Semaglutide

Weight-loss drugs soars among kids and young adults

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Teen’s Remarkable Weight Loss Journey with Wegovy: A Look into the Rise of GLP-1 Drugs Among Young People

At 17, Israel McKenzie struggled so much with obesity that he stopped attending high school in person and felt embarrassed to interact with people at his restaurant job.

“I was in a really dark place,” says McKenzie, whose weight had reached 335 pounds on his 6-foot-1 frame, despite numerous attempts to diet and exercise. “I had given up hope.”

But last year, the weight-loss drug Wegovy helped him shed 110 pounds in nine months, making the rural Tennessee teen part of a growing trend of adolescents and young adults using diabetes and obesity medications known as GLP-1 receptor agonists, according to new research.

Even as millions of older adults seek out drugs like Ozempic and Wegovy, monthly use of these medications has surged among people aged 12 to 25. This information comes from a new analysis of dispensing records from nearly 94% of U.S. retail pharmacies from 2020 to 2023.

New Insights from Research

The report, published in the journal JAMA, used the IQVIA prescription database to provide the first national look at the uptake of GLP-1 drugs among this age group. Nearly 31,000 children aged 12 to 17 and over 162,000 people aged 18 to 25 used these medications in 2023 alone, said Dr. Joyce Lee, a University of Michigan pediatrician and diabetes expert who led the research.

“What it’s suggesting is that it’s one of the tools in the toolbox and there are more providers prescribing this medication for the population,” she said.

The report indicates that the number of 12- to 25-year-olds using any GLP-1 drug — including older medications first approved for diabetes treatment in 2005 and for weight loss in 2014 — increased from about 8,700 a month in 2020 to over 60,000 a month in 2023, a nearly 600% increase. This rise occurred even as prescriptions of other drugs among these patients fell by about 3%.

Addressing the Obesity Epidemic

Those who received the drugs are just a fraction of young people struggling with obesity, Lee noted. About 20% of U.S. children and adolescents and approximately 42% of adults have the chronic disease, according to the U.S. Centers for Disease Control and Prevention.

In early 2023, the American Academy of Pediatrics recommended that children and teens with obesity be evaluated early and treated aggressively, including with surgery and medication if warranted.

McKenzie’s Transformation

McKenzie, the Tennessee teen, said he began gaining weight five years ago, during puberty.

“I started turning to food for all of my problems,” he said.

The extra weight worsened his asthma and put him at risk of developing diabetes, according to his doctor. Despite following medical advice to cut out sugary soda and snack foods and to exercise more, these efforts didn’t make a difference.

“My old doctor told me there was nothing he could do,” McKenzie said. “He told me it was my fault.”

In early 2023, McKenzie connected with Dr. Joani Jack, a pediatric obesity specialist at Children’s Hospital at Erlanger in Chattanooga, Tennessee, who regularly prescribes GLP-1 drugs for kids.

“I told him I’ve seen 10 other people just like you today and we have lots of tools and treatment options,” Jack said. These typically include intensive behavioral and nutrition interventions combined with medication, if necessary.

In McKenzie’s case, Jack prescribed the weight-loss drug Wegovy, which in late 2022 was approved for use in U.S. children over age 12. More than 6,000 kids in that age group received Wegovy in 2023, according to new data. More than 7,600 received Ozempic, approved to treat diabetes in adults but used off-label in adolescents. Others received older GLP-1 drugs such as Saxenda and Trulicity.

Considerations and Challenges

McKenzie reported no notable side effects from the medication, but Dr. Lee noted that some young people experience nausea, vomiting, or constipation, including symptoms severe enough to stop the drugs.

Understanding the surging use of these medications in young people is crucial, Lee said. The drugs are intended for continued use, so “we really need to think about the long-term safety and effectiveness of these medications for this population,” she said.

Additionally, the drugs are expensive and often difficult to obtain due to supply issues or lack of insurance coverage.

Government-run Medicaid plans paid for nearly half of the GLP-1 drugs prescribed to 12- to 17-year-olds and about a quarter of those used by people aged 18 to 25, the research found. Commercial insurance covered nearly 44% of the younger kids and about two-thirds of those who were older.

A New Lease on Life

Today, McKenzie says his asthma has improved and he looks forward to interacting with co-workers and friends.

“I have a lot of self-confidence now, a lot more than I used to,” he said. “It has changed everything.”

Federal Ban on Ozempic Replicas

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ozempic replica ban

Federal Government to Ban Compounded Replica Ozempic Amid Safety Concerns

The federal government will prohibit all compounding pharmacists from producing replica versions of diabetes drugs like Ozempic and Mounjaro, widely used off-label for weight loss, following a Four Corners investigation that exposed illegal manufacturing practices in Australia.

Investigation Findings

A video recorded by investigators from the Therapeutic Goods Authority (TGA) revealed that a facility in Western Sydney was producing these drugs under unsanitary conditions, using kitchen equipment and chemicals. The investigation found that these illegally manufactured drugs were being exported overseas.

Ongoing Drug Shortages

Global shortages of Ozempic are expected to continue into next year. The government has announced a four-month transition period for the industry before the ban takes effect.

Public Safety Concerns

The Four Corners investigation uncovered that a registered Australian pharmacist was running an international operation, manufacturing and exporting replica Ozempic to the United States. Patients who used medication from Total Compounding Pharmaceuticals (TCP) reported serious side effects, including nerve damage, rashes, vomiting blood, and bleeding gums, which they believe were linked to the compounded drugs.

Currently, Australian compounding pharmacists are allowed to reproduce brand-name drugs during shortages, but these replicas are not subjected to the same stringent safety checks. Federal health minister Mark Butler announced that this loophole will close in October, removing the exemption for compounding active ingredients in drugs like Ozempic.

Impact on Patients and the Industry

In Australia, an estimated 20,000 people use compounded weight loss medications, but the actual number may be higher. The TGA has already seized vials of unlawfully manufactured semaglutide from a Victorian pharmacy.

Minister Butler expressed concern that many patients using compounded versions of these drugs were unaware of the safety risks, which have also been highlighted by the FDA in the United States. He emphasized the lack of oversight in the manufacturing conditions and the ingredients used, as well as the absence of a formal system for reporting adverse events.

Filthy Manufacturing Conditions

The TGA provided footage showing the deplorable conditions in which TCP was allegedly producing replica Ozempic. The facility, filled with kitchen mixers and blenders, did not meet the standards expected for manufacturing injectable medications.

Regulatory and Industry Response

The announcement of the ban has garnered support from various health organizations, including the Pharmacy Board of Australia, Diabetes Australia, the Medical Board of Australia, and the RACGP. However, some pharmacy groups and telehealth companies, like Eucalyptus, opposed the ban, arguing it would deny thousands of Australians access to life-changing medication amid global shortages.

Addressing the Shortage

RACGP president Dr. Nicole Higgins acknowledged the shortage and the potential anxiety it might cause for patients using Ozempic off-label for weight loss. Minister Butler assured that the government is working with pharmaceutical companies to mitigate the impact of the ban. He stressed the importance of prioritizing diabetes patients for whom these drugs are approved under the PBS.

“We’ve already got a shortage of this medication for the people it was initially designed for, which is our [people with] type 2 diabetes. I expect that those shortages may be exacerbated, and it’s going to cause some anxiety for those who’ve been using Ozempic off-label,” Dr. Higgins said.

The TGA’s latest update indicates that the supply of Ozempic will remain limited throughout 2024 due to increased demand for weight loss, with Mounjaro also expected to be in short supply until at least September.

Moving Forward

Patients relying on compounded medications are advised to consult their GPs and healthcare teams for support during this transition. Minister Butler reiterated the government’s commitment to ensuring that diabetes patients have priority access to these essential medications.

The four-month transition period is intended to allow the industry to adapt while safeguarding public health by eliminating unsafe manufacturing practices.

Nestle $5 Pizza for Ozempic Users

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ozempic and alcohol

Nestle Launches $5 Pizza for Ozempic Users

Nestle (NESN.S) is introducing a new $5 line of frozen pizzas and protein-enriched pastas in the United States, specifically designed for individuals taking weight-loss medications like Wegovy and Ozempic. These new products are tailored to meet the nutritional needs of those on GLP-1 agonists, drugs known for their appetite-suppressing effects.

Targeted Nutrition

Nestle, the world’s largest food company, which already sells popular brands like DiGiorno pizza and Stouffer’s meals, has developed these new offerings with higher levels of protein, iron, and calcium. Tom Moe, president of Nestle USA’s meal division, described the new brand, Vital Pursuit, as “food solutions” for people seeking the right nutrition to complement their use of weight-loss drugs. These meals are priced at $4.99 and under, slightly more than a DiGiorno four cheese personal pan pizza, which retails at $4.79 at Target.

Rapid Development

Nestle began developing companion products for GLP-1 drugs last year. “We moved real fast on this,” Moe said. Nestle CEO Mark Schneider noted in October that the company was closely monitoring the potential impact of these drugs on food product demand and was working on products to help mitigate “loss of lean muscle mass” in users.

Market Response

Despite concerns that appetite-suppressing drugs could reduce food company sales, executives at Nestle and other companies like Conagra (CAG.N) see an opportunity to market products such as beef jerky, popcorn, and frozen meals. Mondelez (MDLZ.O) also views its snack bars as fitting well into the diet of a GLP-1 patient.

Growing User Base

Goldman Sachs estimates that 10 million to 70 million U.S. consumers could be using GLP-1 drugs in the next four years. Nestle has engaged with individuals on these medications to develop suitable meals and will soon offer samples. The company first introduced the brand to Walmart (WMT.N) and plans to expand to other major retailers like Kroger (KR.N) and Target (TGT.N).

Addressing Protein Needs

People on GLP-1 medications risk losing lean muscle mass as they lose weight and often have reduced appetites. Dr. Ethan Lazarus, an obesity doctor in Colorado, emphasized the importance of ensuring adequate protein intake for these individuals. Lazarus, who has worked with GLP-1 drugmakers Eli Lilly (LLY.N) and Novo Nordisk (NOVOb.CO), noted the potential popularity of protein-rich, easy-to-digest foods.

Other Market Players

Nutrition company Herbalife (HLF.N) has also begun selling shake mixes and fiber supplements in bundles targeting people on GLP-1 drugs, with plans to expand these bundles to other markets, including South America. Meal kit provider Daily Harvest offers a GLP-1 companion food collection but has seen slow sales.

Vital Pursuit Details

Vital Pursuit meals will range from eight to 10 ounces (227 to 284 grams). Unlike the calorie-focused Lean Cuisine brand introduced in the 1980s, Vital Pursuit emphasizes higher fiber, protein, and other macronutrients.

By addressing the nutritional needs of people on weight-loss medications, Nestle aims to provide better dietary support for those seeking to maintain their health and muscle mass while using these popular drugs.

Saxenda & Wegovy Patients Stop Early

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Study Reveals Over Half of Patients Stop Weight-Loss Drugs Too Early

More than half of the individuals prescribed weight-loss drugs Saxenda and Wegovy over the past decade did not continue their treatment long enough to gain significant health benefits, according to a study by a major U.S. health insurer.

Key Findings

The Blue Cross Blue Shield Association analyzed pharmacy and medical claims of nearly 170,000 people between July 2014 and December 2023. They discovered that 58% of patients didn’t complete a 12-week course of the medications liraglutide or semaglutide, sold under the brand names Saxenda and Wegovy.

Nearly one-third of patients stopped treatment within four weeks, before reaching the drugs’ targeted dosage. These early dropouts were less likely to achieve the weight loss benefits intended by the medications, the study indicated.

Study Background

Blue Cross Blue Shield Association is a federation of numerous for-profit and nonprofit companies providing health insurance for about 118 million people across all 50 states. The insurer released this non-peer-reviewed data to help decision-makers and the public understand the usage patterns and success factors for these popular weight-loss drugs, explained Razia Hashmi, vice president for clinical affairs at Blue Cross Blue Shield.

A spokeswoman for Novo Nordisk, the company that markets Saxenda and Wegovy, declined to comment on the study, which has not been published in an independent medical journal.

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Popularity and Cost of GLP-1 Medications

GLP-1 (glucagon-like peptide-1) receptor agonists, the class of drugs to which Saxenda and Wegovy belong, have become extremely popular. Quarterly sales of anti-obesity drugs exceeded $1.1 billion by mid-2023, according to a Congressional Budget Office report.

Initially developed to treat diabetes, these drugs were later approved for weight loss and heart disease. Drug companies are also exploring other potential uses for GLP-1s, which can cost over $10,000 annually out of pocket.

Given the widespread use and high cost of these drugs, Hashmi emphasized the importance of understanding how patients use these medications and whether they achieve the intended health benefits. It is also crucial to understand why a significant portion of patients discontinue the drugs before reaching the effective dosage.

Factors Influencing Treatment Adherence

The study found that patients prescribed weight-loss drugs by an endocrinologist or obesity specialist were more likely to continue their treatment. Additionally, patients who frequently visited their doctor or prescriber during the first 12 weeks were more likely to stay on the medications. Young adults between 18 and 34 were the most likely to stop the medication before completing the prescribed course.

Saxenda, requiring daily injections, was the only GLP-1 drug approved for weight loss from 2014 to 2021. During that period, fewer than 6,000 individuals started the medication each year. However, when Wegovy, a weekly injectable, gained FDA approval for weight loss in 2021, prescriptions surged, reaching nearly 121,000 in 2023.

Efforts to Manage Costs

Employers and health insurance plans are trying to curb spending on these drugs. Many insurers have imposed requirements such as prior authorization or step therapy, which mandates trying less expensive drugs first. In some cases, employers and insurers are denying coverage altogether.

The study did not address how different Blue Cross Blue Shield insurance plans cover these weight-loss medications. Hashmi stated that Blue Cross Blue Shield will not use this study’s findings for coverage decisions until the study is published and peer-reviewed.

“Our coverage decisions are always based on published, evidence-based studies and literature,” Hashmi said. “This study adds to the knowledge about real-world evidence, but until it’s published and peer-reviewed, it won’t be part of the criteria.”

Employer Perspectives

James Gelfand, president and CEO of the ERISA Industry Committee, which represents companies providing employee benefits, noted that employers will closely watch whether patients adhere to these medications.

“It can take a year or more to get real results from these $1,000-per-month weight loss medications,” Gelfand said. “When patients quit early, as most patients do, that money was wasted. The result is higher health insurance costs for everyone on their employer’s health plan.”

By understanding these trends and the factors influencing patient adherence, stakeholders can better address the challenges associated with the use of weight-loss medications and manage the associated costs.

Ozempic and Alcohol

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Novo Nordisk to Investigate Ozempic’s Impact on Alcohol Consumption

Study Announcement

Novo Nordisk, the manufacturer of Ozempic, has announced plans to investigate the drug’s potential to reduce a user’s desire to consume alcohol. The company revealed a 28-week study aimed at evaluating the impact of semaglutide, the active component in Ozempic and other medications, on alcohol intake.

Focus on Liver Health

In a statement to CNN, Novo Nordisk mentioned that the upcoming trial will focus on whether the drug can enhance liver health by addressing liver fibrosis or scarring, rather than targeting alcohol addiction specifically.

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A person on a scale Related: Ozempic May ‘Potentially’ Influence Your Personality — and Sex Life, Expert Says

Trial Details on Ozempic & Alcohol

A Novo Nordisk spokesperson told the outlet, “Secondary endpoints include safety and tolerability and changes in alcohol consumption. There is a significant unmet medical need in alcohol-related liver disease, and the first line of treatment for this condition is lifestyle intervention to refrain from drinking alcohol.”

They added, “Even though not all participants in the trial will have alcohol use disorder, it is natural to include alcohol consumption as a secondary endpoint.”

The trial plans to recruit 240 participants and is set to commence on Monday, May 20, as per a government database, CNN reported.

A set of semaglutide injection pens

Clinical Observations

Ania Jastreboff, M.D., PhD., an obesity medicine physician scientist at Yale University, shared with PEOPLE last year that some patients using Ozempic report a diminished craving for alcohol.

“Clinically, I’ve seen this. Some patients say they have less desire to drink alcohol. For instance, they used to drink a couple of glasses of wine, now they only drink half a glass and don’t feel the urge to finish it,” she said.

“It seems they achieve the reward or satisfaction from a smaller amount or just don’t feel like having a glass of wine,” Jastreboff added.

A woman injecting a weight loss pen into her stomach (stock image) Related: Celebrities Who’ve Talked About Ozempic — and What They’ve Said

Expert Insights

Dr. Steven Batash, a board-certified gastroenterologist and weight-loss specialist at Batash Endoscopic Weight Loss, told PEOPLE in April that weight-loss medications can also affect libido and potentially alter personality.

“GLP-1s specifically reduce the amount of dopamine the brain releases after engaging in activities like drinking, smoking, or eating a sweet dessert,” he explained.

“Dopamine is a neurotransmitter that reinforces the pleasure of these activities. When GLP-1s remove that pleasure, they also reduce the motivation to partake in these activities,” Batash added.