In 2022, Elon Musk caused shortages across the world of drugs containing semaglutide with a single tweet. With people attributing his notable weight loss to the world of injectable medicines, the stage was set for sales of these drugs to rocket.

Ozempic and Wegovy, both manufactured by Novo Nordisk in Denmark, cause weight loss by encouraging you to eat less, in simple terms. The US Food and Drug Administration (FDA) has authorised Ozempic for managing type-2 diabetes, but not for weight loss. Wegovy is authorised to treat cardiovascular disease and obesity.

However, Ozempic’s new-found popularity as a weight-loss drug means that sales have been increasing since 2021 and are estimated to continue rising. The number of prescriptions in America has risen by 5,000% since 2018.

For Novo Nordisk, experts in insulin medicine research, the popularity of its drugs is an opportunity to capitalize on the weight-loss obsession since it could generate more than $50bn dollars in global sales by 2030 if they maintain market leadership.

But there is still so much to know about these drugs, especially concerning societal perceptions of weight and the long-term health implications.

What is Ozempic and how does it work?

Ozempic is an injectable medication primarily used by adults with type 2 diabetes. The scientific name of the active drug is semaglutide and it belongs to the family of drugs called GLP-1 receptor agonists.

The way it works is by mimicking the naturally occurring hormone GLP-1, which regulates blood sugar and appetite levels. It increases the amount of insulin (a hormone that regulates blood sugar levels) in your body and makes you feel full. This is why it’s a very effective weight-loss medication.

Who can take Ozempic?

Ozempic explains that the drug is FDA-approved for regulating blood sugar in type 2 diabetes (alongside diet and exercise) and not for people seeking weight loss. The drug can also be prescribed to people at risk of cardiovascular disease, although it’s not common. Ozempic only requires a weekly injection, compared to typical type 2 diabetes medications, which require daily intake. This makes it easier to use.

Experts explain that it is not suitable for people who are pregnant or breastfeeding, have a family history of thyroid cancer or have severe gastrointestinal disorders. It doesn’t treat type 1 diabetes, and its safety in use for under-18s has not been certified.

Are there any side effects?

As with any drug, there are common side effects for people taking Ozempic, such as nausea, vomiting, diarrhoea, stomach pain and constipation. To combat that, patients are recommended to eat slower, in smaller quantities and to focus on low-fat food.

The most serious (but not common) side effects that may require medical attention include vision changes, mood swings (especially thoughts of hurting yourself) and feeling light-headed as well as kidney problems. Because the drug acts directly on the digestive system, patients can develop pancreatitis, which causes severe stomach pains.

There is also the observation that those who take it develop an “Ozempic face” – a new term for rapid weight loss in the face. Fat pads beneath the skin provide structure and volume; the sudden loss of fat creates hollowness around the eyes, cheeks and temple, a ‘skeletal’ appearance that is also seen with ageing.

Price and social implications

Ozempic’s recent popularity is partly due to social media influencers framing it as a miracle drug due to its effective weight-loss benefits. This is proved by the 1,900% increase in internet searches for Ozempic since 2020.

The frenzy over the drug has also affected its affordability. Since its approval in 2017 as a drug strictly for adult diabetics, it has seen an almost 70% rise in its list price in the US, from $600 per month to around $1,000. With insurance, this could drop to as low as $25, but that relies on a strong plan.

In other countries, the price is much lower. In Germany, it costs about 100 euros per month and it’s even less in Australia and other countries.

Critics argue that Ozempic reinforces the idea that being thinner is better and healthier, which undermines the acceptance of larger bodies in fashion and modelling. In recent years modelling agencies have started opening their doors to plus-size models and promoting inclusivity, a principle now being reversed due to models normalising the use of Ozempic throughout the industry.

Ozempic poses ethical challenges since its use has also heightened misconceptions around obesity, with some people treating this chronic condition as a self-control issue or money-focused issue, disregarding the influence of hormones, genetics and health conditions. Those who oppose taking it say that encouraging weight-loss drugs as a quick fix does nothing to improve the stigma surrounding obesity or aid the body positive movement.

Ozempic is a treatment for diabetes, not a weight loss drug. Following this principle would reduce demand and stop shortages, allowing the price to be more affordable to those who really need it. It’s important to use Ozempic with medical supervision to avoid side effects and misuse.

For people who want to lose weight, Wegovy is available and FDA-approved for weight loss. It is also more effective: users of Wegovy on average lose 15% of baseline body weight over 52 weeks, whereas those on Ozempic lose around 12-15% over 68 weeks.

Regulation is necessary to make sure those with medical conditions are prioritised. Medicine should be there for those who need it rather than for people who are willing to pay more.