A Cardiologist’s Perspective on the Ozempic Phenomenon

A Cardiologist’s Perspective on the Ozempic Phenomenon

It appears that Ozempic and its counterparts have become ubiquitous in today’s landscape. Semaglutide, the molecule found in Ozempic, Rybelsus, and Wegovy, surged into the public eye boasting impressive claims of enhanced diabetes control, weight loss, and a reduced risk of heart attacks and strokes. Novo Nordisk, the company behind semaglutide, is finding it challenging to keep up with the overwhelming demand for these medications. It’s hardly surprising given the ubiquitous advertising for Ozempic at gyms and spas.

But does semaglutide deliver on its promises? Are there significant downsides that potential users should be aware of?

In short, the answer is yes to both questions. Semaglutide and its relatives in the GLP-1 family are remarkable drugs for suitable patients. Prior to this drug class’s development, available weight loss medications tended to be modestly effective at best and often limited by significant side effects. In contrast, semaglutide has exhibited significant weight loss, approaching the efficacy of bariatric surgery (the gold standard for severe obesity management) in some cases. Unlike insulin and many older diabetes drugs like glyburide and glipizide, which tend to promote weight gain, semaglutide facilitates weight loss while regulating blood sugar levels. Achieving these three simultaneous benefits — weight loss, better blood sugar regulation, and reduced cardiac event risk — is a medical feat. For patients dealing with obesity and diabetes, I often recommend switching to one of these drugs, especially if they have a history of heart disease or stroke.

However, nothing in life comes without trade-offs, particularly in medicine. Semaglutide does have its share of potentially serious side effects. Common gastrointestinal (GI) side effects such as upset stomach, bloating, and nausea are directly linked to the drug’s mechanism of slowing down food movement through the gut, which in turn creates a prolonged feeling of fullness and reduced appetite. Typically, managing these GI side effects involves eating smaller meals and adjusting the drug’s dosage gradually for improved patient tolerance. Yet, in rare instances, severe reactions have persisted even after discontinuing the drug, resulting in ongoing GI issues (known as gastroparesis). Additionally, rare cases of semaglutide-induced pancreatitis and a specific type of thyroid cancer have been reported. It’s worth noting that while semaglutide induces weight loss, it doesn’t replicate the essential benefits of exercise such as increasing muscle mass and reducing the risk of bone demineralization/osteoporosis, both vital for staying healthy as you age.

Every medication, regardless of its breakthrough nature, has its downsides. Semaglutide is a fantastic drug for many patients, and I wouldn’t discourage those who could benefit from it due to potential side effects. However, I would also advise caution for those considering semaglutide solely as a shortcut for shedding a few pounds without incorporating the effort of a balanced diet and exercise. This drug does pose potentially serious side effects, some of which could persist even after stopping it, and it misses out on the essential benefits of regular exercise.

If you’re grappling with diabetes, metabolic syndrome, cardiac issues, or obesity, I’d gladly consult with you regarding semaglutide. Yet, if your weight-loss goals are less ambitious, I’d recommend pursuing them the conventional way. Weight management is a challenge, and unfortunately, there’s no magic fix to make it effortless.