Using diabetes, obesity drugs for weight loss comes with risk

The weight loss craze is on.

Injectable weight loss medications like Wegovy, Ozempic and Mounjaro are the new go-to for many Floridians displaying on social media platforms the large amounts of pounds they shed. Hyped by celebrities like Charles Barkley, Elon Musk and Amy Schumer,  these drugs — intended for diabetes and obesity —  quickly have become game changers for people struggling for years to slim down.

With demand high, the cost and shortages of these drugs have created a frenzy in Florida: Clinics are selling off-brand versions, Latin Americans are importing them from their home countries, and social media groups are forming to share information on low-cost suppliers.

Florida doctors say patients think they can use drugs like Wegovy to lose some weight and then stop taking them. It’s not that simple, doctors say. There’s a lot to know about how they work, the current off-brand use, and the risks.

“In the fight against obesity, in 2023 we now have medication that works. It’s a great development,” said Dr. Raul Rosenthal, a bariatric surgeon at Cleveland Clinic Florida. “However, nothing is perfect.”

How these medications work

Wegovy and Ozempic are made by Novo Nordisk and are different doses of the same drug, semaglutide. It works by slowing down movement of food through the stomach and curbing appetite, which has the bottom-line effect of causing weight loss.

After clinical trials, the Food and Drug Administration approved Ozempic for Type 2 diabetes and Wegovy for obesity. Both now are being given off-label for weight loss, and need to be injected under the skin once a week to work. Rybelsus, also made by Novo Nordisk, is essentially Ozempic in pill form with the same active ingredient, semaglutide

Mounjaro, known generically as tirzepatide, has joined this drug class. It technically is FDA-approved to treat type-2 diabetes, like Ozempic, and uses the same mechanism to suppress the appetite, but it also has an ingredient that causes an added weight-loss effect.

Some doctors believe the demand for Mounjaro soon could surpass other weight-loss injectables. Wegovy has been shown to help people lose up to 15% of their body weight. At certain doses, Mounjaro has been shown to be able to induce a loss of 21% of body weight, results almost as significant as that of bariatric surgery.

Rosenthal at Cleveland Clinic Florida said the rapid weight loss mostly likely will happen only during the initial start-up.

“I would say after a period of time, about three to four months, your weight loss will plateau,” Rosenthal said. “You will probably take the injections less frequently, just for maintenance.”

Ozempic boxes
Floridians are using Ozempic and Wegovy to lose weight fast. (Photo illustration by Mario Tama/Getty Images)

Where to get the drugs

To get these injectable weight-loss drugs, you need a healthcare provider to write a prescription. You can fill it at your local pharmacy or through an online pharmacy. However, demand for these drugs has soared over the last year, to the point that they are in short supply in some areas of the state.

In addition to supply issues, cost is a factor. These medications are pricy, and because they aren’t approved for weight loss in the way most people are using them, insurance doesn’t cover them.

Thus, a secondary market has cropped up of doctors and nurse practitioners who will prescribe these medications over the phone. In addition, Florida weight-loss clinics and medspas are selling injections created by compounding pharmacies. These local pharmacies combine ingredients to create lower-cost versions of semiglutide.

Dr. Dawn Sherling, associate professor of internal medicine at Florida Atlantic University, says Floridians need to be cautious: “There’s a lot of variation in what’s being produced. When there’s a huge demand quickly for this medication, it encourages some labs that are not super adept at doing this to make it.”

On Twitter @Charlotte_Dunne of Fort Lauderdale says she can get generic semiglutide injections for $100 a week from a local botox doctor and recently tried it. She decided not to continue.

The Tampa Weight Loss (Semaglutide/Wegovy) Referral Group on Facebook, has dozens of posts from people who are selling and buying off-brand versions of these drugs and sharing their experiences



Just this week Novo Nordisk, the pharmaceutical company that makes Ozempic and Wegovy, took legal action. The drug maker filed multiple lawsuits against businesses selling off-brand versions of their popular drugs, including two in Florida.

The U.S. Food and Drug Administration said last month that it has received reports of adverse events after people took injections of semaglutide that came from compounding pharmacies.


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