Ozempic: Cypriots shed kilos with weight-loss drug

But diabetics – its intended target – can barely get it

The global frenzy over a new weight-loss drug has, unsurprisingly, hit Cyprus too – with the added complication that we don’t yet have access to the drug itself, but only its equivalent aimed at Type 2 diabetes.

The active agent is a medication called semaglutide, which “mimics the GLP-1 hormone that is released in the gastrointestinal tract in response to eating,” to quote the FDA website in the US. Semaglutide is the basis both for Ozempic, a drug designed for diabetics, and Wegovy, for general weight loss.

Wegovy was due to be launched in Cyprus in June, but global demand – fuelled by celebrities who’ve lost weight on the drug – has exceeded supply so dramatically that the company behind it has postponed any expansion to new countries.

The unintended consequence is that people who want to lose weight use Ozempic instead, making it inaccessible to those for whom it was originally intended.

“Yes, it’s being used by people who don’t have diabetes,” Dr Iosif Kasios, a pathologist and member of the National Committee on Diabetes, told the Cyprus Mail. “It’s being used quite widely. Yes, they lose weight, most of them. In some cases the weight loss is spectacular, in others less so.”

Dr Kasios notes that his diabetic patients are often unable to find the drug: “It’s a daily problem”. Nonetheless, he adds, it’s a free market and the state is unable to intervene – especially since Ozempic isn’t available on Gesy.

“There’s nothing we can do,” confirms Antonakis Mavrides, general secretary of the Cyprus Diabetic Association. The only question is “whether Gesy could buy some quantities and sell them on” – but that’s unlikely, and in any case diabetics do have other options. “They’re not going to die if they don’t get Ozempic.”

Then again, overweight individuals have other options too – namely, to go on a diet.

Admittedly, some may be morbidly obese due to a medical condition. But it doesn’t seem like those taking the drug belong exclusively – or even mostly – in that category.

Anna (not her real name) is a non-diabetic 47-year-old who took Ozempic as an “easy solution” to lose weight. She lost 10 kilos, going from 75 to 65. She may have been overweight, even technically obese in terms of BMI – but still, that’s not the kind of weight to suggest a serious health issue.

The price tag – around €120 per month for the lower dose, €150 for the higher, 1mg dose – doesn’t seem to be dissuading people, either. “The strange thing,” notes Dr Kasios dryly, “is that, when we were recommending this medicine for diabetes, the price was considered prohibitive. Now, strangely enough, when it means you’re going to lose weight, the price is no longer prohibitive.”

Nicosia pharmacist Vera Christoforou told the Cyprus Mail that she fills around 10 prescriptions every month for Ozempic. (It’s a monthly prescription with four injections, one per week.) Most of those taking the drug are women, and almost all take it for weight loss; “Very few have a health problem, like insulin resistance”.

One significant detail, says Christoforou, is that customers tend to get hooked on the drug – whether because it’s such an easy fix or because, inevitably, the kilos start piling up again once you go off it:

“Even though they start off saying, okay, I’ll just do a couple of months, lose some weight and then that’s it, what you see is that they continue and continue – because they want to stay at that weight, or maybe lose a bit more… I don’t know how good that is in the long term.”

Speaking personally, Christoforou is worried by the Ozempic craze. “I wouldn’t use it myself,” she says. “You’re not letting your body work naturally, you’re getting in the way. Right now everything seems fine, it’s passed all the tests, it’s been approved by the FDA in the States. But – well, you know, medicines take a while to show their effects.”

This raises another question altogether, whether the drug is safe.

Life-threatening (but rare) complications like acute pancreatitis and thyroid cancer are certainly possible. Doctors seem to agree, however, that – so far at least – side effects are generally minor, and in any case well-known.

Most are gastrointestinal, like diarrhea or stomach pains. Christoforou says some customers have complained of nausea. Anna reports nausea and fatigue that lasted for about three days after some doses – and indeed she sometimes skipped a week due to side effects, taking the eight injections over three months instead of two.

Some may wonder if a drug designed for diabetics should be taken by non-diabetics at all. What semaglutide does, after all, is essentially fool the pancreas into producing more insulin, by mimicking the GLP-1 hormone – a needless ruse if you’re already producing enough insulin.

Both Dr Kasios and Dr Costas Toufexis (an endocrinologist at the Hippocrateon private hospital in Nicosia) agree, however, that this is done in “a controlled manner”, and won’t push a healthy person’s sugar down into hypoglycemia.

If anything, being healthy allows for greater tolerance. It’s significant that Wegovy, the drug for general weight loss, has been approved in the US at much higher doses than Ozempic, the drug for diabetics. It should be available – once it finally arrives in Cyprus – at 2.4mg, instead of the current maximum 1mg.

All that said, cautions Dr Toufexis, taking either drug is “certainly a stress on the pancreas”, and not recommended for anyone with a history of pancreatitis.

The history of weight-loss drugs is one of early promise and eventual failure. This new candidate looks more promising – but it does beg the question whether it’s worth the hassle, except in the case of obesity caused by a medical condition.

Not only do we seem to be walking into a future where everything is medicated – one drug to lose weight, another to be happy – and the choices we make about our own bodies become less important, but weight loss is the rare conundrum where an individual can make a simple and effective choice: namely, to eat less. They just have to stick to it.

As Dr Kasios puts it: “There are many ways to lose weight. For me, the simplest way is to keep your mouth shut”.