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Journalism of Courage
TV celebrity and author Sharon Osbourne has done what doctors have been trying to do for a long time — create awareness about the side effects of using Ozempic, a weight loss drug meant as a treatment for those with Type 2 diabetes but one which has been overhyped as a magic pill for knocking off the pounds. She now claims that using Ozempic has shrunk her badly, that she has become “too gaunt” and has a hollowed out face.
Osbourne warns against the drug landing in the hands of body image-conscious teenagers, saying, “You can lose so much weight and it’s easy to become addicted to that, which is very dangerous. I couldn’t stop losing weight and now I’ve lost 42 pounds.”
Ozempic or Semaglutide (its generic name) is part of a class of medications known as incretin mimetics and is administered as an injection. This ensures the pancreas releases sufficient insulin when the blood glucose level is high. As a long-lasting glucagon-like peptide-1 receptor agonist, it keeps you full, suppresses hunger and delays gastric emptying, so that you consume fewer calories. “This means weight loss and better blood sugar control. While Ozempic is safe to use with a doctor’s recommendation on a case-specific basis, in recent times, it is being used indiscriminately with people sourcing it from foreign markets (the drug is not available in India, where only oral Semaglutide is prescribed). Taking the shots can cause rapid weight loss that is often more pronounced on the face,” says Dr Subhash K Wangnoo, head of the Apollo Centre for Obesity, Diabetes, and Endocrinology (ACODE). Facial fat, which has a protective function and ensures elasticity, gets dislodged and results in sunken hollows.
Dr Wangnoo has several patients who are flying in the drug from the West or the Middle East and while he insists on a strict medically-guided protocol for use, very few follow it. So when should one take Semaglutide? “It is primarily for controlling diabetes and obesity, which is a disease, and not about body shaming or cosmetic sculpting,” adds Dr Wangnoo.
Semaglutide should be ideally had when your obesity, which is measured by the body mass index (BMI), is in the risky category and associated with co-morbidities. So, those with a BMI of 28, classified as overweight but still close to the normal limit of 25, should lose weight through diet, exercise and lifestyle corrections. “Semaglutide should be used only when your BMI is above 30 and diet and lifestyle modifications have failed. Kickstart your weight loss with it, knocking off 10 to 15 per cent of your total weight. That gives you tremendous metabolic benefits,” says Dr Wangnoo. Then one has to wean oneself off and resort to traditional weight loss tools. That’s because the weight comes back once medication is stopped. So unguided dosage usually results in sarcopenia, when muscle and bone mass go down.
Begin with 0.25 mg injected subcutaneously once weekly. After four weeks, it can be increased to 0.5 mg and then 1 mg. Still if additional glycaemic control is needed, the dosage may be increased to 2 mg once weekly.
Dr Dheeraj Kapoor, HOD, Endocrinology, Diabetes and Bariatric Surgery at Kokilaben Dhirubhai Ambani Hospital, Mumbai, has dealt with many patients with side effects. “People think you just get nausea and constipation but there are serious issues. Most do not know that the drug is contraindicated in those with a family history of thyroid tumour or cancer,” says he. In fact, new data published recently in the medical journal, JAMA, shows that Ozempic pushes up the risk of pancreatitis, stomach paralysis, gallbladder disease and bowel obstruction. “Diabetic retinopathy can worsen with Ozempic use too,” he adds.
