It came to treat diabetes and it has become such a sought-after medicine that it has been exhausted at times. Because? Because it helps to lose weight in a, let’s say, painless way. “Ozempic” is the trade name of an injectable drug – with “semaglutide” as its active ingredient – that some describe as “revolutionary”: it reduces blood sugar levels and regulates insulin, as expected; but, in addition, it has demonstrated cardiovascular protection; and, by suppressing the appetite, it facilitates the loss of kilos. Of course, nothing is perfect: food is no longer a pleasure and the rebound effect, once you stop taking it, can be very considerable.
What is happening in Asturias? As the Asturian Pharmaceutical Cooperative (Cofas) has indicated to this newspaper, the new antidiabetic treatments “have been gaining market share since their launch, in 2021, and they are expected to continue growing in 2023.” Cofas points out that “during the last months of 2022 there were supply problems that led to changes in the prescription towards the oral presentations available at that time.” However, he adds, “at this time the supply is correct.”
But this family of drugs is going to grow in the near future. In Asturias, he is carrying out trials with another member of this family, “tirzepatide”, in patients with both obesity and diabetes in whom “loss of 20 or 30 kilos is being obtained in two or three months, and without side effects,” says Elias Delgado Alvarezprincipal investigator of the Endocrinology, Nutrition, Diabetes and Obesity Research Group (ENDO Group).
Some celebrities, like the tycoon Elon Muskthe head of Twitter, triggered demand for these drugs by publicizing the “secret” of their diet: “Fasting, Ozempic and away from appetizing food.”
As stated, the active substance in Ozempic is semaglutide, which mimics a hormone called glucagon-like ‘peptide-1’ that we produce naturally in the intestines. Consequently, it limits appetite by signaling to the body that we feel full and makes the stomach empty more slowly.
It is estimated that in Spain there are about 5 million patients with type 2 diabetes, 14 percent of the adult population. . In Asturias, around 90,000. But overweight and obese people there are many more.
Elías Delgado, in turn head of the Diabetes section of the Endocrinology service of the Central University Hospital of Asturias (HUCA), guides the question around Ozempic: “In people with diabetes we have been using it for years. It achieves significant improvements in its glycemic control, cardiovascular protection and weight loss unthinkable until now.In addition, it is already approved in the United States, by the FDA, and in Europe, by the EMA (European Medicines Agency), for people with obesity.In Spain it is studying whether it is financed by public health”.
The Ozempic itself is subsidized by the National Health System to treat diabetes. With a prescription, four doses cost these patients 4.24 euros per month. The protocol for use is one weekly injection, much more bearable than its predecessor, “Saxenda”, which involved a daily injection and, furthermore, led to less weight loss.
However, when it is purchased without a public prescription its price shoots up to 128.15 euros per month. What is currently under debate is whether its price is also reduced to treat obesity in non-diabetics. Dr. Delgado predicts that the decision will be negative: “My prediction is no. Talking about obesity is talking about ten million Spaniards or more. And the cost of that is enormous.”
However, adds the HUCA specialist, Ozempic already has “the medical seal” from the regulatory agencies to use it against obesity. In other words: it is not a dangerous medicine. “Obesity is a disease that opens the door to many other pathologies. It is clear that it is better to prevent the disease than to treat it”, points out the expert.
Analyzing pros and cons, Elías Delgado opts for an intermediate route: “I understand that public financing should be limited to a segment of obese people with more seriousness or with a greater risk of suffering diseases.”
At the present time, what is happening in some cases is that the portion of the population that has resources and wants to reach the summer with their homework done to show off their thinness goes to the pharmacy, pays for the injections and causes shortages for those who need them most: people with diabetes.
However, points out the head of Diabetes at HUCA, it is not convenient to act cheerfully and without medical supervision: “No one should self-medicate lightly. These drugs have their indications, their contraindications and their side effects”. On the other hand, the specialist indicates that the most appropriate strategy to lose weight should not be limited to Ozempic injections, but rather frame this treatment in a broader framework that includes other healthy and complementary lifestyle habits, such as exercising more and following a diet. , if what you want is to reap a balanced result in the long term.
The nutritionist’s perspective is provided by the Oviedo Susana Sanchez: “As nutritionists, we understand that drugs are being sought to deal with the obesity pandemic, a serious problem today. However, we will continue to insist that what is really important is to change our daily habits: follow a Mediterranean diet pattern, avoid a sedentary lifestyle, limit alcohol consumption and take care of sleep hygiene”.
The Asturian expert adds that it is common to consider some drugs as “a miracle product”, when “the reality is that if the person does not change their lifestyle, what will happen is that, when they stop taking the medication, they will suffer a rebound effect and return to recover what you have managed to lose by consuming fewer calories.
Consequently, Susana Sánchez emphasizes that “it is more effective to invest money in a balanced and individualized diet (so as not to be hungry), increase exercise and learn to manage the stress that leads us to eat more and worse”.