Shortages of weight loss and diabetes drug Ozempic are expected to last until mid-2024 as demand continues to rise, despite the drug being put under review over mental health concerns.
Semaglutide – sold under the names Ozempic and Wegovy – was initially introduced because it helps people with type 2 diabetes to manage their blood glucose levels, but has been touted by celebrities and social media influencers as a “miracle drug” for weight loss.
Wegovy is licensed as a weight-loss treatment, but as its NHS roll-out has been delayed, more people wanting to lose weight quickly are turning “off label” to Ozempic, which is only licensed for type 2 diabetes.
The scramble to get access to Ozempic is leading many to private firms – with Better Health Group’s Weight Loss Clinic receiving 50 inquiries per day – and the drug now has an “infinite” waiting list, according to professor Rishi Singhal, the group’s medical director.
Ozempic and Saxenda are among the drugs being reviewed by the Medicines and Healthcare products Regulatory Agency (MHRA) after reports of suspected adverse reactions in patients.
The popular weight-loss treatments – which belong to a class of drugs known as GLP-1 receptor agonists sold by Danish multinational pharmaceutical company Novo Nordisk – are under review by the MHRA after concerns were raised that they could be causing suicidal thoughts and inducing self-harm.
Ozempic, made by Novo Nordisk, was approved for weight loss in 2021 and is sold in the UK under the brand name Wegovy. A planned rollout of Wegovy in the UK this year, following its approval for use for weight loss on the NHS was delayed following concerns about supply.
Dr Suhail Hussain, a private GP and home-visiting doctor in Hertfordshire and Greater London, said the jabs are not a silver bullet and called them a “money-making machine” for pharmaceutical companies.
The National Institute for Health and Care Excellence recommends that drugs containing semaglutide should be used for a maximum of two years to control weight.
The MHRA said in its statement that though Ozempic was not approved for weight loss, “it is commonly used off-label for that purpose” in Britain.
But Dr Hussain said patients would need to be on weight loss drugs “forever” to keep the weight off as “there is no such thing as a magic bullet”.
At present, Ozempic cannot be prescribed at NHS weight management centres, but it can be prescribed for weight loss in private settings.
Dr Hussain does not prescribe the drug despite having at least one client asking for the drug per week for the past two months.
He told i the interventions have “varied results” and that patients “end up putting on” a substantial amount of weight when they stop taking the drugs. Trial data suggests patients who stop taking the drug are likely to regain between half and two-thirds of the weight they lost.
He said Ozempic can cause nausea and vomiting, as well as mental health side effects “due to the close relation of the microbiome to overall wellbeing”.
This can include stress, depression and anxiety and – in severe cases – the drug “may increase suicidal tendencies in those who are prone to such thoughts”, he added.
Dr Hussain expressed concern over an “unhealthy relationship” between pharmaceutical companies and the medical industry, with doctors prescribing “a pill for every ill”.
Despite health concerns, Ozempic has risen in popularity over the last year, leading to ongoing shortages.
The Association of Independent Multiple Pharmacies said the drug is currently out of stock and likely to be in “short supply” until mid-2024.
Layla Hannbeck said it is an “effective” medication for managing diabetes but there have been shortages due to “high global demand” of Ozempic as a weight-loss treatment.
The shortage has been compounded by the delay to Wegovy, which was due to launch in the UK in May.
Professor Singhal, said he has an “infinite” waiting list for Ozempic with its boom of popularity over the past six months – but the drug is not currently available.
The private clinic gets around 50 enquiries per day and has treated up to 700 people over the past two years
Professor Singhal said no patients have reported suicidal thoughts due to being on Ozempic, but some patients who wish to lose weight have a “low mood anyway”.
“Patients complain of low mood a lot of the time, but that doesn’t equate to suicidal ideation,” he said.
He said obesity patients should be allowed to take weight-loss drugs “for the rest of their life” as the condition is a disease – not dissimilar to blood pressure, high cholesterol or type 2 diabetes.
“It requires you to be overweight to understand what the plight of these patients is,” he said, adding that it offers them “hope”.
He continued that medicines for conditions like diabetes and blood pressure are meant for life, so asked: “Why shouldn’t the medicine for obesity be lifelong?”
“Lifestyle changes are important everywhere. That doesn’t mean that we should stop treating the disease,” he said.
Novo Nordisk said patient safety is its “top priority” and all reports about adverse events are taken “very seriously”.
A company spokesperson said: “GLP-1 receptor agonists have been used to treat type 2 diabetes for more than 15 years and for treatment of obesity for eight years, including Novo Nordisk products such as semaglutide and liraglutide that have been in the UK market since 2018 and 2009, respectively.
“The safety data collected from large clinical trial programmes and post-marketing surveillance have not demonstrated a causal association between semaglutide or liraglutide and suicidal and self-harming thoughts. Novo Nordisk is continuously performing surveillance of the data from ongoing clinical trials and real-world use of its products and collaborates closely with the authorities to ensure patient safety and adequate information to healthcare professionals.
“Novo Nordisk received a request 24 July from MHRA requesting a review of suicidal and self-injurious ideation cases for GLP-1 receptor agonists, with reference to the EU Pharmacovigilance Risk Assessment Committee’s request dated 7 July, 2023. The review is ongoing and a response will be provided within the requested timelines.”
They added that weight gain is likely once patients stop taking Wegovy but clinical experts view obesity as “a chronic disease that should be managed similar to other long-term health conditions such as diabetes and hypertension”.
Dr Alison Cave, MHRA chief safety officer, said: “Patient safety is our top priority. We are currently reviewing safety data on the risk of suicidal thoughts and thoughts of self-harm associated with medicines known as GLP-1 receptor agonists, used for treating both type 2 diabetes and weight loss.
“We will carefully consider all available evidence and communicate any further advice to patients and healthcare professionals as appropriate.
“If you are experiencing suicidal thoughts or thoughts of self-harm, please seek immediate medical assistance. We ask everyone to report any suspected side effects using our yellow card scheme website.”
A Department for Health and Social Care spokesperson said: “The next generation of obesity drugs have the potential to help patients lose significant amounts of weight, helping reduce pressure on the NHS and cut waiting times – one of the Government’s five priorities.
“But it’s vital they’re used alongside diet, physical activity, and wider behavioural support to help minimise weight regain.
“We’re implementing food labelling guidelines to help people make healthier choices when eating out. People can also improve their health with the NHS Weight Loss app, Food Scanner app, Couch to 5K, Active 10 and the Better Health Website – all of which are free.”