With breathless coverage of the ‘miracle’ weight loss jabs Wegovi and Ozympic have so far, you’d be forgiven for thinking they’re a cure-all for every ailment.
Originally designed to treat type 2 diabetes – and life-changing for those living with the disease – they have also become a universal treatment for people with obesity.
A-list celebrities are said to swear by them to keep them looking slim and glowing. Headlines suggest they can improve your heart health. And if the myths are true, they may curb addictive behaviors like gambling, smoking, and excessive alcohol consumption.
But like any drug, there is a downside.
A study earlier this month linked semaglutide, an ingredient found in both drugs, to blindness.
Experts at the Association for Acute Medicine have warned that the number of people coming to hospital with drug-related problems such as nausea and vomiting is ‘increasingly increasing’.
But how significant are these risks? And, if you’re curious about taking it yourself, how do you know if you’re actually getting a benefit? Here, the experts tell you everything you need to know to make an informed decision about your treatment…
Our experts will tell you everything you need to know to make an informed decision about your treatment…
Who will definitely benefit from these drugs?
If you have a BMI greater than 30 and other weight-related obesity, such as high blood pressure or type 2 diabetes, the strongest evidence is that these drugs can change your health.
In trials, about half of the people who received a once-weekly injection of semaglutide lost 10 percent of their body weight—and kept it off over the four years of the trial.
One in five managed to lose 15 percent of their weight, and one in 20 managed to lose a quarter of their weight.
But there are other life-changing benefits. The drugs reduce the risk of heart attack and stroke by 20 percent, help prevent type 2 diabetes and prevent kidney disease.
They lower blood pressure and cholesterol levels, and early studies show that they may reduce the risk of ten of the 13 obesity-related cancers.
Side effects of taking the drug include nausea, vomiting, diarrhea, constipation and pancreatitis.
However, obesity itself causes chronic disease and shortens life – making these drugs ‘mind-boggling’, says Professor Navid Sattar at the University of Glasgow. A growing body of evidence shows that obesity can promote or accelerate more than 200 diseases, including diabetes, stroke, many cancers, conditions such as arthritis, and mental health issues.
It is for this reason – that the benefits are considered to outweigh the known risks – in 2023, the NHS has approved Wegovy for those with a BMI over 30 and at least one weight-related health issue.
The drugs are licensed as Ozempic to treat type 2 diabetes when standard medications don’t work.
Experiments show that some people lose enough weight to treat diabetes and that the drug can reduce the risk of diabetes-related kidney disease.
Are there any benefits to not being overweight?
Yes. Although the drug is only available to selected obese NHS patients, studies have shown that obese people can also benefit greatly.
Earlier this year, a trial of more than 17,000 adults with a BMI of 27 and above — overweight but not obese — also concluded that they lost an average of 10 percent of their body weight as long as they stayed on the drug. .
The participants – all of whom were over 45 and had previously suffered from heart problems – were significantly less likely to develop further heart problems. This is because any unhealthy level of weight increases the risk of life-threatening diseases, experts say.
In the year In 2017, researchers reported that people with a BMI between 25 and 30 were one-third more likely to develop heart disease than those with a healthy weight. People with a BMI of over 25 are also more likely to develop cancer, according to Cancer Research UK.
Private clinics are available for free to give the drug to any patient they believe would benefit, regardless of BMI.
There are also several online pharmacies that sell the drug, but only to patients who meet minimum requirements.
What about nausea and other side effects?
In trials, about one-fifth of patients experienced nausea, vomiting, and diarrhea, which were among the most common side effects. It’s not clear why some people suffer so badly and others don’t, but it appears to be related to first starting the drug or increasing the dose — and it goes away as the body adjusts.
The drug slows down the body’s metabolism, keeping food in the gut longer, which explains the problems, experts say.
‘It is self-limiting and resolves within a few weeks,’ said Professor David Strain of the University of Exeter.
Although tests have not been done on people of normal weight, there is anecdotal evidence that they may be at increased risk.
Dr Vicky Price, of the Association for Acute Medicine, said there had been a ‘real increase’ in the number of people misusing medicines coming to hospital with vomiting, diarrhea and dehydration.
That’s because Jab works by mimicking the ‘hunger hormone’ GLP-1, which is the stomach’s response to eating and tells the brain it’s full.
Overweight people do not respond well to this hormone being produced naturally by the body, which is why they continue to eat.
But this synthetic version has a much higher concentration and lasts longer in the body and suppresses appetite. But normal-weight people are responding well to natural GLP-1 hormones – taking larger doses than they need means ‘they may feel more ill,’ says Professor Strain.
According to Professor Sattar, most patients can avoid serious side effects by starting with a low dose and tapering off gradually.
Eat slowly to control illness and drink plenty of fluids only when you are hungry and choose unhealthy unprocessed foods.
Are cancers dangerous if they run in the family?
Not for most people. According to the official Ozempic and Wegovy safety information, patients with a family history of medullary thyroid cancer should not take the drug.
This is a type of tumor that develops in the thyroid gland.
Earlier studies indicated that mice given the drug were more likely to develop the disease.
There is no evidence that it increases the risk in humans.
But as a precaution, the drugs’ Danish manufacturer, Novo Nordisk, has warned of possible thyroid side effects.
People with a rare condition called multiple endocrine neoplasia type 2, or MEN2, should also not take it, as they have genetic mutations that increase the risk of these types of cancer.
However, fewer than 2,000 people in the UK have MEN2.
‘It’s a very small theoretical risk,’ said Professor Strain.
But Novo Nordisk doesn’t want to risk it. For everyone else, early studies suggest that taking jabs can reduce the risk of ten of the 13 types of cancer known to be associated with obesity, including colorectal, endometrial, kidney, liver and ovarian cancer.
Do they really make you blind?
IT is unlikely. Earlier this month, a new study found that obese patients who take semaglutide have a higher risk of developing blindness called non-arterial ischemic optic neuropathy — or NAION.
However, the number of cases was still low. About 20 out of 1,000 patients who receive injections for weight loss experience NAION, and many experience temporary vision problems rather than permanent blindness.
Many experts are skeptical of the findings.
Professor Alex Miras, a lecturer and consultant endocrinologist at Imperial College London, said: ‘We have been using these drugs for 17 years in diabetic patients, who have never had this disease before.’
It cannot be said that we are suddenly seeing issues now.
The researchers involved suggested that people who develop NAION may have an underlying eye problem, such as glaucoma.
For this reason, doctors suggest that their patients make sure they have no eye problems before starting the drug.
However, there are other serious semaglutide risks.
Pancreatitis, which affects one in 100 people, causes inflammation of the pancreas, which is the lining of the stomach. If left untreated, this can be ‘very serious and life-threatening’, says Dr Vicky Price.
Gallstones — tiny balls of cholesterol that form in the gallbladder — are an added risk for anyone trying to lose weight too quickly.
I know the risks but do they work if I’m thin?
We don’t know the truth. Clinical trials have not been conducted on people of normal weight, so we do not have evidence of how well it works and what the side effects might be.
What we know is that about 15 percent of people do not lose any significant weight on these drugs, which means that you can take it and expose yourself to side-effects, for nothing.
We all know about the ‘Ozempic face’ – the plump, hollow-cheeked look caused by rapid facial fat loss that has affected celebrities such as Sharon Osbourne.
But in addition, there is good evidence that this rapid weight loss (by any method, and not exclusive to Ozempic) also significantly reduces muscle mass.
Experts believe that this can be especially dangerous for the elderly as the loss of muscle strength increases the risk of falling.
Professor Miras said: ‘When you take these drugs, you lose fat and muscle.’ But when you stop using them, you may get the fat back, but not the muscle.’
However, perhaps most importantly, experts say there is a moral consideration for anyone considering taking these drugs.
NHS England reports that national shortages of semaglutide are expected to continue until 2025.
‘These are game-changing drugs for obese people, but we shouldn’t be encouraging people to take them just for weddings or to be seen on the beach,’ said Professor Miras.