In early 2021, feeling deflated about my menopausal weight gain that was seemingly impervious to both diet and exercise, I talked to my primary care doctor about it, and she immediately recommended Ozempic for off-label use, off-label because it’s for type 2 diabetes which I don’t have, at least not yet, but I’m working on it. She had used it herself to lose weight. I was just freaking out over having a BMI that was over 25 for the first time in my life, and not being able to work my way out of it. Unfortunately, after the free one-month trial, my insurance would not cover it, so I only got to take it for the one month. I lost 13 pounds, which was pretty damn good, and even when I quit taking it, the weight did not return.

Can Ozempic cure obesity, without the slog of diet and exercise, and without the difficulty of legislating food in this wealthy country of ours so that we aren’t ingesting so much corn starch and corn syrup?

There’s a bit of a moral panic right now about the Ozempic trend. First, let me explain what it is and how it works. Ozempic (semaglutide) is a medication used to treat type 2 diabetes. It belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of the natural hormone GLP-1 in the body.

GLP-1 is produced by the intestine in response to food intake, and it helps to regulate blood sugar levels by increasing insulin secretion and reducing the production of glucose by the liver. GLP-1 also slows down the rate at which food leaves the stomach, which can help to reduce appetite and promote weight loss.

Ozempic works in a similar way to GLP-1 by stimulating the insulin-secreting cells in the pancreas to release more insulin in response to rising blood sugar levels. It also reduces the amount of glucose produced by the liver and slows down the rate at which food leaves the stomach.

Ozempic is administered once a week by subcutaneous injection (subcutaneous shots are no big deal–kind of like a bug bite), and it has been shown to be effective in improving blood sugar control, reducing the risk of cardiovascular events, and promoting weight loss in people with type 2 diabetes. It is usually prescribed as part of a comprehensive diabetes management plan that includes a healthy diet, regular exercise, and other medications as needed.

I’ve heard some stories that some people who take it get very sick, experiencing nausea, vomiting or diarrhea. I did not have these symptoms. What was weird was that sweets and “junk food” didn’t look better to me when I was taking it. Healthy foods just looked better, so that’s what I ate. I also couldn’t finish a meal. I would stop about halfway through and push my plate toward my husband to see if he wanted the rest. I didn’t feel like snacking. I just wasn’t hungry.

If not covered by insurance, the monthly cost of Ozempic is usually around $880 in the US (that’s the cost I was quoted). There is now a generic version called Wegovy which has a slightly higher dosage of semaglutide and is specifically designed for weight loss rather than Type 2 diabetes. The monthly cost in Mexico for these products runs closer to $150, and it does not require a prescription. It can also be purchased from Canadian suppliers and shipped to your house for a lower rate, but a prescription is required. Because of its off-label use for weight loss, there have been shortages of Ozempic for those using it to treat diabetes, particularly in Mexican border towns and tourist destinations.

So what’s the controversy? There are several ethical angles to consider:

  • Moral panic over the idea that we can lose weight and keep it off through medication rather than diet and exercise.
  • The accompanying moral panic that we are continuing to fill ourselves with unhealthy food rather than changing and regulating the food industries in the US.
  • That the medication costs so much in the US vs. Mexico points to issues surrounding Big Pharma in the US, including the complicity of many of our politicians in keeping the cost of medications high to enrich their donors.
  • That the medication doesn’t require a prescription in Mexico, and there have also been reports of “counterfeit” product being sold in Mexican pharmacies under the manufacturer’s label; the manufacturer has replaced these fakes with actual product when notified, but that doesn’t mean some unwitting vain tourist isn’t injecting something that is not Ozempic!
  • Whether it’s ethical to take a medication like this for off-label use, particularly narcissistic celebrities buying up the entire Tijuiana market, when there is a shortage.

Here’s my take on these issues. First, while I agree that the food we are buying and eating in the US is often terrible for us, so far nobody’s making any improvements on that, and we have a lot of people in this country who are either obese or overweight who can’t seem to keep the weight off for a variety of reasons. The deck is stacked against us in our wealthy country, and we’d be healthier at a lower weight, so why not use Ozempic to achieve better health and to avoid (not just treat!) Type 2 Diabetes!

Next, I’m not sure how to solve the political problem that is Big Pharma. Big donors across various industries are a huge problem and are ruining lives. I’d love to see us not live in a country where donors (small or large) are a factor in politics (e.g. in Germany, candidates are given an equal fund for their campaigns so you aren’t buying support or being bought either), but that’s the system we have. Nobody is motivated to change it. It’s utterly ridiculous that this is where we are.

Mexican medicine intrigues and scares me. Living in a border state as I do, I’m aware of many people who go to Mexico for medical or dental procedures (a lot of small business owners do this) to avoid having to pay for health insurance. And it’s true that Mexico doesn’t have the regulatory control that we have in the US and Canada, but given the cost difference, it might be worth the risk. From my time living in Asia, I also saw (and benefitted from) these types of differences. My son’s eczema creme was $110 in the US. The identical creme in Singapore cost $60 a tube. When we were hiking in Nepal, I stopped in a pharmacy, and the exact same creme was 60 CENTS a tube. So, AITA because I literally bought every tube on the shelf? Maybe.

As to the issue of Ozempic shortages, that feels like another Big Pharma problem, not a consumer problem. Make more of it. Make more Wegovy. It’s all supply and demand. But yes, it’s a shame that all “miracle” drugs end up going to the rich first. I still haven’t figured out how to solve capitalism.

What’s your take?

  • Do you believe that taking a medication as a means to lose weight is bad because you should have to lose & maintain weight through diet & exercise only, so shortcuts are morally wrong?
  • What do you think about Big Pharma’s influence on this and other medications?
  • How do you feel about medical tourism morally? Are rich people robbing from the poor? Or is this just a free market thing, and they can get more product from the manufacturers?
  • Have you tried Ozempic? Would you?