You know there’s a problem with a drug when people who aren’t sick covet it and use it…and patients who might benefit from it don’t have access to it.
This is what is currently happening with substances such as Ozempic, the Novo Nordisk drug against diabetes which also causes weight loss. It’s the worst of both worlds.
It is high time to set guidelines for the use of these drugs and ensure that they end up in the right hands, for the right reasons.
This is all the more crucial since we might not have seen anything yet.
While Ozempic creates a commotion, the pharmaceutical industry is developing new molecules with double and even triple mechanisms of action that promise to make you lose weight even more effectively.
Last week, a study published in the prestigious New England Journal of Medicine reported that retatrutide, a molecule developed by pharmaceutical giant Eli Lilly, can cause patients to lose up to 24% of their weight (compared to about 15% for Ozempic).
This raises tons of questions that go far beyond the medical world and affect the whole of society.
In Quebec, one in four adults is obese. This predisposes hundreds of thousands of people to many chronic diseases, from hypertension and type II diabetes to osteoarthritis, cardiovascular disease and certain cancers.
By helping to lose weight, drugs like Ozempic could represent a major contribution to modern medicine.
Except that the public health nightmare is not far away.
Today, everyone and his sister believe they have pounds to lose. The cult of thinness is omnipresent, as is fatphobia. Eating disorders, especially among young women, have been on the rise since the COVID-19 pandemic.
However, molecules like Ozempic profoundly modify the relationship to food. This drug imitates the action of a hormone secreted by the intestines at the end of a meal which gives the signal to stop eating. Clearly, it provides an artificial feeling of satiety. A person who consumes it loses a good part of their appetite – sometimes accompanied by nausea, heartburn or diarrhea.
The risks of skidding are obvious and can already be observed. On social networks, Internet users brandish the hashtag #OzempicChallenge to expose their weight loss.
Elon Musk boasted on Twitter of having lost 14 kilos thanks to the molecule. Rumor has it that Kim Kardashian took Ozempic so she could put on an old Marilyn Monroe dress. Whether this is true or not, this contributes to the popularity – and the trivialization – of a drug whose consequences, both physical and psychological, are significant and still poorly known.
Meanwhile, doctors would like to prescribe the drug to very obese patients who need to lose weight before undergoing surgery or a transplant, for example. But they come up against an obstacle: the drug is not reimbursed by the Régie de l’assurance maladie du Québec and costs several hundred dollars a month.
The need for beacons is therefore crying out. The benefits, side effects, and costs of weight-loss drugs need to be analyzed to determine which patients, under what circumstances, might benefit from them.
In Quebec, the National Institute of Excellence in Health and Social Services (INESSS) exists for exactly that. The problem: products against obesity are excluded from its mandate, probably because historically, they were not very serious.
INESSS has indeed produced an “information document” which concludes that drugs like Ozempic can be “effective for short-term weight loss, when used in conjunction with lifestyle changes”.
It reads that these drugs could prove “relevant for people living with severe obesity having a significant impact on their health”.
It encourages you to learn more. But to carry out a true cost/benefit analysis, INESSS’s mandate must be reviewed by the Ministry of Health. This seems imperative to us.
Another struggle is looming in communications. Developing products that really make you lose weight is an old fantasy of the pharmaceutical industry. Now that it is happening, we should not expect restraint from companies. “Talk to your doctor” ads are surging for Ozempic, boosting already huge demand. Health Canada should consider a moratorium on these advertisements.
As for the noise circulating on social networks, it must be fought with facts and warnings.
In the right hands, weight-loss drugs can represent a real medical advance. But in touching on one of our most unhealthy obsessions, they represent a double-edged sword. Science and medicine must make their voices heard in the current chaos.