But Ted Kyle, a registered pharmacist and healthcare professional and obesity expert, says there is not evidence to support the prevalent idea that misuse of the drug for cosmetic reasons is in fact the cause of the shortage.
Kyle, who is an Advocacy Advisor to The Obesity Society, says that there's not factual data yet about misuse of the drug, and while he doesn't doubt that misuse exists, he's concerned about the way our cultural dialogue around Ozempic and Wegovy may be affecting people with diabetes and obesity who could benefit from the drugs.
So it's inaccurate to assume that the Ozempic and Wegovy shortages are happening due to misuse?
We do not know for sure, but something that we do know is that 73% of the population is either overweight or has obesity, and 43% of the population is in the range of obesity itself. And so just as a matter of odds ... every other person you meet more or less is going to in fact have medically qualified as having obesity.
All of these glib statements about rampant misuse are not based upon any kind of informed interaction with individuals who know their health in consultation with their doctor.
And I'll give you an example. One of the sort of benchmark stories about misuse of Wegovy is the anecdotal story about Elon Musk. Now, the presumption from that interchange on social media, which was not a medical discussion of his health, was purely anecdotal. Neither you, nor I, nor anybody knows what his health state is.
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He might have an indication for using it, and it might be working very well for its intended purpose. And until he decides that he wants to discuss his medical history, it's really not our business. But people assume, because it's kind of a cool story to talk about, 'Oh, he's just trying to lose a little bit of weight with Wegovy,' and then that becomes a very popular narrative.
Do you think this assumption of rampant misuse is harmful?
I think the idea is, when people say, 'Oh, look at all these people taking this drug, and they're misusing it,' it fits in with our biases. But the thought that there's rampant misuse doesn't line up too well with the reality that a lot of people are living with the complications of excess weight and obesity.
How do you define obesity?
The medical definition of obesity is abnormal or excess adiposity [body tissue that carries fat] that harms health. That's how the WHO defines it, that's how clinicians and the expert societies that work with it define it.
People aren't used to thinking about obesity as a chronic condition. They're used to thinking about obesity as something that you choose to have or not have based upon lifestyle. The science tells everybody who cares to listen that that's not true.
There's been decades of research now to show exactly how the body regulates weight, and that's governed by your genes acting in concert with the environment that you're living in. Just like diabetes, where the environment we're living in has caused diabetes to increase, there's that interplay of nature and nurture that happens in so many chronic conditions.
But if someone is using it for purely cosmetic reasons, what are some of the problems that could result from that? Could they be harming their health?
The short answer to that is that semaglutide hasn't been studied in that setting. I am a pharmacist, and every drug has risks and benefits. When you use a drug for an indication where it hasn't been studied, you're just taking a shot in the dark.
So if I'm at a very healthy state of adiposity where my body is doing a good job of regulating my weight, where I don't have any metabolic risk factor whatsoever, where my life is not really, apart from cosmetic appearance, my life is not really compromised at all, and I go and talk to my doctor about taking one of these drugs that aren't indicated for me, just to make myself look trimmer and slimmer, on the theory that there's no such thing as being too rich or too thin, well then you're taking a risk with your health because it's an unknown. It just hasn't been studied.
If people think they are a good candidate for semaglutide, should they go to an obesity medicine specialist?
Not everybody needs to see an obesity medicine physician, I don't think. But I would want to see somebody who understands the disease of obesity and actually can treat it rationally and not just offer advice about, 'Well eat less and move more and everything will be fine. Just put down the fork, push away from the table.' The bias against obesity runs so deep, even in the medical community.
And you think that bias is a part of the cultural assumption that many people are misusing the drugs?
I would not stand here and say to you that nobody's misusing semaglutide. I would not deny that there's truth to the anecdotal stories, 'Oh, it's an open secret in Hollywood, that everybody's using it.' But I would say in that presumption, in that chatter about everybody using it, there are some people who might be misusing it for purely cosmetic reasons, but there may well be some people who don't describe themselves as having obesity, but who have had conversations with a medical professional and concluded that this is a sensible thing for them to do for good medical reasons.