Ozempic: Dieters Who Use Scarce Diabetes Drug Could Face Side Effects
Dennis Thompson
WEDNESDAY, Feb. 1, 2023 (HealthDay News) -- Mila Clarke started taking Ozempic in 2020 to help manage her diabetes, but was pleasantly surprised to find herself soon shedding pounds.
“I was like, this is really weird because I’m not having to try very hard to do this,” said Clarke, who has been diagnosed with both type 1 and type 2 diabetes and chronicles her diabetes journey on her Hangry Woman blog. “And as I kept going on, I kept noticing that the weight was falling off.”
Then the side effects started — most worryingly, a racing and palpitating heartbeat.
“I could be laying down in bed and my heart rate, like resting heart rate, would be 120 beats per minute,” the sort of rate associated with exercise, Clarke said in an interview with HealthDay Now. “It was really having an effect on my heart rate, and that was really terrifying.”
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First approved to treat diabetes under the brand name Ozempic, the drug semaglutide received federal approval in June 2021 to also be prescribed as a weight-loss medication — with the brand name Wegovy.
People interested in dropping pounds — either for their health or for vanity’s sake — flooded the market for semaglutide, making it difficult to impossible for people with diabetes to fill prescriptions needed to manage their condition.
But semaglutide comes with some troubling side effects that people might not have considered in their search for the perfect body, experts say.
These can range from nausea and vomiting to premature aging of the face, as well as heart problems.
The drug is a synthetic form of a naturally occurring gut hormone, Dr. Holly Lofton, an obesity medicine specialist with NYU Langone Health in New York City, told HealthDay Now.
“It goes to different areas of the brain and blocks hunger signals, it goes to your stomach and slows down the rate your stomach empties, and it hormonally helps your body be more sensitive to the insulin that you produce, thus helping your fat cells shrink,” Lofton explained.
Because of the way it works, semaglutide’s most commonly reported side effects involve the gastrointestinal system, Lofton said.
Those were the first that Clarke experienced.
Scary side effects, like a racing heartbeat
“You start out on a very low dose to have your body get used to it,” Clarke said. “You can get a lot of nausea, diarrhea, you can feel dizzy.”
When Clarke advanced to the therapeutic dose of semaglutide, she developed heart palpitations and tachycardia (racing heartbeat).
“It got to a point where it was like I could feel my heart beating out of my chest,” Clarke said. “It would wake me up in the middle of the night, and I was kind of panicking because I was like, this doesn’t feel right. It feels very scary.”
Clarke didn’t mention it, but other people who take semaglutide appear to develop what’s becoming known as “Ozempic face,” in which rapid weight loss causes a person’s face to look gaunt, saggy and prematurely aged.
“When you lose weight so acutely and quickly, you see more of a global facial wasting,” Dr. Paul Jarrod Frank, a New York City dermatologist, told NBC’s TODAY show.
"It’s not just a wrinkle we’re seeing in one area or a heaviness around the eyes,” Frank continued. “We’re seeing it in the temples, the jaw line, around the mouth, under the eyes."
Despite her side effects, Clarke stuck with Ozempic for about a year because the drug was very effective in controlling her diabetes and helping her lose weight.
Clarke dropped about 10 pounds within a month. By the time she decided to stop taking Ozempic a year later, she’d lost 35 pounds.
“It was really tempting to continue it because it's such an easy medication to take,” Clarke said. “It's once weekly, it's an injection, it does not hurt that badly at all, barely feels like a pinch.”
“I just felt like, I kind of want to continue this because I'm seeing really good results on it. But then for the flip side, it was like, even though I'm seeing these great results, I feel awful all the time,” Clarke added. “I don't feel good, I don't have any energy, I feel sick and nauseous. And that's not quality of life.”
Clarke was worried that she’d regain the weight she lost after she stopped taking Ozempic, but that wasn’t what happened.
“I actually ended up maintaining my weight for a little while and then even losing a little bit more. So total, I lost about 50 pounds,” Clarke said.
As demand exceeds supply, some with diabetes go without
Clarke has described the semaglutide shortages as “really frustrating” on her blog, particularly for people who need the drug to manage their diabetes.
Wegovy contains a higher dose of semaglutide, because that’s the dose needed to treat obesity as approved by the U.S. Food and Drug Administration.
Ever since Wegovy arrived on the market, manufacturer Novo Nordisk has struggled to meet demand, prompting off-label prescription of Ozempic for weight loss.
“There are people who are using it for weight loss for health purposes, and I think that is amazing,” Clarke said. “Especially with my own experience, I know how helpful it can be.”
But social media has spurred demand by promoting semaglutide as a miracle weight-loss drug, Lofton said.
Wegovy is meant to help people with weight problems so bad that the extra pounds are harming their health, but semaglutide is instead being used to help people achieve the “perfect body.”
Clarke noted an “Ozempic challenge” circulating on TikTok.
“It's people who are at a pretty normal weight,” Clarke said of the TikTok videos. “Maybe they have like 10 pounds that they want to lose because of some reason. From what I've seen, it's usually vanity purposes.”
“And so they’re using Ozempic, and I think that has a really big impact on people with diabetes because we’re not able to get the drug at this point,” Clarke said. “There are so many shortages, and there’s a lack of production for Ozempic with this increased demand because people are seeing that it works for weight loss very well.”
Lofton said that both uses of the drug are legitimate, and what’s really needed is for Novo Nordisk to resolve its production bottleneck and for insurers to cover semaglutide treatment.
Novo Nordisk has promised to resolve the semaglutide shortages within the first few months of 2023, Lofton said.
“We have about 40 million people with obesity/overweight, and we have about 11 million people in the U.S. With diabetes,” Lofton said.
“If the companies can't meet the demand — which I’m glad the demand is great and people know about these drugs — then we really need to reevaluate how these pharmaceutical companies are allowing us, as well as insurance companies are allowing us, to have access to these much-needed drugs for multiple conditions,” Lofton said.
The U.S. Food and Drug Administration has more on shortages of Wegovy and Ozempic.
SOURCES: Mila Clarke, blogger and activist; Holly Lofton, MD, obesity medicine specialist, NYU Langone Health, New York City
‘Ozempic Face’ Explained: Why It Happens And How To Fix It
ToplineSome users of the diabetes drug Ozempic who use the drug off-label for weight loss have reported “Ozempic face” as a side effect to their rapid weight loss, causing the facial skin to sag and making them appear older.
Woman looking in a mirror.
Universal Images Group via Getty Images Key Facts“Ozempic face” is a term used to describe the sagging, gaunt look of the facial skin due to the loss of facial fat following drastic weight loss.
The phrase was seemingly coined by a New York dermatologist who has encountered several patients who’ve had noticeable sagging in their faces following the use of Ozempic and similar weight loss medications, according to the New York Times.
Manufactured by Novo Nordisk, Ozempic (semaglutide) is a once-weekly injectable drug, which manages insulin levels—it’s approved for use in type two diabetics by the Food and Drug Administration.
Some doctors have prescribed Ozempic as an off-label weight loss drug for people with type two diabetes, according to Women’s Health.
Studies have shown Ozempic is an effective weight loss drug, with one study finding participants who took the drug saw a 14.9% decrease in body weight.
Big Number2.3 million. That’s how many times posts using #ozempicface have been viewed on TikTok, with hundreds of users either sharing their “Ozempic face” stories, or healthcare professionals providing insight into the phenomenon.
What Causes Ozempic FaceFat loss from the face is “very common with any weight loss,” Silvana Obici, chief of endocrinology and metabolism division at Stony Brook Medicine told Healthline. Massive weight loss can cause people to look older as a result of wrinkled, loose skin. According to a 2019 study, excess skin is linked to “massive weight loss.” However, fat loss while taking weight loss drugs like Ozempic happens across the body, not just in one area like the face. A study found it’s not possible to only reduce fat in specific areas of the body.
How To Combat ItThe American Academy of Dermatology Association recommends dermal fillers (also known as soft tissue filler) to fix the loss of fat and fullness in the face. There are five FDA approved forms of filler, and the sixth form is the use of self-donated body fat, which doesn’t require approval, according to the AADA. When injected into the face, the dermal fillers work to display a fuller, smoother appearance. The filler can be injected in areas such as the chin, cheeks and under eye area, according to the FDA. Possible risks from dermal filler include tenderness, pain, swelling, infection, necrosis (tissue death), a sore and allergic reaction. Rare risks include leakage of the filler, injury to the blood supply, migration and a severe allergic reaction. It’s recommended patients get tested for allergies prior to receiving fillers made from some material like animal-based material.
Other Side EffectsConstipation, diarrhea, nausea and stomach pain are among the most common side effects from Ozempic. More serious side effects include thyroid cancer and tumors. To diagnose this, Ozempic’s manufacturer Novo Nordisk recommends a patient should reach out to their primary care physician if they’re experiencing a lump or swelling in the neck, hoarseness, shortness of breath or trouble swallowing.
Further ReadingWhat To Know About Ozempic: The Diabetes Drug Becomes A Viral Weight Loss Hit (Elon Musk Boasts Using It) Creating A Shortage (Forbes)
Those Weight Loss Drugs May Do a Number on Your Face (New York Times)
What to know about ‘Ozempic face’ as some users claim popular diabetes drugs used for weight loss leave them looking gaunt (Good Morning America)
What To Know About 'Ozempic Face' As Some Users Claim Popular Diabetes Drugs Used For Weight Loss Leave Them Looking Gaunt
As the buzz has continued to grow over Ozempic and other new drugs targeted for Type 2 diabetes and obesity, some users are claiming a new side effect.
The term "Ozempic face" has been coined and used on social media to describe what some people say is an aged or gaunt look on the faces of people who use the medication.
The hashtag #Ozempicface delivers dozens of results on social media platforms like TikTok, and some dermatologists say they are seeing the phenomenon in their practices too.
"It's definitely a real thing and not just something that is on TikTok," Dr. Elizabeth Houshmand, a Dallas-based dermatologist who is also board-certified in internal medicine, told ABC News. "What patients come in complaining of is, you know, 'My face just looks really gaunt. I've lost a lot of volume in my face.'"
Houshmand said that in most cases, the patients who come to her seeking help for facial thinning have lost a significant amount of weight in a short time by using a semaglutide treatment, which in addition to Ozempic includes medications like Mounjaro and Wegovy.
Given as daily or weekly injections, these drugs, called GLP-1 RAs, help people produce insulin and lower the amount of sugar in the blood. They also work by slowing down movement of food through the stomach and curbing appetite, thereby causing weight loss.
Side effects of the drugs can include severe nausea and constipation.
"Patients are less hungry, eating significantly less, losing large amounts of weight in a very short time period," Houshmand said. "And that is why you see the gaunt look or the 'Ozempic face.'"
PHOTO: The diabetes medicine Ozempic in a pharmacy in The Netherlands, on Nov. 10, 2022. (Hollandse Hoogte/Shutterstock)
Houshmand said speeding up the process of weight loss -- particularly for people in their 30s, 40s and 50s, as most of her patients are -- can especially lead to a gaunt look.
She said the only way to regain a fuller look in the face naturally is to regain the weight, and even then the face won't look exactly the same due to skin laxity caused by rapid weight loss.
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"Fat in the face is a very good thing. When we're young and healthy, we have a good amount of volume [in our face] because of that subcutaneous fat," she said. "As we age, we lose bones, we lose fat normally, so if you're speeding that process up, it's gong to lead to an aged and hollow look."
The type of rapid weight loss that may cause a hollow look is not what is supposed to happen when using a semaglutide treatment, according to Dr. Caroline Apovian, co-director of the Weight Management and Wellness Center at Brigham and Women's Hospital in Boston, and a professor at Harvard Medical School.
She said there is nothing in the medications that would cause a person's face to hollow, noting that is a sign of losing weight too rapidly or in an unhealthy way.
"We start these drugs in very low doses and titrate up while while watching patients very carefully for nausea, for vomiting, for weight loss which is too rapid, which is over one to two pounds of weight on average per week," Apovian told ABC News. "We're not trying to get the patient to look better, even though they do. The use of these medications should be regulated to improving the health of the patient by loss of unhealthy adipose tissue."
MORE: What to know about Ozempic as demand for the drug leads to shortage
The U.S. Food and Drug Administration approved Ozempic in 2017 as a treatment for Type 2 diabetes alongside diet and exercise if other medications cannot control blood sugar levels well enough. Although Ozempic is not explicitly approved for chronic weight management, it can be prescribed off-label and used safely for people who are obese.
Wegovy is essentially the same injectable drug prescribed at a higher dosage. The FDA has specifically approved Wegovy for patients with severe obesity, or who are overweight and have one or more weight-associated conditions like high blood pressure or high cholesterol.
Mounjaro was approved by the FDA in May 2022 to treat Type 2 diabetes.
People who don't have diabetes or obesity can still be prescribed the drugs "off-label" but they may have to pay out of pocket, which could cost $800 to $1,400 for a one-month supply.
PHOTO: FILE - A man prepares Semaglutide Ozempic injection to control blood sugar levels (Imyskin/Getty Images/iStockphoto, FILE)
As people have documented their weight loss success using the drugs, their popularity has grown, possibly contributing to some shortages for people who are prescribed them for Type 2 diabetes or obesity.
Apovian said people who are experiencing so-called "Ozempic" face are most likely using the drug off-label.
"That's what happens when you don't have obesity and you use these medications to lose weight rapidly, which you do," she said. "You get fat loss in your face, especially if you don't exercise and don't eat well. You're not going to look healthy just losing weight rapidly."
Apovian said she sees the use of the term "Ozempic face" as a continuation of the fat stigma that has perpetuated American culture for decades.
"It's not one of the side effects of Ozempic so it's erroneous to say that it's 'Ozempic face.' I hate to even use the term," she said, adding of people who do, "They're trivializing the medication and the disease that it's for."
MORE: With growing popularity of new weight loss drugs, doctors emphasize potential risks
On TikTok, some users of the drugs shared a similar concern, noting that after being shamed for being overweight, they now felt stigmatized for taking a medication.
"Sure enough, they have found another way to beat us down," a woman who identifies herself as a Mounjaro user said in a video shared on TikTok. "It's pretty sad that we've had to deal with being bashed because we're obese but now that we're doing something to reclaim our health, to find some way to come after us and still be able to beat us down."
Apovian said she worries that the stigma around weight combined with the "cavalier" way drugs like Ozempic are used off-label could prevent them helping people who could medically benefit.
"This is the problem when people use drugs that are meant for serious illness in a casual manner like this," Apovian said. "It's really upsetting to those of us who really treat people with serious illnesses like obesity and diabetes and heart disease to see our our important medications that are really saving lives used in this manner."
What to know about 'Ozempic face' as some users claim popular diabetes drugs used for weight loss leave them looking gaunt originally appeared on goodmorningamerica.Com
