A GP’S HEALTH WARNING

Dr Ellie Cannon on the risks of taking the drug for weight loss

Despite being a GP well versed in dishing out all sorts of medications, I find it shocking that anyone would choose to take a drug like Ozempic in an unsupervised way like this. All medications come with risks and side effects, even over-the-counter ones such as paracetamol. As a junior doctor I met a patient who ended up dying from liver failure after taking high-street herbal tablets – she had been fooled by the promise of easy weight loss so disregarded potential side effects. But after a month of taking them she had irreversibly damaged her liver. Ozempic – or semaglutide – is a wonder drug if you have diabetes. It’s a once-a-week injection that reduces glucose levels and slows digestion. It is licensed for use in type 2 diabetics when other medications don’t work and where weight loss is helpful. It is known to potentially cause pancreatitis (inflammation of the pancreas), visual and kidney problems as well as allergic reactions, so is prescribed alongside strict medical supervision, with regular blood tests and assessments to monitor patients. I cannot understand why people would risk these side effects unless they truly need the medication. And the pitfalls are even greater if you are prepared to forego medical guidance completely by buying it online, with no one monitoring your blood, checking your medical history or changes in your health to see if you should be taking it at all. The UK guidelines on the medication advise that common side effects include gallstones, burping, diarrhoea, dizziness, fatigue, abdominal pain, nausea and vomiting. This means as many as one in ten people using it will be affected. Of course, these are worth it when balanced against the benefits of the excellent diabetes treatment it can offer. But they hardly seem sensible for trivial weight loss that can be achieved in a safer, albeit slower way. A celebrity endorsement does not make it safe. No medication is risk-free when used in this unsupervised way.

‘CELEBRITIES ARE ACCUSED OF HOGGING SUPPLIES AHEAD OF DESPERATE DIABETES PATIENTS’

three and four stone over her ideal weight for decades, started using it in January. ‘The Paleo diet, 5:2, CBT, NLP, bootcamp, diet delivery services – I’ve tried them all,’ she says from the family home in Hampshire, ‘and I’ve always yo-yoed right back. After my last annual checkup I seriously contemplated giving up. Then my doctor suggested semaglutide.’

After only a month she noticed her clothes had become looser. From then on, the weight started dropping off. ‘The strange thing was, I wasn’t eating anything different. I just couldn’t physically have seconds any more, and the idea of pudding after a full meal had lost its allure.’ Three months on, she is two stone lighter ‒ though occasionally she suffers heartburn if she eats too late at night or drinks alcohol ‒ and when we spoke in autumn, she was looking forward to losing another stone by Christmas.

‘There is a niggling voice that tells me it is both risky and lazy to take a drug to lose weight, and I worry that it will all pile on again if I stop taking it. But if it does, I will seriously consider taking it indefinitely.’

Private London GP Dr Martin Galy has been prescribing semaglutide for about a year to clients who cannot lose the weight they gained in menopause. He has seen it have a transformational effect, too, on much younger women who suffer polycystic ovary syndrome. ‘PCOS sufferers are difficult to treat, and you can imagine how body image plays a very important part when it comes to self-esteem.’

But according to Tom Sanders, professor of nutrition and dietetics at King’s College London, it is not a magic bullet. Commenting on a study on semaglutide published in The New England Journal of Medicine in 2021, he says, ‘The challenge post-weight loss is to prevent a regain in weight,’ he wrote. It may prove to be useful in the short term, but ‘public health measures that encourage behavioural changes such as regular physical activity and moderating dietary energy intake are still needed’.

That said, given our rising national obesity statistics and the escalation in accompanying health issues such as heart failure, cancer and obstructive sleep apnoea clogging up hospital beds, we’re going to need something. Semaglutide may be the rich person’s drug today, but might it be approved for more widespread use? Only time will tell.