Semaglutide

A Dual Approach to Managing Bone Health

Combating Bone Loss with Exercise During GLP-1 Treatment

Recent studies highlight the benefits of exercise in mitigating bone loss among individuals taking GLP-1 drugs for weight loss. Research involving the GLP-1 drug liraglutide showed that participants who engaged in a moderate to vigorous exercise program not only lost weight and body fat but also maintained their bone density effectively.

Understanding the Impact of GLP-1 Drugs on Bone Health

As the use of GLP-1 receptor agonists like Ozempic, Wegovy, and Zepbound becomes more prevalent in treating obesity, concerns about their impact on bone health have intensified. Jennifer Sacheck-Ward, PhD from George Washington University, emphasizes the importance of monitoring bone mineral density, especially since bone mass typically declines after the age of 30. The interaction between GLP-1 receptor agonists and bone density is a critical area of study given the potential for increased fracture risks at younger ages.

Study Insights: Exercise as a Protective Strategy

The study, published on June 25 in JAMA Network Open, involved 195 obese but non-diabetic participants who underwent a year-long treatment with liraglutide combined with an exercise regimen. Results showed that this combination was as effective at preserving bone mineral density as no treatment at all, despite significant weight loss. This finding is crucial as it suggests that exercise can counteract the potential bone density reduction associated with GLP-1 treatments.

Diet and Exercise: The Foundation of Bone Health

Participants initially followed an 800-calorie diet for eight weeks, leading to an average weight loss of 29 pounds. Over the following 52 weeks, the study compared the effects of exercise, liraglutide, both, or neither. Those in the exercise and liraglutide groups maintained their weight loss, with the combination group losing an additional 12 pounds, indicating that exercise not only supports weight maintenance but also enhances the treatment efficacy of liraglutide.

Broader Implications for Treatment Approaches

The differential impact on bone density among groups underscores the importance of integrating exercise into weight loss regimens, particularly those involving GLP-1 drugs. Exercise not only prevented bone loss but, in some cases, actually increased bone density in the forearm. This suggests that specific types of exercise, particularly resistance and high-impact activities, could be especially beneficial for bone health.

Expert Recommendations and Future Directions

Medical experts like Spencer Nadolsky, DO, stress the importance of resistance training to minimize bone loss during intentional weight loss. The effectiveness of newer GLP-1 drugs in promoting weight loss further reinforces the need for complementary physical activities to safeguard bone health.

Concluding Thoughts: Exercise as a Preferred Method

The compelling results from this study advocate for a combined approach of GLP-1 drug use and structured exercise to manage weight while preserving bone health. With many Americans falling short of recommended physical activity levels, integrating exercise into the treatment protocol for weight loss is not only beneficial for bone density but also enhances overall health outcomes, offering a more holistic approach to obesity management.

New research from McAfee reveals a dramatic increase in phishing scams targeting consumers interested in popular weight loss drugs like Ozempic, Wegovy, and Semaglutide.

Rising Phishing Scams

According to McAfee, a computer and cybersecurity company, phishing scams related to weight loss drugs rose 183% from January to April compared to the previous three months. These scams are capitalizing on the high demand and expensive nature of drugs like Ozempic, which can cost $1,000 a month.

How Phishing Scams Work

Criminals use phishing scams to trick individuals into sharing personal information. Typically, scammers send emails or messages pretending to be a reputable company or individual, asking for credit card information, passwords, or other sensitive details.

Common Platforms for Scams

Most scams occur on platforms like Facebook or Craigslist. Researchers found 207 fraudulent postings advertising Ozempic in a single day in April. On Facebook, scammers often pose as doctors offering Ozempic and other drugs without a prescription. Once they engage potential victims, they pressure them to use unconventional payment methods such as Bitcoin, Zelle, Venmo, and Cash App.

Example of a Scam

“One example on Facebook Marketplace included a ‘Doctor Melissa’ based in Canada who could provide Mounjaro and Ozempic without a prescription, with payment available through Bitcoin, Zelle, Venmo, and Cash App — all of which are non-standard payment methods for prescription drugs and should be red flags for consumers,” the McAfee report states.

Why Consumers Fall for Scams

Despite studies indicating that Ozempic costs just $5 to produce, it sells for about $1,000 a month. This high price makes consumers more susceptible to cheap online offers, according to McAfee.

“Cybercriminals are always on the lookout for ways to make their scams more attractive and believable,” Abhishek Karnik, head of McAfee’s Threat Research Team, told Business Insider. “Tapping into the current craze for Ozempic and related weight loss drugs is one way scammers can lure you in through phishing emails, fake social posts, or ads, all under the guise of a deal that seems too good to be true.”

Tips to Avoid Scams

McAfee recommends several tips to avoid falling victim to these scams:

• Stay away from unofficial retailers.
• Be cautious of suspiciously low prices or unusual payment methods.
• Check for missing product details, such as expiration dates.

“Scam websites typically lack verifiable product information and sometimes are poorly designed with grammar issues,” McAfee notes. “Pay attention to and read the fine print.”

What to Do If You’re Scammed

If you fall victim to a scam, recovering your money can be challenging. The Federal Trade Commission suggests contacting the company, bank, or credit card issuer that facilitated the transaction to try and recover stolen funds.

The battle against obesity has long been a public health challenge, prompting the development of various interventions, including lifestyle changes, surgery, and pharmacotherapy. Among the pharmacological options, weight loss drugs such as Ozempic (semaglutide) have recently garnered significant attention for their efficacy. However, their rise has not been without controversy, raising important questions about their safety, long-term effects, and accessibility. Now, doctors in the UK are warning people against using Ozempic to achieve a ‘beach body,’ highlighting how harmful it is for the body.

Official Warnings from NHS England

“Drugs including Ozempic and Wegovy should only be used by people prescribed them for obesity or diabetes,” Stephen Powis, the national medical director of NHS England, said at a press conference in Manchester, according to a New York Post report. “I’m worried about reports that people are misusing them—they are not intended as a quick fix for people trying to get ‘beach body ready,'” he added.

Ozempic’s Intended Use

Ozempic is a medication primarily used to treat type 2 diabetes by helping to control blood sugar levels. It belongs to a class of drugs known as GLP-1 receptor agonists, which work by mimicking the hormones that the body naturally produces to stimulate insulin release in response to meals. Recently, Ozempic has been repurposed for weight loss and marketed under the brand name Wegovy, after clinical trials demonstrated its effectiveness in significantly reducing body weight.

Health Risks and Misuse

Dr. Vicky Price, a consultant in acute medicine and president-elect of the Society for Acute Medicine, has reported that “young, beautiful girls” are landing in emergency rooms across the UK after buying Ozempic online. “Sadly, we are seeing serious, life-threatening complications, including inflammation of the pancreas gland and alterations in blood salt levels in these patients, who were not aware of the risk they were taking,” said Dr. Price.

Call for Regulation

“There is a need for urgent regulation and control of access for weight-loss drugs online to avoid more patients becoming unwell,” Dr. Price added. One girl was treated for starvation ketoacidosis, a potentially life-threatening condition where the body breaks down muscle to use as fuel after running out of fat.

Conclusion

The misuse of weight loss drugs like Ozempic for non-medical purposes poses significant health risks. Medical professionals emphasize that these drugs should only be used under prescription for their intended purposes, such as treating obesity or diabetes, to prevent dangerous and potentially life-threatening complications.

South Africa’s public healthcare system has exhausted its supply of human insulin pens due to the pharmaceutical industry’s shift in production priorities to weight-loss drugs that use similar delivery devices.

Novo Nordisk, the supplier of human insulin pens to South Africa for the past decade, did not renew its contract, which expired last month. No other company has bid on the new contract to supply 14 million pens over the next three years at approximately $2 per pen.

“Current manufacturing capacity limitations mean that patients in some countries, including South Africa, may have limited access to our human insulins in pens,” said Ambre James-Brown, a spokeswoman for Novo Nordisk. The company did not specify which other countries are affected.

Novo Nordisk’s weight-loss drugs Ozempic and Wegovy, widely prescribed in the U.S., are sold in single-use pens produced by the same contracted manufacturers who make the insulin pens. A month’s supply of Ozempic in the U.S. costs about $1,000, far more than insulin.

Impact on South Africa

Novo Nordisk dominates the global market for insulin pens and has supplied South Africa since 2014. Eli Lilly, another major producer, has also indicated difficulty keeping up with the demand for its weight-loss drug Zepbound.

“This is because of the global demand for Ozempic and similar drugs,” said Khadija Jamaloodien, director of sector-wide procurement for South Africa’s health service. “They’re focusing on the more profitable line.”

Novo Nordisk continues to supply human insulin in vials to South Africa, where over four million people live with diabetes. However, insulin pens are easier to use and more precise. Pens can dispense a given amount of insulin with a simple dial and quick injection, whereas vials require drawing insulin into a syringe, confirming the dose, and injecting it.

The vial system was mostly phased out for South Africans in 2014, but recently, the National Department of Health instructed clinicians to teach patients how to use vials and syringes again.

“Insulin vials and syringes are outdated and difficult to use,” stated a national association of diabetes specialists in a public letter to the government. “They contribute negatively to quality of life for people with diabetes and lead to poor medication adherence, resulting in costly long-term complications.”

The Human Cost

Muhammed Adnan Malek, a 19-year-old student in Zeeland, South Africa, has used insulin pens from the public health system for nine years. “I’ve never used syringes, so I asked an 80-year-old I know with diabetes about it. He said it’s very difficult to give the exact dose,” Malek said. “With insulin, being a unit higher or lower has a big effect. An overdose can cause hypoglycemia, leading to coma or death.”

Jamaloodien’s office has instructed clinicians to reserve the remaining pens for those who will struggle most with using vials and syringes—small children, the elderly, and visually impaired individuals.

Boitumelo Molema, a 22-year-old student, recently found her usual clinic out of stock of insulin pens. After visiting two more clinics without success, she bought them at a private clinic for $10 each, a significant financial burden.

James-Brown, the Novo Nordisk spokeswoman, said the company alerted South Africa last year about not bidding on the next contract for insulin pens. However, Jamaloodien stated the company only mentioned a “supply constraint” without indicating a complete exit until the contracting process ended in January. This delay, due to staffing constraints, has led to a scramble to find a new supplier.

Broader Implications

Novo Nordisk started making pens in 1985, and these, along with pumps, are standard care for Type 1 diabetics in industrialized countries. Wealthy individuals in low-income countries also use them.

South Africa is unique among low-resource countries for supplying insulin pens through its public health service. Eighty percent of people with diabetes live in low- and middle-income countries. GLP-1 drugs like Ozempic, used for diabetes treatment in high-income countries, are not on the WHO’s essential medicines list or the diabetes treatment guidelines of low- and middle-income countries.

Novo Nordisk’s insulin access policy provides insulin at $3 per vial to low- and middle-income countries and $2 per vial to humanitarian groups like Médécins Sans Frontières (MSF). Novo Nordisk signed an agreement last year with South African drugmaker Aspen Pharmacare to produce 60 million vials by 2026.

MSF reports that patients in crisis zones, such as Gaza and Ukraine, struggle to revert to vials and syringes. “In the dark without electricity, it’s easy to measure insulin in a pen, which clicks to indicate increments,” said Leena Menghaney of MSF’s Access campaign. “But it’s much harder to confirm a syringe dosage.”

Summary:

GLP-1 agonists like Ozempic have been shown to reduce the risk of dementia in type 2 diabetes patients. A study tracking over 88,000 individuals for up to ten years found a 30% lower risk of dementia compared to sulfonylureas and a 23% lower risk compared to DPP-4 inhibitors.

These findings could help doctors choose the best medications for older diabetes patients, though further randomized trials are necessary to confirm these results.

Key Facts:

– Significant Risk Reduction: GLP-1 agonists reduce dementia risk by 30% compared to sulfonylureas.
– Study Scope: The study followed over 88,000 older adults with type 2 diabetes for up to ten years.
– Clinical Implications: These findings can help doctors make informed medication choices for diabetes patients.
– Source: Karolinska Institute

New Study Links GLP-1 Agonists to Lower Dementia Risk

People with type 2 diabetes who are treated with GLP-1 agonists have a decreased risk of developing dementia, according to a new study from Karolinska Institutet published in the journal eClinicalMedicine.

GLP-1 agonists, also known as GLP-1 analogs, have gained popularity for treating type 2 diabetes and obesity due to their ability to control blood sugar, promote weight loss, and protect heart health.

The study showed that patients using GLP-1 agonists had a 30% lower risk of developing dementia compared to those using sulfonylureas, and a 23% lower risk compared to those using DPP-4 inhibitors.

Study Overview

In this register-based study, researchers followed over 88,000 older individuals with type 2 diabetes for up to ten years. Using a study design called target trial emulation, which mimics a randomized clinical trial, they analyzed the association between three diabetes drugs (GLP-1 agonists, DPP-4 inhibitors, and sulfonylureas) and the risk of dementia.

Findings

The study found that patients using GLP-1 agonists had a significantly lower risk of developing dementia compared to those using sulfonylureas and DPP-4 inhibitors.

“This is important because it can help doctors make better decisions about which medicines to use for older patients with type 2 diabetes,” said Bowen Tang, a Ph.D. student in Sara Hägg’s research group at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “However, proper randomized trials are needed to establish with certainty that GLP-1 agonists reduce the risk of dementia.”

Original Research:Open access. “Comparative effectiveness of glucagon-like peptide-1 agonists, dipeptidyl peptidase-4 inhibitors, and sulfonylureas on the risk of dementia in older individuals with type 2 diabetes in Sweden: an emulated trial study” by Bowen Tang et al. eClinicalMedicine

Abstract

The study investigated the comparative effectiveness of GLP-1 agonists, DPP-4 inhibitors, and sulfonylureas on the risk of dementia in older individuals with type 2 diabetes in Sweden. Using data from Swedish national registers, the researchers followed participants for up to ten years. They found that GLP-1 agonist initiation was associated with a reduced risk of dementia compared to sulfonylureas and DPP-4 inhibitors.

Interpretation

The research suggests that GLP-1 agonists are associated with a lower risk of dementia in older individuals with type 2 diabetes. Further clinical trials are necessary to validate these findings.

Funding

The study was funded by the Swedish Research Council, Karolinska Institutet, the National Institute on Aging, the National Institutes of Health, and Riksbankens Jubileumsfond.

Counterfeit Ozempic Amidst Rising Popularity for Weight Loss

The World Health Organization (WHO) has issued a warning about fake versions of Ozempic, a drug that has gained immense popularity as a weight-loss tool in recent years.

The WHO cautions that using counterfeit Ozempic can pose serious health risks, including exposure to unlisted and potentially harmful ingredients.

Originally designed to treat type 2 diabetes, Ozempic has been widely adopted for weight loss, including by celebrities. Wegovy, another drug containing the same active ingredient, semaglutide, is specifically intended for weight loss.

Semaglutide helps suppress appetite, aiding diabetics in managing their blood sugar levels through weekly injections. However, a significant side effect is weight loss.

Novo Nordisk Counterfeit

Both drugs are produced by the Danish pharmaceutical company Novo Nordisk.

Wegovy is now available on the NHS and from pharmacies in the UK, but high demand for Ozempic has driven some customers to unofficial suppliers, increasing the risk of encountering counterfeit drugs.

The WHO has identified three batches of counterfeit semaglutide, including one sold in the UK last October. These fake products can be dangerous, lacking necessary raw components or containing undeclared active ingredients such as insulin, leading to unpredictable health risks or complications.

The WHO advises patients to only purchase medications through prescriptions from licensed pharmacies and to avoid drugs from unfamiliar or unverified sources, such as online retailers.

Dr. Yukiko Nakatani, WHO assistant director-general for access to medicines and health products, emphasized the importance of vigilance among healthcare professionals, regulatory authorities, and the public. She urged stakeholders to stop using suspicious medicines and report them to the relevant authorities.

Patients using authentic Ozempic and Wegovy have also experienced side effects, including gastrointestinal issues and rapid weight loss, leading to a phenomenon known as “Ozempic face.”

On the same day, US pharmaceutical giant Eli Lilly warned about counterfeit versions of its drugs Mounjaro and Zepbound, which are used for diabetes management and weight loss. Counterfeit drugs containing tirzepatide, the active ingredient in these products, have also been found.

The WHO’s warning serves as a crucial reminder to only obtain medications from trusted sources to avoid potentially dangerous counterfeit drugs.

Nestle Caters To Ozempic Users

Nestle’s new food brand for people taking weight-loss drugs like Wegovy will highlight that the meals are high in protein, fiber, and nutrients, but will not name the blockbuster medications, a company executive told Reuters.

The world’s largest food maker is avoiding mentioning the names of the drugs on the packaging due to regulatory concerns, said Tom Moe, Nestle USA’s president of meals, in a recent interview. Instead, Nestle will market its Vital Pursuit line of $5-and-under frozen meals on social media.

“We won’t directly make the connection (to the drugs) on the food package,” Moe said.

Nestle’s caution in naming drugs like Novo Nordisk’s Wegovy and Ozempic on its packaging highlights the uncertainty global food companies face as they invest in products specifically geared towards millions of people taking these appetite-suppressing medications.

These medications, from a class of drugs known as GLP-1 agonists, threaten to impact the profits of snack makers and fast-food chains as users significantly reduce their food intake. When Nestle’s fajita melts and pizzas hit store freezers this autumn, they will compete against a sea of products making specific claims about targeting people on these medications.

For instance, Biocare, a drink retailing at $4.50 per serving, advertises on its packaging that it can “alleviate side effects” such as nausea for people taking semaglutides, the active ingredient in Wegovy and Ozempic.

Although these medications can cause gastrointestinal side effects, doctors recommend that users maintain their energy and avoid losing muscle by consuming protein-rich foods. Herbalife, for example, sells shakes in a bundle for $185.10, claiming to meet nutritional needs while on “the shot,” as these injectable drugs are colloquially known.

Retailers like GNC are also capitalizing on this trend by introducing store sections dedicated to GLP-1 users, offering protein powder and fiber supplements.

Mentioning weight-loss drugs on Vital Pursuit product packaging could expose Nestle to regulatory scrutiny. “We’re not a medication, we’re a food product,” Moe emphasized. Referencing these medications could imply that the food treats or prevents disease, a claim only FDA-approved products can make, according to Lauren Handel, an attorney specializing in food. “It’s a tricky area where you’d want to be careful about what you say,” Handel said. “The safest course of action is not to mention any drugs.”

The same caution applies to advertising, she added. Labeling items as “suitable for people on a diet” or as “companions” to the medications may comply with FDA regulations. “Some companies will take more risk,” Handel noted. Nestle declined to say whether it will refer to the drugs in advertisements.

Absolute Game Changer

Herbalife adopts a more direct approach, stating on Facebook: “Using a GLP-1 weight-loss drug? Support your nutritional needs by using Herbalife’s GLP-1 Companion Pack.” Herbalife Chief Commercial Officer Frank Lamberti explained that the company chose GLP-1 instead of brand names like Ozempic to avoid alienating users of rival drugs, such as Eli Lilly’s Mounjaro and Zepbound, or those who have quit the medications but still monitor their weight.

Robard Corp, which produces Biocare, is marketing the drink through a “strong influencer community who are all taking GLP-1s.” Influencer Ashley Dunham from Jacksonville, Florida, stated in a TikTok video that Biocare has been an “absolute game changer” in maintaining her weight after losing 100 pounds (45.4 kilograms).

Coca-Cola and yogurt-maker Danone also claim many of their products are ideal for people taking these medications due to their low sugar or high protein content. Coke’s Fairlife shakes, which contain up to 42 grams of protein, are frequently promoted on social media by users of these medications. However, Fairlife does not have any paid partners or influencers linking the shakes to GLP-1s or weight loss and does not target them with free products or other incentives, a spokesperson said. The company has heard from consumers using the medications that they like the shakes.

Healthy Choice meal maker Conagra Brands will also avoid mentioning drug names on food packaging marketed to GLP-1 users, executives told Reuters this month. Using drug names could deter those not taking the drugs but who might still consider buying the food, said Megan Bullock, director of strategic insights at Conagra. The company will focus on the attributes of its existing products, such as protein or fiber content, to help GLP-1 users recognize that the food is suitable for them, explained Bob Nolan, Conagra’s vice president of demand science.

Conagra is not currently developing new brands specifically for GLP-1 users but sees potential in selling more frozen meals to them. Kelli Frias, a marketing professor at American University, noted that consumers do not yet have clear ideas of what to eat while on these medications. Food companies are “trying to create new associations,” she said. “We don’t have those associations in our mind until we’re taught them.”