Do It Yourself Baukästen Set

Reminder: Semaglutide Is Not DIY Weight Loss

In case you haven’t been paying attention, FDA issued a new label warning for semaglutide that should remind everyone of a key fact – it’s not suitable for DIY weight loss. The warning went onto the label for the Ozempic brand of semaglutide. It is already there for the Wegovy brand and for the Mounjaro brand of tirzepatide.

The warning is for an adverse event called ileus. This happens when the movement of digested food through the intestines slows down so much that a blockage occurs.

A Direct Consequence of These Medicines

The way these drugs work is complicated and, indeed, somewhat mysterious. But one thing has been clear all along. They do work by slowing down the emptying of food from the stomach into the intestines. And thus, they do in general slow the movement of food through the entire digestive system.

This is helpful because it helps our gut do a better job of signaling to the brain that we’ve had enough to eat. We’re full. But too much slowing is a problem. The mild version of this is constipation. At the extreme, we have ileus, where everything stops.

A good doctor who prescribes these drugs knows this. They will monitor carefully and take the dose up to the right level slowly to guard against such problems.

The DIY Impulse

From the sensational reporting about Ozempic, Wegovy, and Mounjaro use for weight loss, one might think these drugs are for some kind of DIY weight loss project. But this is a mistake. They are prescription drugs because they require careful monitoring. The research on their use for people with obesity is not focused on short-term weight loss. Rather, it is for ongoing management of the chronic disease of obesity.

Caroline Apovian is an obesity medicine physician and a professor of medicine at Harvard. She tells us this is a reminder that use of these drugs requires careful monitoring:

“Patients can easily become constipated and it can progress. If you don’t do something, it can become life-threatening. So it makes no sense to hand out prescriptions for these medicines without good patient education and careful follow-up.”

Slowly, the world is waking up to the fact that the answer to obesity is not DIY weight loss. But that outlook is not disappearing fast enough. And if people keep looking at semaglutide and other obesity medicines through the faulty lens of DIY weight loss, they will bring themselves some serious trouble.

Click here, here, and here for more on the change to the Ozempic label.

Do It Yourself Baukästen Set, image by Alfio Giuffrida, licensed under CC BY-SA 3.0

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September 29, 2023