduce food cravings can be quite effective, helping many people lose at least 10 to 20% of their body weight. However, in the real world, studies show that as many as half of users quit these drugs within a year due to their expense, side effects, or other reasons.

Post-Drug Weight Regain

After quitting the drugs, the pounds almost invariably creep back, and worryingly, the weight people regain tends to be almost exclusively fat, with little muscle. This often leaves them metabolically less healthy than before they began the drugs.

Study Overview

An important new long-term study suggests a simple, accessible way to stave off unhealthy weight regain after stopping the drugs: exercise.

Combining Exercise with Weight-Loss Drugs

In the study, people who exercised while using a weight-loss drug kept off far more of their weight after quitting the medication than those who didn’t work out, and they maintained more muscle.

Study Details and Findings

Initial Phase: Rapid Weight Loss

The study began with 195 Danish adults with obesity, who were put on an extremely low-calorie diet to rapidly lose about 30 pounds. For the maintenance phase, some volunteers were assigned to start taking Saxenda (liraglutide), an early GLP-1 medication, to see if it would help them maintain and augment their dieting weight loss.

Introducing Exercise

A separate group started the same drug but also engaged in a supervised exercise program, including twice-weekly, half-hour group spinning classes and 15 minutes of high-intensity, full-body resistance training, along with two at-home jogs or similar workouts.

Control Group

A control group didn’t exercise and received a placebo instead of liraglutide. After a year, almost everyone who took the drug maintained or lost more weight, but those combining the drug and exercise lost the most weight, primarily fat instead of muscle.

Stopping the Medication

The researchers then stopped the medications and exercise sessions for everyone, leaving them to maintain or regain their weight loss on their own.

Long-Term Results

After a year, those who had taken the drug without exercise regained about 70% or more of their lost weight, mostly as fat. However, those who exercised while taking the drug maintained more of their weight loss and healthier body composition, with some weight regain being muscle.

Key Takeaways

Continued Exercise Benefits

The study found that participants who continued to exercise on their own, even without supervision, added fewer pounds after stopping the drug. Exercisers generally worked out several hours a week voluntarily, suggesting that about two hours a week of vigorous exercise, mixing aerobic and resistance exercise, may be a good goal for staving off weight regain after ceasing a weight-loss drug.

Sedentary Post-Drug Phase

Those who didn’t exercise while on the drug were almost completely sedentary afterward, averaging fewer than 30 minutes of exercise a week. More of these participants complained of fatigue during treatment and afterward, contributing to their inactivity.

Conclusion: The Importance of Exercise

Overall, the results strongly suggest the importance of adding exercise to a regimen that includes a GLP-1 medication. “The results are very encouraging,” said Robert Kushner, an endocrinologist and professor at Northwestern University Feinberg School of Medicine. Further studies are needed to determine if a less intense exercise routine has similar effects on weight maintenance when people stop a GLP-1 drug.

Kelly Osbourne: “I Did Not Take Ozempic”

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Clearing Up the Ozempic Speculation

Kelly Osbourne has addressed rumors about her weight loss, firmly denying that she used Ozempic to achieve her 85-pound weight reduction. Her impressive transformation came after the birth of her son.

“I know everybody thinks I took Ozempic,” Osbourne told Extra. “I did not take Ozempic. I don’t know where that came from. My mom (Sharon Osbourne) took Ozempic.”

Weight Loss Journey After Pregnancy

At 39, the DWTS alum shared details of her weight loss journey that began after the birth of her son, Sidney, in 2022, with Slipknot DJ Sid Wilson. “I had gestational diabetes and I had to lose the weight that I had gained during pregnancy,” Osbourne explained. “Otherwise I was at a higher risk of actually getting diabetes, which I did not want. I cut out sugar and carbohydrates and I rapidly lost weight.”

Previous Praise for Ozempic

Earlier this year, Osbourne had spoken highly of Ozempic for its weight loss benefits. “I think it’s amazing,” she told E! News. “There are a million ways to lose weight, why not do it through something that isn’t as boring as working out?”

She also addressed the criticism surrounding Ozempic, suggesting that much of the negativity comes from those who cannot afford the medication. “People hate on it because they want to do it and the people who hate on it the most are the people who are secretly doing it or pissed off that they can’t afford it. Unfortunately, right now it’s something that is very expensive, but it eventually won’t be because it actually works,” she said.

Sharon Osbourne’s Experience with Ozempic

Kelly’s mother, Sharon Osbourne, has shared her own experience with Ozempic, revealing that she stopped using the drug due to excessive weight loss. “I’ve lost 42 pounds and I can’t afford to lose any more,” she told the Daily Mail. “I’m too gaunt and I can’t put any weight on. I want to, because I feel I’m too skinny.”

Private Schoolers Want Ozempic

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Rising Use Among Students

Dr. Allie Melendez has been conducting sex education and wellness workshops at many of Los Angeles’ most elite independent schools. During these sessions, she discovered a disturbing trend: a significant number of high school seniors are using weight-loss drugs like Ozempic.

Disturbing Discoveries

Over the last academic year, Dr. Melendez held workshops at various schools and noticed a growing issue. “I have a slide in one of my presentations that shows the logo for Ozempic and I ask the students, what do you know about this?” she explains. When she asks students to raise their thumbs if they have considered, are currently using, or are in the process of getting access to Ozempic, more than a third of the seniors raised their thumbs.

Widespread Use

If this had happened at just one school, Melendez might have considered it an anomaly. However, she encountered similar results across seven top private academies in L.A., which deeply disturbed her. Despite her internal anguish, she maintained a calm exterior, thanking the students for sharing.

Personal Experience and Professional Insight

As a graduate of UCLA Lab School and Windward High School, Melendez understands the pressures students face in elite Westside schools. Her firsthand experience with peers suffering from eating disorders inspired her to pursue a career in education and human sexuality.

Growing Trend Among Youth

Early data aligns with Melendez’s observations. A University of Michigan report noted a significant increase in the number of individuals aged 12 to 25 receiving prescriptions for diabetes or weight-loss drugs, growing from 8,722 to 60,567 per month between 2020 and 2023. This represents an almost 600 percent increase, predominantly among females.

Pressure and Mixed Messaging

The pairing of injectable weight-loss drugs with teenagers in a body-conscious city like L.A. has potential for undesirable outcomes. Appearance pressures start early, with beauty products and gift cards being common birthday presents for young girls. Celebrity culture and media messaging only amplify these pressures.

Cultural Impact and Concerns

Celebrity use of semaglutides is openly discussed in L.A., with everyone from restaurant owners to personal trainers feeling the impact. With sex education curriculums promoting body positivity, there is a risk of mixed messaging influencing vulnerable minds.

Widespread Marketing and Influence

Dr. Melendez, who grew up in Cheviot Hills and is the daughter of advertising executives, understands the power of persuasion. She has noticed aggressive marketing of anti-obesity medications on social media and in popular media, such as Family Guy and South Park.

Social Media Influence

On social media, Ozempic and other GLP-1 drugs are ubiquitous. TikTok, for example, has over 91,500 videos with the hashtag #Ozempic, garnering millions of views, likes, and comments.

The High-Achieving Environment

For students at elite schools, the allure of drugs like Ozempic is understandable. High-achieving students often face higher rates of anxiety, depression, and substance abuse. The demand for these drugs has surged, making it difficult for diabetics to access them.

The L.A. Context

California ranks low in the number of GLP-1 prescriptions per capita, but wealthier neighborhoods in L.A. likely mirror high consumption areas like New York’s Upper East Side.

Psychological Risks

Christina King, a Manhattan Beach-based psychotherapist, notes that high-achieving schools amplify pressures, potentially leading to more students using these drugs. While she hasn’t yet seen a surge in her practice, she predicts that could change soon.

Long-Term Implications

The American Academy of Pediatrics recently included anti-obesity medication in its guidelines for treating childhood obesity. However, the long-term effects of these drugs on teenagers remain unclear, with concerns about growth, development, and potential abuse.

A Call for Awareness

Melendez is cautious about sharing details with school therapists due to privacy concerns but believes it’s crucial to raise awareness. “What I was trying to do is to have kids think critically about problems that plague our society today like the use of Ozempic,” she says.

Final Thoughts

Melendez is going public now because, “We just don’t know what the long-term side effects of all this is.”

Proper Storage of Ozempic

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Storage Issues Impacting Efficacy

The diabetes-turned weight-loss drug Ozempic has helped tens of thousands of Americans slim down, yet some people report their prescription isn’t delivering the results it should. Experts now suggest that improper storage might be a reason for the drug’s reduced effectiveness.

Refrigeration is Key

While it’s common to keep prescriptions in the bathroom medicine cabinet, providers say Ozempic should be stored in the refrigerator instead, kept at a cool 36 to 46 degrees Fahrenheit. Doctors also warn that the medication should never be frozen or stored in direct sunlight, as this can cause the medication to break down.

Expert Warnings

Dr. Mir Ali, a bariatric surgeon, said: “If Ozempic is not refrigerated, it will likely lose its efficacy over time. In some cases, it may cause more side effects.” Incorrect storage can lead to the drug not working as intended, affecting weight loss results.

Proper Storage Instructions

Instructions say to keep all new and unopened Ozempic pens in the refrigerator. Once Ozempic is used for the first time, it can be kept either in or out of the fridge, but it should not be exposed to extremely cold or hot temperatures.

Dr. HaVy Ngo-Hamilton, a pharmacist, advises that opened Ozempic should be kept between 59 degrees and 86 degrees Fahrenheit for up to 56 days or until its expiration date, whichever comes first. After that point, any leftover medication should be discarded.

Importance of Stability

Dr. Jennifer Bourgeois, a health expert based in Fort Worth, emphasized: “Proper storage of medication ensures its effectiveness and safety. Even the slightest deviations in storage conditions can affect the medication’s stability.”

Impact on Effectiveness

Ozempic is sensitive to temperature changes because it contains semaglutide, a protein that can start to break down in warmer temperatures. This means that if not stored correctly, the medication may no longer mimic hunger-suppressing hormones in the body and will not work as intended.

Other Weight Loss Drugs

Other similar weight loss drugs should also be kept in the refrigerator, including Wegovy, which can only be stored at room temperature for 28 days, and Mounjaro, which must be used within 21 days of being opened.

Celebrity Usage

Eagle-eyed viewers discovered the weight loss drug Mounjaro stocked inside Scott Disick’s fridge on an episode of The Kardashians. This underscores the importance of proper storage for these medications.

Expected Weight Loss

Experts prescribing these medications say patients can expect to lose as much as 1lb per week while using drugs like Ozempic, Wegovy, and Mounjaro. Marlee Bruno, who owns the medical spa Mind Body & Soul Medical in Florida, previously told DailyMail.com: “After three months, patients may have lost at least 12lbs of fat — which is a significant loss and makes patients feel much better.”

Combining Diet and Exercise

Many doctors advise those taking Ozempic to use the drug alongside a high-protein diet and exercise to avoid muscle loss and help maintain weight loss when they come off the drug.

Patient Experiences

Some patients have reported that the drugs were not working for them, with some saying they “out-ate” the drug. Comedian Tracy Morgan, 55, revealed in March that he “gained 40lbs” while taking Ozempic, saying, “I’ve learned to out-eat Ozempic. I out-ate Ozempic. I’ve gained 40 pounds.”

Rising Demand

Prescriptions for Ozempic and similar weight loss medications have exploded in the US, with 39 million people — or 12 percent of the population — now thought to have used them. If users aren’t seeing a difference, they should check how they’re storing their shots. Proper storage is crucial for the medication’s effectiveness and safety.

Navigating Ozempic and Weight Loss Drug Shortages

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Increased Popularity and Shortages

Ozempic and other weight loss medications like Wegovy, Zepbound, and Mounjaro are more popular than ever. While the increased acceptance of these drugs is positive, it comes with a downside: shortages are making it difficult for patients who need them. In some countries, these medications are being rationed.

What to Do When Your Pharmacy Runs Out

If your pharmacy is out of your prescribed weight loss drug, you’re not out of luck.

Alternative Pharmacies and Locations

Dr. Mir Ali, MD, board-certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, suggests asking your pharmacist to locate the medication at another branch within their system. “An alternative would be a legitimate weight loss center that may be able to obtain the medication from other sources,” Dr. Ali notes.

Mail-Order and Independent Pharmacies

Dr. Katrina Mattingly, MD, chief medical officer of Options Medical Weight Loss, recommends considering mail-order pharmacies and independent neighborhood pharmacies. “Large commercial chain pharmacies typically carry prescription drugs at higher prices. Looking into a mail-order pharmacy or your neighborhood pharmacy truly is worth your time,” she says.

Compounding Pharmacies

Dr. Mattingly also suggests considering compounding pharmacies, which can combine drugs for specific needs. “Compounding pharmacies have the green light from the FDA to fill in the gap on some GLP-1 medications that are on the drug shortage list,” she says. Ensure the compounding pharmacy has proper certifications and ask for the certificate of analysis.

Avoid Rationing Medication

Dangers of Lower Doses

Rationing your medication by taking smaller doses is not recommended. “Lower doses may not be as effective for many patients,” Dr. Ali advises. “The medication is designed to start at a low dose and increase every four weeks to minimize side effects.”

Risks of Sharing Medication

Dr. Mattingly warns against sharing your medication with others, even if they are also short on their prescription. “Please do not share medication prescribed specifically for you with another person or share needles,” she cautions. Sharing needles can risk infections such as cellulitis, HIV, and hepatitis.

Missed Doses

Impact of Missing a Dose

If you miss a dose due to the shortage, don’t panic. “If patients are not able to take the drugs immediately, they should be OK for another seven to 10 days,” Dr. Mattingly says. Some weight loss injections can stay in your system for up to 80 days. However, prolonged gaps can affect your weight loss goals, so maintaining your diet and exercise regimen is crucial.

Regaining Weight

“Patients who stop the medication can see weight regain if they have not adopted significant dietary and lifestyle changes,” Dr. Ali explains. If you stop the medication for a while, you may need to restart at a lower dose to avoid side effects.

Switching Between Medications

Ozempic, Wegovy, and Mounjaro

Dr. Mattingly explains that while some weight loss prescriptions have similar ingredients, switching between them isn’t always straightforward. “Ozempic and Wegovy are both semaglutide, with slight variations in maximum doses. Your physician may prescribe the other with proper dosing adjustment, but insurance may not cover the switch,” she says. Mounjaro, a mixture of two active medications, currently has no substitute.

Conclusion

Navigating the shortages of weight loss medications like Ozempic, Wegovy, Zepbound, and Mounjaro requires understanding your options and consulting with healthcare providers to ensure continuity in your treatment. By exploring alternative pharmacies, considering compounding pharmacies, and maintaining open communication with your doctor, you can manage your medication needs effectively.

Ozempic and Wegovy: Improves Rheumatoid Arthritis Symptoms

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Positive Reports from RA Patients

A growing number of people with rheumatoid arthritis (RA) are reporting that GLP-1 drugs like Ozempic, Wegovy, and Zepbound are helping them better manage symptoms and decrease flare-ups.

Connection Between Obesity and RA

Some people report that GLP-1 anti-obesity medications like Wegovy have helped improve their rheumatoid arthritis. Body fat and higher BMIs have been associated with a higher risk of developing rheumatoid arthritis. Health experts say more research is needed to understand the connection.

Beyond Weight Loss Benefits

The weight-loss benefits of GLP-1 medications like Ozempic, Wegovy, and Zepbound are widely known. However, as more people take these medications, there appear to be other benefits, such as reducing the risk of heart disease, stroke, kidney disease, and colon cancer. Recently, anecdotal accounts have surfaced of GLP-1 medications also helping people with rheumatoid arthritis (RA) manage their pain and experience a decrease in flare-ups.

Expert Insights on GLP-1 and RA

Impact on Autoimmune Patients

“It is well established that autoimmune patients with obesity fare worse than those without. [They] have higher symptoms and less response to traditional therapies,” Dr. Elizabeth Ortiz, rheumatologist and clinical advisor at WellTheory, told Healthline. “I have seen patients lose weight and then require less immunosuppressant therapy for their condition.”

Systematic Review Findings

According to a systematic review and meta-analysis of cohort studies, there is a positive association between levels of body fat and the risk of developing RA. Additionally, higher BMI (in middle age and early adulthood) and waist circumference are associated with a higher risk of RA. Obesity has been linked to worse autoimmune and inflammatory symptoms and less favorable responses to standard therapy for RA.

Holistic Care Approach

“In addition to keeping autoimmune patients from feeling their best in the short term, the combination of obesity and autoimmunity can have a major impact on health in the long term,” Ortiz said. “Those with rheumatoid arthritis and other autoimmune diseases carry a higher risk of cardiovascular disease than those without these conditions. Our best defense against this is tight control of autoimmune inflammation and all other cardiovascular disease risk factors, such as obesity.”

Emerging “Obesity First” Approach

Potential Benefits

Dr. Fatima Cody Stanford, associate professor of medicine and pediatrics at Harvard Medical School, said reducing weight can lead to less joint pain and inflammation, improved mobility, and reduced disease activity. “Moreover, weight loss can improve overall health, reduce comorbidities such as cardiovascular disease and diabetes, and enhance the effectiveness of RA medications,” Stanford told Healthline.

Holistic Strategy

Treating obesity first to help with other conditions has been coined the “obesity first” approach. Stanford said it is an emerging and promising strategy because addressing obesity directly can have a broad range of positive effects on multiple chronic conditions. “By targeting obesity first, healthcare providers can potentially improve or even resolve associated conditions like type 2 diabetes, hypertension, and dyslipidemia,” she said. “This holistic approach recognizes obesity as a root cause rather than a consequence, aiming to improve overall patient health and simultaneously reduce the burden of multiple chronic diseases.”

Caution Against Solely Focusing on Obesity

However, Ortiz believes it is too early to take an “obesity first” approach for autoimmune disease. While a proportion of patients with autoimmunity may have positive results by solely focusing on obesity, she said this will not be the case for everyone. “The biologic triggers for any particular individual’s autoimmune disease are complex and personal, and taking an ‘obesity first’ approach without also addressing the underlying autoimmune disease may expose patients to unnecessary risk from poorly controlled inflammation,” she said.

Future of GLP-1 Drugs in RA Treatment

Need for Collaborative Treatment Plans

As the complex relationships between obesity, metabolic health, and chronic diseases deepen, Stanford said collaboration between obesity medicine physicians, endocrinologists, rheumatologists, cardiologists, and primary care providers is needed to create comprehensive treatment plans that address the root causes of these conditions. “As new therapies and strategies emerge, they offer hope for improved quality of life and outcomes for patients struggling with obesity and associated chronic diseases,” she said. “Continued research and innovation will be key in advancing these efforts and providing evidence-based care.”

Exploring Anti-Inflammatory Properties

Given the anti-inflammatory properties that GLP-1 drugs provide and their effects on the immune system, Stanford said these medications could be promising in the context of autoimmune diseases. She anticipates more research regarding their potential benefits. “Preliminary research has suggested that GLP-1s may modulate immune responses and reduce inflammation, which could benefit conditions like RA, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD),” said Stanford. “Further research is needed to understand the mechanisms involved and to evaluate their efficacy and safety in these contexts.”

Addressing Key Questions

Ortiz agreed. She said those treating autoimmune diseases don’t want to turn to GLP-1 drugs without a better understanding of how and why autoimmune patients may benefit from them. For instance, key questions that need to be answered include:

  • What are the anti-inflammatory effects of GLP-1s, and how do they impact those with autoimmune disease?
  • What type of autoimmune disease patient would benefit from this type of treatment, and what kind of effect can be expected?
  • What is the effect of these medications on the microbiome, and how does that impact autoimmune disease?
  • How much weight loss (if any) is needed to see an impact?
  • Are the benefits of GLP-1s in RA patients solely from weight loss?

Balancing Benefits and Risks

Understanding the effects of GLP-1 drugs on a person with an autoimmune disease like RA who is not overweight or obese needs further research. “As we continue to discover [GLP-1s] biologic effects on inflammation and our immune systems and continue to accrue data in people using them for obesity and diabetes, we may find they are a useful tool against autoimmunity, aside from their impact on obesity,” said Ortiz. Any positive impact would have to be weighed against potential risks of using these medications, such as the risk of muscle loss, as muscle loss can lead to osteoporosis, a condition often associated with autoimmune diseases, she noted.

Conclusion

Overall, more time is needed to determine whether or not GLP-1 drugs can be used to control autoimmunity and inflammation in those with or without obesity and how best to utilize the medications for these purposes. “What is likely to be addressed more quickly is how these medications can be utilized as a supplement to standard autoimmune therapy to improve metabolic syndrome and decrease an autoimmune patient’s cardiovascular risk,” said Ortiz.

Ozempic’s Effectiveness in Diabetes and Kidney Disease

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Presentation at the American Diabetes Association

Results from the FLOW trial were presented at the 84th Annual Scientific Sessions of the American Diabetes Association, highlighting significant findings in diabetes and kidney disease treatment.

Prevalence of Diabetes and Kidney Disease

According to Diabetes UK, out of the 5.6 million people living with diabetes in the UK, 90% have type 2 diabetes (T2D). Approximately 40% of people with T2D will eventually develop chronic kidney disease (CKD), a condition that affects more than 800 million people worldwide.

Trial Overview

Previously presented at the 61st European Renal Association Congress and published in the New England Journal of Medicine, the FLOW trial compared once-weekly 1mg injectable Ozempic with a placebo. The study focused on kidney outcomes, assessing the risk reduction in the progression of kidney impairment, kidney and cardiovascular mortality in 3,533 people with T2D and CKD.

Ozempic’s Role and Indications

Indicated along with diet and exercise, Ozempic injection is a once-weekly glucagon-like peptide-1 receptor (GLP-1) agonist that helps improve blood sugar levels in adults with T2D and reduce cardiovascular events in adults with T2D who have known heart disease.

Key Findings from the FLOW Trial

Risk Reduction and Efficacy

Results demonstrated a 24% reduction in the risk of kidney disease progression and cardiovascular and kidney mortality compared to placebo. Ozempic 1mg showed superiority to placebo for all secondary outcomes assessed, including a significant reduction in the mean annual glomerular filtration rate.

Cardiovascular and Mortality Benefits

The risk of major cardiovascular events and the risk of death were significantly lower in the Ozempic group, with fewer serious adverse events reported compared to the placebo group.

Study Conclusion and FDA Review

After a median follow-up of just over three years, Novo Nordisk stopped the FLOW study due to the efficacy of Ozempic in preventing kidney disease-related incidences. Novo submitted a label extension application, which was accepted for review by the US Food and Drug Administration, with a decision anticipated in January 2025.

Expert Commentary

Anna Windle, senior vice president, clinical development, medical and regulatory affairs at Novo, commented: “The results from the FLOW trial represent important data as we look to better understand what GLP-1 treatment options could mean for this patient population.”

Concerns Over Ozempic Supply

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TD Cathal Crowe Voices Concerns

Clare TD Cathal Crowe has raised serious concerns regarding the supply of the controversial Ozempic drug after a Clare woman experienced judgmental behavior from a pharmacist while trying to fulfill her prescription.

Ozempic: The ‘Miracle’ Weight Loss Drug

The controversial drug, used to treat type 2 diabetes and obesity, has recently been touted as a miracle weight loss solution. Its popularity has surged, especially among Hollywood celebrities seeking quick weight loss results. In Ireland, Ozempic is licensed solely for diabetes treatment, though some doctors are prescribing it off-label for obesity. The Irish Pharmacy Union reports that the drug has been in short supply, forcing patients to search multiple pharmacies.

Incident at the Pharmacy

Speaking in the Dáil this week, TD Crowe recounted an incident involving a Clare woman who struggled to find Ozempic.

Pharmacist’s Questionable Conduct

“I raise the issue of the supply of the drug Ozempic. Someone called into one of my advice clinics this week. She has been prescribed Ozempic by her GP and had gone to many pharmacists in County Clare and beyond trying to get this all-important medicine. When she went into one pharmacy, the pharmacist looked her up and down and asked her if she had diabetes or was obese. He asked this question in front of a queue of people.

“Since when have pharmacists had a role in terms of diagnostics? If this person I mentioned appears at a pharmacy with a script, surely the intention is that it will be fulfilled and handed over to her, and then she will make her payment,” he said.

Call for Official Guidance

Crowe called for the Minister of State to address the Ozempic supply issue and provide clear guidance to pharmacists on dispensing the drug.

“Could the Minister of State tell me where the supply of Ozempic is at and if some circular or guidance could come from the Department of Health to give guidance to the pharmacists on who should be getting this drug and how it should be dispersed? Let us get them out of diagnostics or looking people up and down as they queue for this medicine,” he concluded.

Minister’s Response

In response, Minister for Mental Health and Older People, Mary Butler, acknowledged the concerns raised by Crowe.

Addressing Medication Shortages

“I thank the Deputy very much for his question. Some concerns have been raised about shortages of medicines. This is a feature of modern health systems worldwide and a global health problem. I know this can cause stress and anxiety for patients and pharmacists.

Specifics on Ozempic

“Regarding the specific issue raised by the Deputy concerning Ozempic, I will get a written response for him. I do not want to comment on the other issue he raised, but I understand the perspective he is coming from. If people need medication and are prescribed it by their GP, it is very important that they are able to access it from a pharmacy,” she finished.

GLP-1 Drugs Spurs Counterfeit Concerns

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Boom in GLP-1 Drug Usage

When GLP-1 drugs for diabetes and weight loss exploded onto the scene two years ago, patients scrambled to get their hands on them. GLP-1s, which include Ozempic, Wegovy, Mounjaro, and Zepbound, are so popular that it didn’t take long for them to wind up in short supply. According to one recent survey conducted by KFF Health Tracking, as many as one in eight adults has now used a GLP-1.

Counterfeit Drugs on the Rise

The demand shows no signs of slowing down, and as a result, counterfeit GLP-1 drugs are becoming an increasingly bigger piece of the landscape—so big, in fact, that the World Health Organization (WHO) last week issued a warning to people to be wary of the fake versions. Alongside the warning, drug makers Eli Lilly and Novo Nordisk have filed lawsuits against several entities to stop selling the counterfeits.

Unregulated Sources and Risks

Med Spas and Compounding Pharmacies

“As soon as these drugs hit the market, the demand was so high that pharmacies began running out of them,” says Dr. Supriya Rao of Integrated Gastroenterology Consultants in Boston. “So med spas and compounding pharmacies began filling that gap for patients.”

A compounding pharmacy creates medicines using base ingredients, rather than dispensing the name-brand medications like Ozempic and Wegovy. Med spas, many online sources, and compounding pharmacies do not fall under the umbrella of FDA regulation, so there are no safeguards on what a patient might receive from one of these sources. “Compounded medications are essentially ‘copies’ of available medications, but they do not have the same safety, quality, and effectiveness assurances as approved drugs since these compounded versions lack FDA approval,” explains Dr. Carolyn Jasik, chief medical officer for Omada Health.

Dangers of Counterfeit Drugs

Likewise, counterfeit drugs—like what you might find at a med spa or from an online source—are unregulated. “Counterfeit drugs, no matter what, are dangerous and can lead to serious health consequences,” says Jasik. “These medications can contain toxic doses, the wrong ingredients, or no active ingredients at all. In short, you’re paying for a drug that can either harm you or is doing nothing at all.”

Some of the risks you might face with an unregulated form of GLP-1 include nausea and diarrhea, irregular blood sugar levels, and infections at the site of injection, among others.

Cost and Accessibility Issues

Often, patients are drawn to these alternative sources not just because supply of the originals is short, but also because they can be prohibitively expensive.

“Semaglutide medications are valuable and effective, but we are currently caught in a moment where the supply chain and cost can make these drugs inaccessible to much of the broader public,” says Jasik. “It’s important to note that this is a large part of what drives the development of counterfeit drugs in the first place. As a medical provider, I’m sad that this lifesaving medication is so difficult to access and that it’s come to counterfeit drugs that take advantage of people’s desires and medical needs.”

Safety Measures for Consumers

Buy from State-Licensed Pharmacies Only

As tempting as it might be to go for the cheaper alternatives on the market—or simply just to get your hands on a GLP-1 drug—the experts recommend steering clear. “Consumers should purchase medications from state-licensed pharmacies or FDA-registered outsourcing facilities to minimize the risk of counterfeit products,” says Simona Dorf, PharmD, and clinical pharmacist at First Databank. “It’s essential to verify prescriptions from licensed health care providers and avoid drugs recommended by unverified online sources or social media influencers.”

Do Your Own Research

The FDA’s BeSafeRx website is a good source of credible information to educate yourself before hitting “buy.” The site warns against websites that pose as online pharmacies, and recommends consumers only buy prescription medicines from a state-licensed online pharmacy, plus offers a location tool to find one. Additionally, it recommends talking with your doctor about any meds you purchase online.

Check the Packaging and Labels

A sure sign that you’re dealing with a fake is misspellings on the label, or poor print quality. Give each label a good going over to make sure of its authenticity. Along with those red flags, others include a missing or added word to the drug’s name. You can also do a check on the serial numbers and lot numbers by checking the FDA’s website.

Avoid Compounding Pharmacies

Rao also reminds consumers that any medication you put in your body has the potential for side effects. Those risks only grow if you’re not purchasing them from trusted sources. “Compounding pharmacies can be a slippery slope,” she says. “Depending on who is sourcing the medication, who knows what you’re getting from one day to the next. Injecting a drug from an unknown source is risky.”

Long-Term Weight Loss Advice

There are also important steps to take with regard to weight loss, whether you are using a GLP-1 medication or not, said Jasik. These include consistent self-monitoring, like weigh-ins; maintaining a balanced diet; exercises to help build lean body mass; and lifestyle programming to create a structured approach.

Whether you choose to use a weight-loss medication or not, safety should be front and center to your approach. And if the medication is part of that, even more so. “It is crucial to cross-check such information with health care providers,” said Dorf. “Awareness of the risks associated with counterfeit GLP-1 drugs and taking proactive measures can significantly protect consumers. As demand for these medications continues to grow, vigilance from both consumers and regulatory bodies is essential to ensure safety and efficacy in treating diabetes and obesity.”

‘Rice-Zempic’: A Social Media Weight Loss Trend

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Growing Popularity of ‘Rice-Zempic’

For as long as the market for weight-loss drugs like Ozempic and Wegovy has boomed, people have been on the hunt for non-prescription and cheaper alternatives. Recently, a new natural alternative called ‘Rice-zempic’ has gained popularity on social media, with users claiming it works just as well as the medications.

The Trend’s Appeal

An increasing number of people have begun drinking a beverage consisting of rice-steeped water and lime juice after viral videos claimed it can help them drop 15 pounds in just two weeks. TikTok user Alfredo Valenzuela, known as TheChorroKing, tried the trend to lose weight before a vacation. Starting at 238 pounds, he weighed 235 pounds by day three, despite not exercising that day, prompting him to ask: “Is this the miracle water?”

Expert Opinions on ‘Rice-Zempic’

Short-Lived Results

Despite Valenzuela’s initial success, experts caution that the trend doesn’t work like weight-loss injections and is unlikely to provide long-term benefits. Valenzuela himself experienced a plateau and stopped the trend after 12 days, having lost only five pounds.

Scientific Analysis

Scott Keatley, co-owner of Keatley Medical Nutrition Therapy, stated that there is no evidence to suggest that rice water has significant weight loss properties comparable to anti-diabetic medications like Ozempic. These medications mimic a hormone that controls digestion and hunger, reducing appetite and helping people feel fuller for longer.

Mechanism of ‘Rice-Zempic’

Dr. Mir Ali, medical director of MemorialCare Surgical Weight Loss Center in California, explained that soaking rice in water releases starch, a filling nutrient. While drinking starchy water may help people feel full longer than plain water, it doesn’t impact hormones the way GLP-1 analogs do. Furthermore, substituting meals with low-calorie rice water may result in weight loss due to reduced calorie intake, but experts don’t recommend replacing whole foods with this mixture.

Recipe for ‘Rice-Zempic’

Recipes for this elixir vary, but most users combine equal parts of white rice and room temperature water, letting it sit for five minutes or overnight. The rice is then drained, and the water is mixed with juice from half a lime or lemon.

Real-Life Experiences

TikTok user Olivia Dort followed a similar recipe, starting the trend for fun and to test it out. She called herself part of ‘ChorroKing’s tribe.’ Dort began the trend weighing 174.6 pounds and dropped to 169 pounds by day four.

Comparison with ‘Oat-Zempic’

Valenzuela gained popularity by following a previous trend involving blended oat water, termed ‘oat-zempic.’ Both trends rely on the theory that drinking a more satiating liquid than plain water leads to eating less food.

Long-Term Weight Loss Advice

Dr. Ali emphasized that weight loss is about burning more calories than consumed. Diets aiming for rapid weight loss often fail to produce lasting results. He advised making small, steady changes to diet and exercise, including consuming fibrous, nutrient-dense vegetables and lean proteins. Although this approach requires more patience than trends like ‘rice-zempic,’ it yields better long-term results.