If you have been reading our newsletter, you know that semaglutide is one of the hottest medications in the pharmacy. As I write this, the Food and Drug Administration is reporting that this self-injected diabetes drug is “Currently in Shortage.” That has been going on for months. Why would a brand name diabetes drug be so hard to get? You probably know the answer. It’s because doctors are prescribing Ozempic for weight loss.
This means that people with diabetes are having a hard time filling prescriptions for Ozempic. That’s even though the exact same drug is available as Wegovy. Of course, if someone has type 2 diabetes and is overweight, a prescription for Ozempic is justified. That is the case with this reader:
Eat to Live, Don’t Live to Eat!
This reader says that Ozempic for weight loss makes it possible to exercise:
Q. I have been on Ozempic for 12 weeks. In the beginning, I was very nauseated and fatigued, but I have lost 18 pounds.
After my injection, I am tired for two days. Then I feel pretty good the rest of the week. I am on a 0.5 mg dose, and it has significantly reduced my insatiable appetite. My portions are considerably diminished in size. I feel like I’m eating to live instead of living to eat. For the first time in my life, I can eat responsibly.
As a result, I have much more energy to exercise. I went from not exercising at all to about an hour a day, and I will forever be grateful for this medication. Food is no longer the focus of every waking moment. Instead, I can concentrate on the day.
Ozempic is the first medication that got me over my cravings for sugar. I’ve never been able to do that before. Since I am diabetic, that’s an amazing feat. I am looking forward to my next A1c.
FDA Approved Ozempic for Type 2 Diabetes:
A. Thank you for telling us about your experience. The FDA approved Ozempic to help people with type 2 diabetes use diet and exercise to control their blood sugar more effectively. Evidence indicates it will also reduce the risk of cardiovascular complications. We trust that the next measurement of your glycated hemoglobin (“A1c”) will show that your blood sugar is in its proper range far more often than previously.
We are disappointed to learn that people who do not have diabetes are using Ozempic to lose weight. That has created shortages for those who depend on this medicine to control blood glucose.
Another reader is angry that doctors are prescribing Ozempic for weight loss and that her insurance company refuses to pay for this expensive diabetes drug.
Another Reader with Type 2 Diabetes Got Great Results on Ozempic:
Q. I started taking Ozempic once a week about two months ago. Despite constipation and waves of nausea, I’m grateful to have it. I have very little appetite and have lost 11 pounds, though I wasn’t obese. My HbA1c has come down to 6.3 after being around 10.
Others I know have been told they can only take this drug for a limited time. Do you know about the time frame? In addition to Ozempic, I’m also on metformin.
A. Semaglutide (Ozempic) was initially approved for treating type 2 diabetes. The results you report are impressive. Lowering your HbA1c (glycated hemoglobin) to 6.3 indicates much better blood sugar control.
Because this drug and its twin, Wegovy, have received so much publicity about weight loss, there have been shortages. We are not aware of any reason to discontinue the drug other than side effects. If you stop taking semaglutide, you will lose both the advantages you have experienced and the adverse reactions.
To learn more about the benefits and risks of both semaglutide and metformin you may wish to consult our eGuide to Preventing & Treating Diabetes. This online resource can be found under the Health eGuides tab.
Can Insurance Companies Practice Medicine Without a License?
Q. I’m a type 1.5 diabetic (yes, it’s a thing), so I rely on insulin (as if I were a type 1) plus a couple of medications typically prescribed for type 2. I need all of them to keep my blood sugar under control.
However, when my doctor prescribed Ozempic, the insurance company claims people denied me twice. (Surely they have degrees in medicine…don’t they?)
I am disgusted to read that people who don’t even have diabetes are taking Ozempic just to lose weight! Amazing. Are insurance companies paying for this?
A. You certainly educated us about type 1.5 diabetes. It is also known as latent autoimmune diabetes in adults (LADA), and we were not aware of it previously.
Some medications used to treat the more common type 2 diabetes are not appropriate for your condition. However, Ozempic (semaglutide) is considered helpful.
How Can Insurance Companies Play Doctor?
We think it is unethical for insurance companies to practice medicine by second-guessing your doctor. It is unlikely that insurance is covering the cost of Ozempic for weight loss. If insurance won’t pay for an FDA-approved use such as diabetes it certainly should not pay for an unapproved use such as weight loss. The cost for one prefilled injectable “pen” of Ozempic could cost as much as $1,000.
This brand name diabetes drug hasn’t been approved to help people lose weight. Some doctors are prescribing it off label, however. As a result, current shortages are making it difficult for people with diabetes to access this medication.
Other Forms of Semaglutide:
The same medicine, semaglutide, is prescribed as Wegovy for seriously overweight patients to help them lose weight. An oral version of semaglutide is also sold as Rybelsus to treat type 2 diabetes.
This reader wants to know why the FDA permits physicians to prescribe a diabetes drug for weight loss, especially when there is a shortage of both Ozempic and Wegovy.
Ozempic Is for Type 2 Diabetes…not for Weight Loss:
Q. Because I have type 2 diabetes, I’ve been taking Rybelsus since April. My HbA1c is now down to 6.0 and I have lost close to 30 pounds.
There’s a lot of noise around using semaglutide (the ingredient in Rybelsus) for weight loss. I am sick of it! They are literally leaving those of us who truly need the medication for diabetes in the lurch, since there’s a shortage of the injectable medication.
Why would the FDA let doctors prescribe diabetes drugs for weight loss?
A. The FDA regulates drugs, but it has no authority over the practice of medicine. We think it is inappropriate for physicians to prescribe a critical drug that is in short supply to treat an unapproved condition.
This gets confusing, though, because semaglutide is prescribed under three different brand names.
First came Ozempic. The FDA gave this self-injectable formulation the green light in 2017 to treat type 2 diabetes. Novo-Nordisk launched an oral version, Rybelsus, in 2019, also for type 2 diabetes.
In 2021, the FDA gave the same self-injected form as Ozempic approval under the brand name Wegovy.
Wegovy is approved:
“…for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity.”
Elon Musk and Wegovy:
Ever since Elon Musk attributed his weight loss to “fasting…and Wegovy,” social media has been buzzing about this medication. The FDA reports that both Wegovy and Ozempic are:
“currently in shortage”
Oral semaglutide (Rybelsus) does not appear to be in short supply at this time.
Prescribing Ozempic for Weight Loss:
Like you, we are dismayed that doctors would prescribe Ozempic for people without diabetes to lose weight. The drug can cause low blood sugar, abdominal pain, diarrhea or constipation, nausea and vomiting. There are also cautions about thyroid cancer, pancreatitis and gallbladder disease.
We have not seen any word of Rybelsus shortages at this time. The oral version of semaglutide has not received FDA approval for weight loss. Our hope is that doctors exercise restraint and do not prescribe this diabetes medication to people without this serious metabolic disorder.
To learn more about this controversial drug you may want to read our article at this link.
What Do You Think?
Should doctors be prescribing a diabetes drug for weight loss, especially if it is in short supply? Should insurance companies be allowed to second-guess doctors and deny coverage for a medicine a physician believes would be best for a particular patient?
Please share your thoughts in the comment section below.
