As a doctor, I know why Ozempic and other weight loss drugs are so controversial

One size doesn’t fit all when it comes to health

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I tried my first weight loss program at fourteen; a short, rigorous affair. My exercise regimen involved skipping and sit-ups with a diet mostly comprised of orange juice and eggs. Six weeks later, the results were in. I had lost enough weight to get admiration from my classmates,  escape fat-shaming, and begin a lifelong battle with the scale.

Today, I am a medical doctor and, obviously, all those lost pounds have been regained. I do my best to manage my weight, but it hasn’t been easy. The idea of a weight loss drug that would instantly make me thinner drew me like candlelight calls a giddy moth. But the allure was short-lived. A deep dive into the science, economics, history and ethics of taking weight loss drugs made the idea absolutely revolting.

We are in the middle of a global obesity crisis. Humans weigh more today than we ever have. Over four in ten adults in the United States are classified as obese. The situation isn’t different for most of the world; globally, obesity has tripled since 1975, and over one billion people are affected, with numbers rapidly increasing.

In June 2013, doctors classified obesity as a disease. In addition to health reasons, many obese people may want to lose weight to escape discrimination, shaming, and body image problems. All of these personal battles and struggles help drive the burgeoning billion-dollar global weight loss industry. There’s always money to be made when people want things badly.

So, when new “weight loss drugs” become available, they are often an instant hit. TikTok trends, online providers, celebrity endorsements, and lax restrictions help to fuel an unprecedented surge in demand. But it makes me wonder, at what cost?

Ozempic, a brand name for semaglutide, is a drug used to help treat diabetes that has recently been popularized by social media and celebrity usage for weight loss. A study found that semaglutide could be safely taken for 68 weeks. However, questions remain around the long-term impact of the medicine as a weight-loss tool. The most common side effects of the drug are nausea and diarrhea, but others listed include inflamed pancreas, vision changes, kidney failure, and allergic reactions, with the possible side effects still being observed.

Another study showed that once people stopped taking semaglutide, they gained all lost weight within a year – faster than they had lost it. They also lost any gains they made in heart or metabolism function. In other words, they only work for weight loss if you keep taking them.

The deluge of people seeking these drugs for weight loss has also limited their availability for people with diabetes.

Taking drugs like this without medical consultation is an enormous personal gamble without a safety net. You are betting that this drug will be safe, affordable, and available for your lifetime, give you no side effects and you will stay motivated to inject yourself every week throughout the period.

History shows some weight loss drugs can do more harm than good. In the 1800s, a thyroid hormone extract was tried but abandoned when it was found to cause hyperthyroidism. In the 1940s, amphetamine was proposed to treat obesity but was discarded when it caused addiction. The 1960s saw the rise of Rainbow pills containing amphetamine, diuretics, and digitalis; several people died. Fen-phen was removed from the market when it was found to damage heart valves in 1997. From 2008 to 2010, other weight loss drugs were withdrawn from the market for causing liver damage, suicidal thoughts, and an increased risk of heart disease.

Managing weight is a lifelong process. One size doesn’t fit all and there are no magic codes, silver bullets, or AI solutions. However, I can advise that you only consider these medications if you meet the criteria, see a qualified doctor and have a long-term plan to manage your weight. And if, like me, you won’t be getting the latest drug touted online as a weight loss solution, but still want to strike towards a healthy weight, I say be kind to yourself, and don’t lose hope or confidence. Let’s continue to study ways to help our bodies get the right nutrients and the exercise needed for a healthy life. Let’s make sleep, self-care, screenings, and personalized goals a priority. Get help from professionals where possible, and let’s avoid risky, costly, futile gimmicks destined to fail.