The dangers of the Ozempic craze

Ozempic, a purported miracle cure for weight loss, is in short supply after taking the world by storm in recent months. Here's everything you need to know:

What is Ozempic?

Ozempic is a semaglutide-based medication that, while meant to treat Type 2 diabetes, has more recently inspired "off-label" use as a weight-loss drug among the rich and famous. In addition to lowering blood sugar levels and regulating insulin — which is "crucial" for Type 2 diabetics, The New York Times notes — Ozempic imitates a naturally-produced hormone that limits appetite by "signaling to our bodies that we feel full and prompting our stomachs to empty more slowly." Food that was once exciting becomes boring, and the pounds subsequently fall off.

Though the U.S. Food and Drug Administration has not officially cleared Ozempic for weight loss, it has approved a similar drug known as Wegovy for adults struggling with obesity or at least one weight-related condition, like high blood pressure, the Times reports. Without insurance, Wegovy (which has the same active ingredient as Ozempic), can cost over $1,300 for a 28-day supply, while Ozempic can cost about $892 for roughly the same amount. While most insurance plans won't cover Wegovy, most will pay for Ozempic, since it's technically a diabetes treatment (and weight loss is an "off-label" use).

Why is there a shortage?

The spotlight on Ozempic as a weight loss tool has led to a run on prescriptions, consequently siphoning valuable medication away from diabetics who need it. Hollywood celebrities are, at least anecdotally, some of the worst offenders here. "Once you know it exists, you start to see Ozempic everywhere," one source told Vanity Fair's Emily Jane Fox of La La Land's injection habits. And TikTok isn't helping either — the hashtags #Ozempic and #OzempicChallenge have more than 400 million views combined.

The resulting word-of-mouth fueled demand has been more than Novo Nordisk — the company that manufactures both drugs — could anticipate. That, coupled with skyrocketing usage and supply chain issues, has hindered the stock of both medicines. And of course, there is also the insurance factor — most health plans will cover Ozempic as a diabetes medication, but won't cover Wegovy, making the former a more enticing alternative for the average joe looking to drop a few pounds.

In Hollywood at least, much of that conversation is happening via telemedicine, Jane Fox says in Vanity Fair. "Several people I spoke with told me that they've heard of people lying about their weight on video chats with doctors in order to get the prescription (the party line is that your body mass index has to indicate that you are obese)." But regular people are still contributing to the problem, too. "It's the most common medication that I get asked about," Dr. Sudeep Singh told The Cut. "Everybody knows. Everyone's asking about it. My mom's asking. My neighbors are asking about it. The news is out."

Which celebrities are using it?

It's hard to get a straight answer out of anyone (save for Elon Musk, who openly attributed his physique to Wegovy) — but there are rumors. Some say Kim Kardashian was taking Ozempic to fit into her Marilyn Monroe dress at the 2022 Met Gala. Actress and producer Mindy Kaling has been accused of hosting "Ozempic parties," where she and friends allegedly gather to inject themselves together. And comedian Chelsea Handler has revealed she was briefly on the drug, albeit unknowingly. "My anti-aging doctor just hands it out to anybody," Handler said recently on an episode of the podcast, Call Her Daddy. "I didn't even know I was on it." (Handler claims she no longer takes Ozempic).

Regardless, Andy Cohen, host of Bravo's Watch What Happens Live, thinks it's pretty obvious something's up, even if celebs aren't being forthcoming about it. "Everyone is suddenly showing up 25 pounds lighter," he tweeted in September. "What happens when they stop taking #Ozempic?"

So why exactly are people mad?

Diabetics and those who use Ozempic for reasons other than weight loss are worried that interest in the drug is fueling shortages at risk to their health. "The Hollywood trend is concerning," Dr. Caroline Apovia, co-director of the Center for Weight Management and Wellness at the Brigham and Women's Hospital in Boston, told People in October. "We're not talking about stars who need to lose 10 pounds. We're talking about people who are dying of obesity, are going to die of obesity."

"You're taking away from patients with diabetes," she continued. "We have lifesaving drugs … and the United States public that really needs these drugs can't get them."

"Hopefully this trend will stop," added actor Anthony Anderson, who takes Ozempic to treat his Type 2 diabetes. "[I]t's creating a shortage for those of us who need the medicine that we need and not for weight loss issues, but for our health."

Are there any other side effects?

Aside from the weight loss, which is technically already a side effect, Ozempic users have described feelings of nausea, fatigue, and dehydration, as well as changes to their bowel movements, severe vomiting, and heart-rate spikes. Even weirder, the drug has also been linked to facial aging and sagging, a side effect that has inspired the rise of a new term: "Ozempic face."

"I see it every day in my office," New York dermatologist Jarrod Frank told the Times. "A 50-year-old patient will come in, and suddenly, she's super-skinny and needs filler, which she never needed before. I look at her and say, 'How long have you been on Ozempic?' And I'm right 100 percent of the time. It's the drug of choice these days for the 1 percent." That said, it's not Ozempic that's causing the drooping, Dr. Sophie Shotter told British Vogue. Rather, it's the speed at which patients are shedding pounds. "With rapid weight loss, the skin struggles to 'shrink' around your new shape, which means there can be excess facial skin that feels more lax and pinchable," Shotter said.

What happens when you stop using Ozempic?

Many people gain back the weight they lost, oftentimes because their appetite returns at or above pre-medication levels. "When you're at that max weight loss, your body's hunger hormones are the highest," Dr. Holly Lofton of NYU Langone Health told NBC News. "So if you lose 50 pounds and regain 25, your hunger is the highest when you've lost the 50. And even when you regain the 25, it doesn't go back to baseline; your hunger is higher than prior to losing weight."

Take TikTok influencer and model Remi Bader, for example, who began taking Ozempic to treat prediabetes but gained "double the weight back" when she stopped. "I saw a doctor and they were like, 'It's 100 percent because you went on Ozempic,'" Bader said on an episode of the podcast, Not Skinny But Not Fat. "It was making me think I wasn't hungry for so long. I lost some weight. I didn't wanna be obsessed with being on it long-term. I was like, I bet the second I got off I'm gonna get starving again. I did, and my bingeing got so much worse. So then I kind of blamed Ozempic."

Is there a broader takeaway from this craze?

In some ways, both Wegovy and Ozempic (as well as the class of medicines in which they belong) "have become a lightning rod in an obesity conversation that is increasingly binary — swinging between fat acceptance and fatphobia," Julia Belluz writes for Vox. For instance, is it wrong to medicalize obesity in the age of self-love? Or do drugs like Wegovy and Ozempic afford overweight and obese individuals a rare chance to regain control of their bodies and their relationship with food?

Of course, the answer to those questions depends on who you ask, and likely won't be decided any time soon. For many medical professionals, the benefits of weight loss and the risks of weight gain are impossible to ignore, even when fatphobia is taken into account. But to others, like journalist Evette Dione, promoting weight loss as an obese person's only real option is indicative of the broader problem in society. "It is objectively a good move to unlink the idea of moral virtue from fatness," Dione wrote recently for BuzzFeed. "However, in these attempts to complicate our cultural understanding of fatness, the remedy remains the same: lose weight rather than changing the ways in which our society interacts with and treats fat people."

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