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  • Writer's pictureSociety of Bioethics and Medicine

Oh-Ho-Ho-Ozempic - Linked to Higher Risk of GI Issues

Written by Jonathan Gao

Edited by Raheem Sheikh


It’s that bizarre yet familiar jingle on TV: the catchy chorus of Pilot’s 1975 hit song—“Magic”—that goes “Oh! Ho! Ho! It’s magic you know”, but comedically reworded to sell Ozempic, a weekly injection to lower blood sugar levels, to American consumers diagnosed with type II diabetes. However, Ozempic has taken America by storm for its unintended but highly desirable outcome: rapid weight loss.


As a result of the copious amounts of money that companies spend on drug advertising on an annual basis, many Americans are now familiar with the brand names of drugs such as Ozempic and even more, the long list of side effects that accompany them — despite potentially never needing to be prescribed such medications themselves. The body weight program, Ro, has recently implemented a full-scale marketing strategy to promote GLP1 treatments alongside personalized care and coaching.


For semaglutide, the drug’s generic form, that long list of side effects has only grown.


Recently, a new paper published in JAMA Network shed light on the increased risks of gastrointestinal adverse events in a cohort study comparing 16 million health claims from patients prescribed glucagon-like peptide 1 (GLP1) agonists, either semaglutide (the active ingredient in Ozempic) or liraglutide, against a non-GLP1 weight loss drug, bupropion-naltrexone from 2006 to 2020 (Sodhi et al., 2023). Compared to patients on bupropion-naltrexone, there were three times as many patients on semaglutide who experienced gastroparesis and nearly five times as many who experienced pancreatitis per 1000 patient reports studied.

This study comes at a time when semaglutide is touted as the king of weight-loss medications. The New York Times reported that the drug has been championed on social media and raved about by celebrities, including Elon Musk who tweeted about being on Wegovy, a version of Ozempic with a higher semaglutide dosage. #Ozempic has been viewed over 273 million times on TikTok, with influencers and creators boasting about their medication-induced weight loss regimen. Interest in the medication for its ability to make people appear fit and healthy in a relatively short time frame will only continue to grow as its appeal continues to reach the everyday consumer.


The effects of semaglutide cannot be understated. Semaglutide boosts GLP1 levels in the body, indicated by heightened feelings of fullness. In turn, this slows digestion and increases the time it takes for the digested food to exit the body. A report by Chao et al. (2022) stated that weight loss with semaglutide, when compared to a placebo, was associated with clinically meaningful improvements in waist circumference, blood pressure, and even benefits to quality of life.


But not everyone is guaranteed this increase in quality of life. Jaclyn Bjorklund, a 44-year old woman from Louisiana, filed an ongoing injury lawsuit in August 2023 against Novo Nordisk, the manufacturer of Ozempic, and Eli Lilly, the manufacturer of Monjaro (another diabetic medication that Bjorklund switched to after a year on Ozempic). Bjorklund stated that the companies failed to warn patients of “severe gastrointestinal events” that can be caused by the use of both drugs; her lawsuit stating that she suffered from “severe vomiting, stomach pain, gastrointestinal burning” and was even hospitalized for these stomach issues.


Bjorklund falls under the small group of medicated patients who are prone to that host of rare conditions. As Sodhi describes on NBC, despite the rarity of such conditions, the widespread popularity of GLP1 medications means that out of 1 million people, there remains a considerable number of people who can experience them and that these issues can have “a significant impact on the quality of life.”


Novo Nordisk remains steadfast, asserting that they stand by the safety of their products and that patient safety remains a top priority. Similarly, physicians are unlikely to change their treatments because of the report, stating that they were not overly swayed and that the side effects could be the result of rapid weight loss, not the medications.


Nevertheless, the consensus is that this new information places greater significance on taking good patient histories and carefully monitoring their treatment regimen. Thus, for the time being, the beneficial outcomes of GLP1 medications far outweigh the slight chance of developing gastrointestinal issues.


But perhaps the effects of semaglutide are quite like the jingle: It’s magic. Never believe it’s not so.


References:


Blum, D. (2022, November 22). What Is Ozempic and Why Is It Getting So Much Attention?

https://www.nytimes.com/2022/11/22/well/ozempic-diabetes-weight-loss.html


Chao, A. M. (2022, December 29). Clinical Insight on Semaglutide for Chronic Weight Management in Adults: Patient Selection and Special Considerations

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9807016/#:~:text=Fully%2086.4%25%20of%20the%20semaglutide,weight%20(32.0%20vs%201.7%25).


Dunleavy, K. (2023, August 3). Novo Nordisk, Eli Lilly face injury lawsuit from user of popular GLP-1 medicines. https://www.fiercepharma.com/pharma/novo-nordisk-eli-lilly-slapped-lawsuit-user-ozempic-and-mounjaro


Lovelace, B., Jr. (2023, October 5). Popular weight loss drugs linked to rare but severe stomach problems, study finds.

https://www.nbcnews.com/health/health-news/ozempic-wegovy-linked-severe-medical-conditions-stomach-problems-study-rcna118823


Ro, (2023, March 26). Why we’re putting ads for our Body Program on the subway. https://medium.com/ro-co/why-were-putting-ads-for-our-body-program-on-the-subway-fca79aec720c


Sodhi, M. (2023, October 5). Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss. https://jamanetwork.com/journals/jama/fullarticle/2810542


Stewart, E. (2023, February 9). The bizarre Americanness of prescription drug commercials. https://www.vox.com/23583280/prescription-drug-ads-commercials-ozempic-humira-fda

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