Good side effects, bad side effects
At first, weight loss was just a side effect. GLP-1 RAs were originally developed to treat type 2 diabetes; Their hormone mimicking action stimulates insulin production. In the year In 2005, the US Food and Drug Administration approved Exenatide, the first drug of its kind, for diabetics. In the year In the 2000s, more and more GLP-1 RAs came to market. Immediately, patients noticed that these drugs helped them lose not only their diabetes but also their weight.
Ozempic and Wegovy, brand names for GLP-1 RA known as semaglutide, are both manufactured by Novo Nordisk, a Danish pharmaceutical company. Although both contain the same active ingredient, the drugs have different indications, dosages, prescribing information, titration schedules, and delivery devices. In the year In 2017, Ozympic was approved for the first time as a treatment for diabetes, and soon doctors began to prescribe it to overweight patients. Next, Novo Nordisk created Wegovy specifically for weight loss. In June 2021, it became the first new treatment for chronic obesity approved by the FDA since 2014.
Then, in May 2022, the FDA approved Mounjaro as a diabetes treatment. Now, the agency is officially “fast-tracking” its investigation of the tirzepatide substance in obesity. Eli Lilly, a spokeswoman for the drug’s manufacturer, said it is currently only approved for glycemic control in adults with type 2 diabetes, and that the company “does not recommend or promote Mounjaro outside of its FDA-approved indication.” However, since the drug came on the market, doctors have been using it off-label for weight loss — a Facebook group called “Mounjaro Weight Loss Success” has nearly 100,000 members.
Clinical trials have shown that tirzepatide patients lose at least 20% of their body weight in 72 weeks, while obese adults on Wegovy lose an average of 15% of their body weight in 68 weeks.
Edenfield is one such success story. Unable to work during the epidemic, he stayed at home “eating too much and eating unwholesome food.” He compares his diet to that of a teenager: his regular consumption of fast food sandwiches, cheesesteaks and burgers has become a “crippling addiction” to Coca-Cola. When his weight dropped to 357 pounds (6 feet 3 inches tall), he sought gastric sleeve surgery because his employer would cover the cost. However, the doctor he saw suggested Ozempic instead. He lost 15 pounds in his first month on the drug and switched to Wegovy in February 2022. Now weighs 228.
Judgment of Michael Edenfield
“It’s changed in every aspect of my life,” says Edenfield—he no longer feels “kidnapped” by hunger and breathless on the way to work. “I feel like I’m in my 20s again,” he says.
The results can be enviable, but the daily reality of weight loss injections is not always pleasant. The most common side effects include constipation, nausea, diarrhea and constipation. Edenfield consulted Reddit for tips on how to ward off “cruel” nausea. Some subreddits for semaglutide have emerged or grown in popularity over the past year—the Edenfield post was created in 2021 and has nearly 22,000 members today. Meanwhile, countless Facebook groups have also been created during the weight loss injection boom. Here, people report experiencing vomiting, headaches, fatigue, “sulfur cramps,” and hair loss—though most seem like a small price to pay for weight loss.
During the 68-week Wegovi trial, 4.5% of participants discontinued treatment due to gastrointestinal events. According to Novo Nordisk’s chief scientific advisor, Peter Kurtshals, such side effects gradually decrease as patients develop a tolerance to the drug. A company spokesperson added that patients who experience nausea on Wegovi should “contact their healthcare provider who can provide guidance on how to manage it.”
