‘It’s not fair some just

Semaglutide is a treatment meant to fight clinical obesity. But amid unfounded claims that Kim Kardashian used it simply to get slimmer... Barney Calman and Eve Simmons

2022-11-20T08:00:00.0000000Z

2022-11-20T08:00:00.0000000Z

dmg media (UK)

https://mailonline.pressreader.com/article/282411288316452

Health

ATIKTOK-fuelled stampede for a pioneering obesity drug has led to a global shortage, leaving desperate patients with serious health problems such as type 2 diabetes without vital treatment. The medication semaglutide, known by brand names Ozempic and Wegovy, has been hailed as a major breakthrough, helping people who take it shed almost a fifth of their weight. It works by suppressing the appetite, with users saying they crave less and sometimes forget to eat. In February, NHS spending watchdog the National Institute for Health and Care Excellence (NICE) approved the weekly jab for obese patients with a weight-related illness, such as type 2 diabetes, or at high risk of a heart attack, as slimming down can help protect against these problems. The drug is taken via an easy-to-use self-injection pen. When, in May, reality TV star Kim Kardashian told Vogue magazine she had lost 16lb in three weeks so she would be thin enough to fit into a dress that once belonged to Marilyn Monroe, rumours began to circulate that she had used semaglutide. KARDASHIAN has never commented on the claims, yet in one TikTok clip, viewed more than a million times on the video-sharing app, an evangelical patient speculates: ‘In my opinion Kim’s drastic weight loss could be due to something like [semaglutide]… I might be wrong. These [medicines] are tools for people to completely metabolically change their bodies.’ In another clip, with 2.4 million views, TikTok user Kendyl Page Burnstein charts her own transformation, losing 30lb. Scores of comments on this and other posts say: ‘Where can I get some?’ The hashtag #ozempic alone has more than 270million views on TikTok, with hundreds of millions for #semaglutide, #wegovy and similar. In October, entrepreneur Elon Musk claimed on Twitter that he had lost weight thanks to the drug. Although semaglutide is licensed for use only in people with obesity suffering health problems, specialists can legally offer it to anyone they feel might benefit – this is known as ‘off-label’ use. It has allowed doctors to prescribe semaglutide to high-risk patients as a preventative measure, rather than wait for them to develop an illness. The phenomenal success of the drug, where almost all other approaches have failed, has led to surging demand in America, where more than 70million adults, or about 40 per cent of the population, are obese. But it seems semaglutide is also being prescribed to those who are not overweight. US entertainment magazine Variety published an investigation in September that suggested A-list actors were using the jabs to stay as skinny as possible. ‘Styling teams for celebrities have come to accept the injections as part of grooming rituals,’ it reported. ‘It has become the worstkept secret in Hollywood.’ Soaring demand has led to stocks of semaglutide running dry. Social media is littered with stories about patients with type 2 diabetes and other serious weight-related problems, who need the drug to help control their condition, struggling to get hold of the medication. When approached by The Mail on Sunday, semaglutide manufacturer Novo Nordisk UK confirmed it was ‘aware of a stock shortage’, adding: ‘Unprecedented demand has tested our manufacturing capacity. We are working to remedy this as soon as possible.’ SEMAGLUTIDE is a type of drug known as a GLP-1 agonist, and there are others that have a similar effect available, including dulaglutide and liraglutide. However, the shortages are now affecting these, too, says Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacists: ‘There has been a problem getting hold of all GLP-1 agonists for a few months now – particularly semaglutide. ‘It is similar to what happened with HRT – people post about the benefits on social media and suddenly everyone wants to take it. ‘We have concerns about unregulated websites reselling the drug for eye-watering prices, because there is profit to be made.’ Doctors have told The Mail on Sunday of bona fide patients who have had to come off the drug as they are unable to get hold of it. ‘Without semaglutide, patients relapse – they become incredibly hungry and are drawn to consume more food,’ explains obesity expert Dr Carel le Roux, Professor of Metabolic Medicine at Ulster University. ‘They regain weight and their health suffers.’ One patient in this dire situation is 59-year-old Carol – who asked us not to reveal her surname – from Brent in North-West London. The mother-of-one struggled with her weight for much of her life and tried ‘every diet going’ without success. ‘I’ve done WeightWatchers, the Atkins, those meal replacement shakes – I’d lose a bit of weight, but then put it back on,’ she says. Six years ago she reached 17st – which, at 5ft 5in, meant she was severely obese – and underwent gastric band surgery. She lost three stone, but found she was unable to resist snacking, adding: ‘I craved sweet foods, like biscuits and chocolate.’ In June, suffering from chronic backache and asthma symptoms, she was offered a private prescription for semaglutide. ‘I needed to do something to control my appetite, so I agreed,’ she says. ‘It worked. Before, I’d feel hungry all the time, but with the injections I’d often go all day and forget to have lunch.’ In just two months, Carol lost a stone. ‘My back was less achy and my asthma improved,’ she adds. In September her pharmacist told her they were out of stock. ‘I’ve not been able to get hold of it since then,’ she says. ‘I’ve been to every chemist in my area, and it’s the same story. It’s really scary because I can see all the progress I’ve made being undone.’ Another patient we spoke to, who also asked us not to reveal her full name, has a two-week supply of semaglutide left and has been warned by her pharmacist that stocks are dwindling. Daphne, 60, was first prescribed the drug last year after undergoing a kidney transplant. At her heaviest, the mother-of-two from London weighed 18st. Already suffering high blood pressure, she was diagnosed with kidney failure in 2009. She underwent a gastric sleeve operation and lost six stone in preparation for a kidney transplant in 2019. But she regained much of the weight and was told she was borderline type 2 diabetic. Daphne was put on semaglutide at the end of 2021, and now weighs just over 14st, but is struggling to get more supplies. She says: ‘Basically, the medicine means I don’t feel hungry, ever. Whereas before I had to stop myself from eating chips and sweet things, now I forget to eat unless I actively remind myself. ‘If I can’t get the drug I’ll try not to go back to my old ways, but I’m worried I will. And if I put on weight again, I’m frightened about what it’ll mean for my health.’ Semaglutide works by mimicking the hormone glucagonlike peptide-1 (GLP-1), which is released after eating. It signals to the body to release another hormone, insulin, which helps move digested sugar from the blood into cells where it can be used for energy. This leads to feelings of being full. Trials of semaglutide published last year caused a stir after they showed patients, on average, lost 16 per cent of their body weight after a year on the drug. Most startling was that this result was seen even if they did not change their diet. While some patients on one arm of the trial received intensive diet support, others got none – but both groups lost the same amount of weight. Another arm of the trial involved switching some patients who were on semaglutide to a dummy jab after six months without them knowing which injection they were getting. They reported feeling hungrier and eating more, and regained much of the weight they had lost. A private prescription for semaglutide costs roughly £100 a month, and many doctors feel that obese patients should be offered the treatment on the NHS before serious conditions such as type 2 diabetes develop. The trials have convinced some doctors that obesity should be seen in itself as an illness, and one that requires lifelong drug treatment. ‘Obesity is a disease that affects part of the brain involved with feelings of hunger,’ says Prof le Roux, who runs campaign group It’s Not Your Fault. ‘It’s a biological problem that can’t be controlled with willpower. ‘Semaglutide targets the part of the brain affected by the disease of obesity. Ultimately the goal of treatment is to improve health, not what people see in the mirror.’ Although NICE says that semaglutide can be offered for only two years, Prof le Roux expects this to change. ‘There isn’t the evidence yet to show having patients on semaglutide for longer is cost-effective in terms of preventing illness,’ he says. ‘Next year we’ll have data to show whether or not the treatment reduces the risk of heart attacks. If it does, there will be a strong argument to put patients on it for life.’ Prof le Roux believes the main driver of the current semaglutide shortage is the staggering number of obese Americans who need it. But he warns that those who take it in a quest for slimness could be in for a shock He says: ‘There is a rebound effect when the drug is stopped. Natural levels of GLP-1 will be lower, meaning patients will feel hungrier and end up heavier than before. This drug will not make someone thin – it’s a treatment for obesity.’ DR ALEX Miras, a consultant endocrinologist and lecturer at Imperial College London, adds: ‘If someone develops obesity because they over-indulge, there is a reason they over-indulge – it is because their brain is telling them to over-eat. ‘Of course, the environment and situation we’re in has an influence, but biology is far more important in regulating how hungry we feel. The medication works because it targets that system – the hunger and fullness part of the brain.’ Patients on semaglutide often report short-term nausea as the body adjusts to the medication, but there are other side effects, explains Dr Miras. ‘It can dull the pleasure of eating,’ he says. ‘Patients say they don’t enjoy food as much.’ For patients unable to get hold of semaglutide, Leyla Hannbeck of the Association of Independent Multiple Pharmacists, suggests it may be possible to switch to another GLP-1 drug, saying: ‘GPs can work out what the most appropriate replacement is.’ Novo Nordisk UK said it was trying to supply new stock of semaglutide ‘as soon as possible’. Meanwhile, patient Carol has been told by her pharmacist that the supply issues could continue well into next year. ‘I am trying to stay in control,’ she says, ‘but I’m craving sweet things again. ‘It’s not fair if this shortage is being caused by slim women who are just taking the drug for vanity. I need it for health reasons.’

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