Ozempic Boom: Who Pays the Price?

Ozempic © chemist4U

Amid a global shortage of Ozempic, a medicine normally prescribed to regulate the blood sugar levels of type 2 diabetes patients, other individuals are obtaining the drug for weight loss.

The active ingredient in Ozempic, semaglutide, regulates blood sugar levels but has also shown to work as an effective appetite suppressant. This has opened up an off-label use for the drug, so while diabetes type 2 patients are struggling to access Ozempic, some people are able to access it and use it as a quick solution to achieve a slimmer figure.

A Miracle Drug?

Ozempic has become popular in the United States, in part fueled by celebrities such as Elon Musk and Kim Kardashian openly advertising the drug’s slimming effects on social media. The medication’s growing popularity has also reached the Netherlands.

“The number of Dutch people using slimming medication, including Ozempic, increased by almost 40 percent in the beginning of 2024, compared to the previous year. The number of people using the drug has increased by more than 10,000 in a year,” according to De Telegraaf.

UMCG © Justine Kozlovska

Anton Scheurink, a professor in Neuroendocrinology at University of Groningen, told The Glass Room that the number of off-label users has been exploding in Denmark, America, and now in the Netherlands. “GLP-1 [Semaglutide belongs to a class of medications known as glucagon-like peptide-1] has a lot of functions that are beneficial for type 2 diabetes patients. Only in high concentrations, it might be effective for people who have real obesity with a risk for type 2 diabetes. I think it's ridiculous that it's now basically hijacked by overweight people, who are using it for 10% weight loss,” said Dr. Scheurink.

The main reason for Ozempic’s popularity is simple - semaglutide does significantly help in losing weight. Studies have shown that the use of semaglutide accompanied by lifestyle changes, can lead to a loss of an average of 15 percent of initial body weight within 18 months. However, the side effects are far less appealing. These include: nausea, vomiting, diarrhea, constipation, stomach pain, headaches and fatigue. The long-term side effects are still unknown.

The Human Cost

Alongside the medical concerns, the off-label use of Ozempic limits the accessibility of semaglutide for people with type 2 diabetes. “People who have type 2 diabetes are insulin resistant and they have lower insulin deficiency, but they also have a deficiency of GLP-1.

So by restoring their normal GLP-1 levels, you're doing a great thing. You restore something wrong in the body. And this is not the case with all the people that are overweight,” said Dr. Scheurink.

In 2023, a total of 1.4 percent of usage of Ozempic in the Netherlands was off-label, or, not for its intended purpose.

Demand for the drug has grown so high that shortages are occurring, putting people with diabetes type 2 at risk. Switching to a different drug can pose significant health risks for patients with type 2 diabetes, and none to individuals trying to lose weight.

In response to this, the Duch Association of General Practitioners (NHG) has urged doctors to stop prescribing Ozempic to people with obesity. Nevertheless, the use of Ozempic has grown steadily among Dutch citizens, introducing alternative ways to access the drug. In May 2024, RTL Nieuws discovered that a Dutch weightloss clinic doctor was selling Ozempic on Marktplaas, a Dutch website for selling second-hand goods, without gathering crucial patient information.

The latest report from the National Institute for Public Health and the Environment (RIVM) points out that the number of overweight people will increase by 64 percent by 2050. This indicates that the demand for weight-loss medication such as Ozempic will also increase. While remaining hopeful that the obesity numbers will fail to reach such a peak in the Netherlands, Dr. Scheurink adds, “GLP-1 should not be allowed for people who are overweight. They should go for lifestyle interventions.”