Semaglutide was developed in 2012 by the Novo Nordisk company. It mimics the action of incretin glucagon-like peptide – 1 (GLP-1). It reportedly increases insulin secretion which removes excess sugar from the blood.
It is still under patent and offered to the market as several trade name products; Ozempic (injection), Wegovy (injection), and Rybelsus (oral). Common side effects include nausea, vomiting, diarrhea, constipation, abdominal pain, headache, fatigue, indigestion/heartburn, dizziness, bloating, belching, low blood sugar, gas, and gastroesophageal reflux disease (GERD).
The primary indication for semaglutide is Type 2 diabetes, a disease characterized by high blood sugar, insulin resistance (cells don’t respond normally to insulin), and low insulin levels. More than 37 million Americans have diabetes (approximately one in 10), and approximately 90%-95% of them have type 2 diabetes. It often develops in adults.
The pancreas makes insulin to control blood sugar levels. It tries to get cells to respond to increased levels of sugar. Eventually, the pancreas fails to keep up with the demand (and/or insulin becomes less effective) and blood sugar rises which damages the body and causes other serious health problems, such as heart disease, vision loss, and kidney disease. To survive with Type 2 Diabetes, sugar levels must be lowered.
One conventional school of thought is that Type 2 diabetes is caused by improper lifestyle choices (diet and exercise).
Semaglutide is indicated for diabetes as an addition to diet and exercise.
Since its introduction in 2012, semaglutide usage has increased because the community “discovered” that it can cause as much as much as 15% weight loss, or more, in just a few weeks, without having to fast or exercise. In 2020, there were approximately 4.8 million prescriptions written for 1.2 million semaglutide users.
Using semaglutide for weight loss drug has been an off-label prescription until this year when it gained approval from the FDA for that indication. Since then, demand for the drug has been expanding sharply. Just ask any pharmacist, or prescriber, how often they are asked about semaglutide.
Until semaglutide joined the ranks of weight loss drugs, current treatments offered hope of less than 10% weight loss over long periods of time – and demanded changes in diets plus the addition of exercise.
Improved diet and regular exercise long have been acceptable methods for managing weight. In 2013, the American Medical Association (AMA)House of Delegates members voted at their annual conference to officially recognize obesity as a disease (ICD-10-CM code E66). As such, the only legitimate approaches to controlling it are drugs, surgeries, and radiation. Using a drug remains a medically-accepted approach.
Imagine the sales potential for a drug that would be prescribed to an additional 100+ million persons searching for an easy solution to the obesity.
June 27, Reuters reported that Eli Lilly recently received FDA approval to enter the weight-loss market with their special drug treatment, Mounjaro (nicknamed ”triple G” because it contains three drugs, one of which is semaglutide). The article pointed out that, “The new family of drugs has reignited interest in the weight-loss treatment market, which is estimated to reach $100 billion by the end of the decade.”
As long as the current medical system recognizes obesity as a disease that’s treatable with drugs, pharmaceutical companies will tinker with chemical semaglutide structures and experiment with combining newer ones with existing older drugs to meet the demand for drugs that can make losing weight easier and quicker, regardless of the costs and potential side effects. With a potential U.S. market of almost 50% of the U.S. population, it is doubtful that the new Eli Lilly drug will be the last to be designed to control (not cure) the so-called “disease” of obesity.
Larry Frieders is a pharmacist in Aurora who had a book published, The Undruggist: Book One, A Tale of Modern Apothecary and Wellness. He can be reached at thecompounder.com/ask-larry or www.facebook.com/thecompounder.