Front Burner - Why a weight loss drug went viral

Episode Date: February 3, 2023

Ozempic is a brand name for a drug that's prescribed to help manage Type 2 diabetes. But it's also being used in Canada as a treatment for obesity, something that some doctors – and a lot of people on TikTok – are talking about. There's a lot of questions about the risks and benefits of Ozempic when it comes to weight loss, and so much interest that there's been supply shortages of the drug, particularly in the United States. Elaine Chen is a cardiovascular disease reporter at STAT News. She covers metabolic conditions including diabetes and obesity. Today, she discusses why some people are calling this new drug a gamechanger and how it is challenging the way the medical community treats people who live with obesity.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Jamie Poisson. I'm probably going to regret sharing this with TikTok. I had my first Ozempic shot today. I started Ozempic before Kim K, and here are my thoughts. Ozempic is like winning a mega million lottery.

I lost 52 pounds over the year that I've been on it. So what those TikTokers are talking about is something called Ozempic. It's this new drug that's being talked about a lot on social media and in the news. Proponents say it's a miracle diet drug. Critics call it an eating disorder in an injection. Ozempic is just a brand name for a drug that's being prescribed in Canada for people with type 2 diabetes. It's also being used here as a treatment for obesity, something that a lot of doctors are

excited about. And all this hype and increase in demand has even led to supply shortages. It's not easy to get. The drug is currently in short supply, and it costs more than $1,300 a month. And now diabetics are calling out people just using it to drop a few pounds. It really makes me mad. It infuriates me. It's like you people don't need it. The diabetics, we need it. We need it to stay alive. If those that have the means are able to get them, yet the people that really need them are unable to, then that creates a greater disparity. Elaine Chen is a cardiovascular

disease reporter at Stat News. She covers metabolic conditions, including diabetes and obesity. And she's here today to explain why some people are calling this new drug a game changer and how it's challenging the way the medical community treats people who live with obesity. Elaine, hi. Thanks for being here. Thanks so much for having me. Elaine, hi, thanks for being here. Thanks so much for having me.

So by now, I think many people may have heard of Ozempic, which is a brand name for a generic drug called, and I know we just practiced this, but I feel like I might still get it wrong, semaglutide? Yes, so semaglutide is the active ingredient in the branded medication Ozempic. There's also another medication that contains Imaglutide, which is called Wagovi. So Ozempic is approved for patients with type 2 diabetes to help them control their blood sugar, and Wagovi is essentially a higher dose version approved for patients with obesity to help them lose weight. But as you mentioned in your intro, in some instances in which Wagovi weight may not be available, doctors may also prescribe Ozempic to patients with obesity off-label. And explain to me how these drugs work when it comes to weight loss. Yeah, so semaglutide is part of a class of drugs called GLP-1 receptor agonists.

These drugs essentially mimic the effects of the GLP-1 hormone. And so these drugs stimulate the production of more insulin in the body, which can help lower blood sugar levels. And they also slow the emptying of the stomach. And so they can help people feel full faster and longer. And why is this drug being called revolutionary? The field of obesity medicine in the past has long lacked highly effective and safe medications. And in this field of research, there have been a lot of disappointments and setbacks. So kind of in that context, somaglutide has shown such a high level of effectiveness in weight loss. It can help patients lose 15% of their body weight. We've never seen that level of effectiveness before. So in the backdrop of, you know,

having a lot of disappointments in the past, there's a lot, a lot of excitement from doctors and the medical community about semaglutide. Over the past five years only, we've had this new field of medication that really works. Patients are finally getting some relief from this medical condition that has plagued them for a long time. It is gratifying to see widespread knowledge now surrounding these medicines. And then also, you know, based on the data we have so far, semaglutide seems relatively safe, also compared with earlier drugs for obesity. Okay. And when we talk about safety, I mean, it's a fairly new drug. So is it fair to say we don't know necessarily the long-term effects of it?

Yeah, that's fair. We do know kind of immediately when people start taking the drugs, they can feel nausea, vomiting. You know, as their body adjusts to the drug, there's also potential rare cases of inflammation of the pancreas. But you're right that we don't have long, long-term data on these drugs. These drugs are supposed to be taken chronically, potentially over many, many years. Wagovi, the semaglutide for obesity, recently was approved in the U.S. for adolescents. And so, especially for that group, we don't have data yet on what it'll look like for people who start taking these since their teenage years all the way into adulthood. You mentioned there have been disappointments in the past and that this drug is radically different or, you know, much more effective than past drugs. What makes it different from past drugs?

It's in large part because of the mechanism that I mentioned before. You know, it's a GLP-1 receptor agonist. This class of drugs has actually existed for many years. It was actually initially studied in diabetes. And only after people realized, oh, people who take these for diabetes actually started experiencing pretty significant weight loss, then the pharma industry started to focus in on, okay, let's study this in obesity. And, you know, after like kind of more innovation and formulations, we now have this pretty effective medication. And I know you've spoken to people who have used this drug to treat obesity. What have they said

about how it's impacted their lives? Yeah, so I've spoken with a lot of patients who've used this drug. They've talked about how before they started taking it, they would have a lot of what they called food noise. So a constant thinking of food and thinking about what they're going to eat next, not feeling satiated after eating, and always trying to very carefully monitor what they eat, which can be a really stressful process. Food is really not a reward for me anymore. And it seems crazy to say that after only being on the drug for a week. But honestly, it's been difficult to eat this past week. But once they started taking these drugs, it helped them essentially calm down the food noise.

It helped them feel full earlier. And it kind of helped relieve the stress and anxiety that comes with, you know, constantly thinking about this and constantly having to monitor what you eat. So I feel much lighter and happier. But like my joint pain, my back pain, it hasn't changed since losing weight or starting this medication. So it's changed a lot of things for me, but it hasn't been a cure-all. And it's my understanding like you take these drugs on an ongoing basis? Like what would happen if you stopped taking them? Would you get those, that sensation back? Yeah, so samadhatide is an injection. You take it once weekly, and it is meant to be a chronic medication that you take for the long term. And we do know that

once people stop taking it, they do tend to gain the weight back. So it is meant to be taken over a long period of time. I know there are supply issues with these drugs right now. And part of that reason is because it's so popular to treat obesity and because it has to be taken over the long term. The other part of that reason is because it's become very popular on social media. Nicknamed skinny pens on social media, skyrocketing popularity led to shortages of Ozempic and Wagovi. Happy weigh-in day, happy shot day. By the way, how'd you lose your weight? I had my first Ozempic shot today.

I lost over three pounds this week. Lord, if you let me get skinny one more time, I promise I won't mess it up. It's like very trendy on TikTok. It's everywhere on TikTok. There are a lot of like celebrities and influencers talking about how this can help you lose weight. And how would you describe the way these drugs are being talked about online? Yeah, no, it's really interesting. There has been a lot of discussion online on social media in coverage about these drugs. They've been talked about kind of as the next big thing that people in Hollywood are talking about.

And there's been a lot of online and media speculation of, oh, this celebrity lost a lot of weight. Are they taking this drug? Everyone's talking about the new so-called magic bullet for obesity. A noticeably slimmer Elon Musk credits his weight loss to the prescription drug Wagovi. It has been talked about in sort of this like kind of trendy new thing in a way. Right. I have no idea if this is true, but like I saw people are speculating about whether or not Kim Kardashian used this drug when she lost all this weight to wear like that Marilyn Monroe dress last year. So like, are people able to get a hold of this drug as like a weight loss tool who might not be battling

like a chronic condition like obesity? I mean, yes, people are able to get it. I mean, off-label prescribing exists, which is doctors are able to prescribe things not based on, you know, official regulators approval. So people probably are able to get it if they don't technically, I guess, meet the conditions of obesity that are outlined in the regulators approval. Because there's been so much demand for these drugs, there have also been kind of a lot of clinics or med spas that claim to offer kind of this kind of drug that people are also going to. And is it that drug or? Sometimes it may not be. And I've done some reporting on how, you know, there are some places that offer kind of a compounded version of the drug where kind of you have a specific

pharmacy that can kind of do custom mixes. And so some places are offering kind of a compounded version where it's not the actual branded medication that's sold by the pharmaceutical company, but it's kind of a custom mix. And then some people are also going online and ordering kind of the underlying ingredient itself. It comes to them as a powder and they mix it themselves at home and inject it themselves. And so these are all pretty risky sources because you

don't know where the underlying source of the ingredients are. And there's, you know, issues that can come up when you're trying to mix it yourself. So, yeah, I think there's just been so much demand for these drugs that people are going to pretty risky lengths. There's another side of this conversation I want to talk to you about. I know some experts say that the controversy around the drug's popularity is a bit of a distraction. And really, like the interesting or real tension at play here is how society and the metal community see obesity and how the conversation around obesity is changing at this moment in time when this drug has entered the scene. And so flesh that out for me. Yeah. So I think obesity has long been seen in society as an individual's own problem. Like it's a personal failing or a lack of willpower on their own part. 79 to 90% of physicians in the United States have significant bias towards individuals that are heavier. Now, doctors listening to me may say, oh, it's not me. Hold your horses because has that patient come to you and told you, look, doc, I'm eating well.

Look, doc, I'm exercising. And the doc says to them, are you sure? I don't believe that that's really what you're doing. It's been seen as like a personal failing in a lot of ways. And I think that with the arrival of these medications, and how people are talking about them, that's contributing to changing that narrative to getting people to see that obesity is not, you know, the result of lifestyle decisions, but it's a biological problem. And so you need a medical treatment for it. So because if you think about it this way, once we have a drug that's really effective, that can help people with obesity lose weight, then that supports the idea that obesity in the first place is a condition that has a biological basis. And, you know, connecting

this back to the conversations online, like you mentioned, like a lot of the discussion in some areas of the internet have kind of framed these drugs as kind of trendy or kind of for cosmetic purposes. And I think a lot of doctors feel that that's kind of counterproductive to the push to get people to realize like obesity is not, you know, a cosmetic concern, but it's a medical concern. Yeah. And just explain to me a little bit more why we know that obesity is a biological condition and how that's evolved over time? Yeah, there's been a lot more research into the underlying causes of obesity. So we now know that it's caused by a combination of various genetic factors, but also environmental factors. So people

have a genetic predisposition to be more likely to develop obesity. But then, of course, there are a lot of environmental factors that occur, you know, throughout people's life to cause them to actually develop obesity. That's why we've seen such a huge surge in obesity rates in recent years because of the environmental factors like, you know, the sedentary lifestyle and the food deserts that have developed over the recent decades. Right. And the introduction, the expansion of so many processed foods, the existence of food deserts, like you said, like, do you live beside a farmer's market? Do you live beside

a series of fast food chains? So what would happen if you took these drugs, but you didn't make any additional lifestyle changes? What would happen? Yeah, I think that a lot of people with obesity do kind of try to work on a lot of the lifestyle factors. Like they do try to change their diet, try to exercise more. Research has just shown that lifestyle changes alone are not that effective in helping people lose weight and maintain the weight loss over the long term. And so that's why people are really excited about these drugs, because we want something that will really work, because they want something that'll work for people. With these new drugs, people are

still recommending that people still do those lifestyle changes, you know, and add these drugs on top of that. That's what people are recommending. But I guess it's good to see kind of how, you know, the medical community will navigate that, you know, because oftentimes people like to introduce a drug and then like really rely on the drug, right? And so another thing that some people who are concerned about is that this narrative that doctors want to push that obesity is a disease. Some people are worried that that narrative can go too far and that you can start and then you start overlooking the environmental causes of obesity and really just talk about how it's biologically driven. And people don't want that people. I mean, people still want to,

I guess the critics still want people to address the environmental causes of obesity. And these critics would say kind of in a cynical view, the pharmaceutical companies, it's their incentive to really hit home the message that obesity is biologically driven and downplay the environmental factors because they want their product to be able to be the solution to the obesity problem, right? able to be the solution to the obesity problem, right? And so I think critics want people to keep in mind, like, environmental factors are still a really big driver of why we have surging obesity rates. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization. Empowering Canada's entrepreneurs through angel investment and industry connections.

Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people and I have some startling numbers to share with you. Did you know that of the people I speak to, 50% of them do not know their own household income? That's not a typo. 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. Is there a concern too that if more and more people start taking this drug as like a fad,

you know, to like lose a lot of weight, to look like a celebrity, that it will like perpetuate negative body images or negative stereotypes. Yeah. Yeah, I have read concerns along those lines. There is also some concern that, you know, we already are in a society that, I guess, largely on a societal level kind of prizes thinness, you know, and so in the context of this is what the society at large values, there's concern that once you introduce these drugs in, that could further promote the idea that, you know, if you want to be healthy, then you should look thinner. And that might, you know, further stigmatize people with, you know, higher BMIs. Yeah, there is that concern. So that's another kind of, you know, debate that's going on around these drugs. Yeah. I wonder, sort of thrown into that is also at this time,

we're seeing like a real body positivity movement as well, right? And so how do you think that plays into this conversation? Interestingly enough, I think that they actually, it shares some similarities with the push by a lot of obesity specialists to get people to recognize obesity as a disease and that both camps both want society to not blame the individual, to know, the doctors want to say that obesity is a disease and you have to treat it. So I don't necessarily have an answer to how to maybe reconcile these two camps of thought. But maybe one way of thinking about it is that people would want to say that you should at least give people the option of accessing the treatment if they want, but not forcing it upon them and really just letting people with obesity choose, you know, how they want to treat themselves and how they want to decide the future for their own body. Elaine, thank you so much for this. This is really interesting. Thank you. Thank you so much. All right, that is all for us this week.

Front Burner was produced this week by Shannon Higgins, Lauren Donnelly, Derek VanderWijk, Mackenzie Cameron, and Jodi Martinson. Our intern is Jack Wanen. Our sound design was by Sam McNulty and Mackenzie Cameron. Our music is by Joseph Chabison. Our executive producers this week are Nick McCabe-Locos and Shannon Higgins. And I'm Jamie Poisson. Thanks so much for listening. Talk to you next week. For more CBC Podcasts, go to cbc.ca slash podcasts.