Rolling Out the Red Carpet for Ozempic

Losing weight is hard. It often takes many months of commitment to diet and exercise to see results. Many of us are already spread thin in our daily lives, so these lifestyle changes can feel like a second job; we usually give up on our diets after 3-5 weeks. Even with consistent effort, some people cannot manage to shed pounds.

The advent of Ozempic, Wegovy, Mounjaro, and Rybelsus, among other drugs, has reshaped the landscape of weight loss. These drugs increase insulin release and lower glucagon production, lowering users’ blood glucose levels. They were originally prescribed for type 2 diabetes, with appetite suppression and, therefore rapid weight loss, as an expected side effect. But soon, the popularity of these newer anti-diabetic medications eclipsed older appetite suppressants, as Ozempic and Wegovy were approved for weight management in adults with obesity.

As this new class of drugs hit the market, many celebrities have simultaneously displayed extreme body transformations. This trend kicked off with Kim Kardashian allegedly losing 16 pounds in 3 weeks to fit into a dress previously worn by Marilyn Monroe. Celebrities like Kim and Khloe Kardashian, Kylie Jenner, and Jessica Simpson are setting a trend of extreme thinness reminiscent of the “heroin chic” aesthetic of the 1990s.

With news outlets and TikTok creators highlighting celebrities’ use of medications for weight loss, the public is now clamoring for these drugs. Many need them to treat their diabetes or health-impairing obesity; others are using them off-label to shed a few pounds. Now, this drug class is experiencing a shortage. Though it is a myth that cosmetic drug use is fully responsible for the shortage, diabetics who need these drugs are struggling to fill their prescriptions.

Changing body image trends have likely led people without diabetes to ask for unnecessary medications and for doctors to liberally prescribe them.

Following their popularization, this drug class is becoming more commonly prescribed to adolescents and young adults. Joyce M. Lee and colleagues tracked trends in prescriptions of anti-diabetic drugs in adolescents and young adults. They used data from the IQVIA Longitudinal Prescription database, which tracks retail pharmacy prescription sales.

From 2020 to 2023, sales of anti-diabetic drugs prescribed to adolescents ages 12 to 17 increased by over seven times. Prescriptions were over nine times higher among young adults ages 18 to 25. As of 2023, Ozempic was the most commonly prescribed drug in its class.

Since 38% of U.S. drug prescriptions are off-label, the authors note that many of the prescription sales among young people may not be for individuals with diabetes or obesity, but rather for mild overweight or for cosmetic purposes. Changing body image trends have likely led people without diabetes to ask for unnecessary medications and for doctors to liberally prescribe them.

Young women were more likely to be prescribed these newer anti-diabetic medications than men, despite the drugs’ effects on the female reproductive system not being well understood. Further research must be done to safely prescribe this class of weight-loss drug to young women.

Weight loss remains a challenge for the average person. Ozempic and other medications are marketed as a powerful quick fix. As a result of this allure, many people with diabetes are struggling to access these medications. As the discourse surrounding Ozempic and similar drugs continues, critical examination of diet and body trends will be essential in promoting balanced approaches to weight management and drug prescriptions.