Can it change the way we look at health inequity?
The 2000s was an age teeming with gratuitous, if not goofy, maximalism. Chunky boots, laughably tiny miniskirts, designer tinted glasses and blinding neon highlights were colorful fashion trends indicative of the era's affinity to extremes; another extreme 2000s fad: diet culture. As rising obesity rates coincided with instantaneous access to celebrities, advertisements for restorative "miracle" diets (especially those with testimonies from media personalities) became a flourishing business. Meanwhile, in June 2008, a pharmaceutical company began research on semaglutide, a hormone later to be understood as an aid for those with Type-2 diabetes. Today, semaglutide — marketed as Ozempic by that same company, Novo Nordisk — is at the forefront of modern weight loss culture.
Semaglutide is a Glucagon-like Peptide Receptor Agonist (GLP-1 agonist), or a medication mimicking the GLP-1 protein. GLP-1, a type of incretin, is a peptide hormone responsible for producing insulin, the chemical responsible for controlling our sugar levels when humans eat. As a stimulant of insulin production, it also suppresses one's appetite, often leading to weight loss. Patients with Type-2 diabetes do not have enough of an incretin response to make insulin. As of 2023, more than one in 10 Americans have the condition, with an additional one in three having pre-diabetes, making it one of America's most common diseases. For those open to better treatments, forms of GLP-1 agonists like Ozempic were reliable and convenient options. Now, nationwide shortages have made the product anything but convenient.
The amalgamation of high demand and supply shortages has rendered Ozempic inaccessible to those with the greatest need. Although supply shortages can be chalked up to manufacturing issues, an NBC article explicitly states that the proliferating demand is due to its weight loss benefits. Wegovy, a higher dose of semaglutide used for weight loss, likewise experienced shortages. Simultaneously, many features in entertainment magazines underscored celebrities' use of Ozempic as moreso a magic weight loss cure rather than a much-needed intervention for diabetes.
Celebrities, however, are but a symptom, not the problem; the real issue is health inequity and the stigma associated with non-traditional weight loss methods. Ozempic can cost well over $1000 in America, and many insurance plans only cover some, if not none, of the payments. For working-class people, this makes the largely privatized healthcare system a pain. Another problem is that overzealous doctors have been complicit in prescribing patients Ozempic that don't meet the criteria (i.e., those with Type 2 Diabetes, kidney disease, heart failure, volatile A1C levels, or cardiovascular disease). Nonetheless, semaglutide medications like Wegovy and Ozempic, and GLP-1 agonists as a whole, are and will be essential in managing obesity in Type-2 diabetes and non-Type-2 diabetes patients.
While there is much to say about the monopolization of the drug, some of the pushback against Ozempic and semaglutide is unwarranted. Amidst an "astronomical obesity epidemic," conversations about our bodies and weight loss have become even more inflammatory. Within the past decade, there has been an online push and pull between people being positive and patient towards their body images and others who shame them for doing so. And for those for whom 1000 pull-ups at the gym or a sugar-free, happy-free, paleolithic keto diet did not work for their body, GLP-1 agonists still might be a shameful or scary alternative. Detractors of these medications might point to Fen-Phen, a weight loss drug that helped patients with weight loss but later resulted in severe heart problems. Adding to the ire, as of late August, one woman from Louisiana sued Novo Nordisk for failing to warn of adverse symptoms after battling gastroparesis, a paralysis of the stomach. Others, however, associate these remedies with either laziness or a cultural obsession with convenience and immediate results. Ultimately, the conversations surrounding Ozempic symbolize the crossroads between the ease of access to new medical interventions and our current and past attitudes toward these novel treatments. Ozempic and other GLP-1 agonists should, foremost, be most accessible to those with diabetes and be less stigmatized if used reasonably for weight loss.