In just a few years, Ozempic has taken the world by storm – but, are we overlooking how it iss damaging America?

Introduction

In May of 2024, CNN published an article stating that 1 in 8 American adults use weight loss drugs, the most well-known medication being Ozempic. This statistic comes from a survey done by the Kaiser Family Foundation in an attempt to understand just how widespread the use of prescription weight loss medications has become in the United States.
The use of weight loss drugs isn't a new discovery. Some of the first attempts of the use of weight loss drugs are seen as early as 1930 – with the use of dinitrophenol (DNP). DNP was indeed successful in aiding uses in losing weight, but was soon discontinued due to toxic and life-threatening side effects. A new drug was then found: amphetamines.

During the ’40s and ’50s, amphetamines dominated as the primary weight loss drug in America – until the ’90s, when the long-term effects of the drugs began to show serious potential side effects. Of course, with “heroin chic” being on the rise, scientists and celebrities alike scrambled to find another solution. Thus, GLP-1 agonists were born. 

The U.S. Food and Drug Administration (FDA) approved the first GLP-1 agonist (exenatide) in 2005. GLP-1 agonists are a specific class of medication whose primary benefit is helping manage blood sugar levels in those with Type 2 diabetes. Moreover, these drugs slow the movement of food from the stomach into the small intestine, therefore suppressing appetite. 

Once the appetite suppressing effects became well known, the popularity of the GLP-1 agonists exploded in just a short amount of time. Drug after drug was approved for weight loss management and their original use was essentially forgotten. The most popular drug to be approved by the FDA being Ozempic. 

It’s not an exaggeration to say that Ozempic has infiltrated Hollywood. Just a few of the celebrities who’ve been open about their usage of Ozempic and other weight loss drugs include James Corden, Fat Joe, Kathy Bates, Bella Thorne, Oprah Winfrey, and dozens more. However, not every celebrity who uses Ozempic is open about it. Celebrities who have lost weight are asked constantly about their methods. Some claim it’s as simple as eating right and exercising, while others simply ignore the questions. Whether or not they've used Ozempic may remain a mystery. Regardless, celebrities as a monolith have never been skinnier. What does that mean for the rest of America?

Social Impacts

The more celebrities announce that Ozempic helped them lose weight, the more Americans pay attention. According to Pew Research Center, three quarters of Americans say they have heard a lot or a little about Ozempic, Wegovy and other similar drugs. Moreover, 53% of those Americans have favorable opinions about these weight loss drugs, compared to the 19% who have unfavorable opinions. 

Majority of Americans support the use of weight loss drugs, but how is the widespread use of these drugs going to affect our societal beauty standards? Are we heading back into a “heroin chic” era? It could be argued that we already have. 

“Ozempic face,” is a term that has been coined by celebrity dermatologist Dr. Paul Jerrod Frank about the apparent “face” Ozempic users get after losing weight. Some of the characteristics that are aligned with “Ozempic face” are increased signs of again, sagging skin, and hollowed out eyes — essentially, Ozempic users begin to look sickly. 

It makes sense. If one suppresses one's appetite in order to lose weight, then yes, the weight will be lost, but the possibility of malnourishment is high. Photo evidence isn’t necessary to demonstrate what an Ozempic face looks like. Chances are, any person reading this article, has already seen it via social media. The comment section of the latest celebrity to lose a significant amount of weight is filled with accusations of drug use or eating disorders, but a few users have begun to catch onto the pattern – they instead comment “Ozempic face.”

As of now, the tone is accusatory. An “I caught you” moment. Social media users aren’t envious of the celebrities' newfound thinness. But, could that change?

We’ve been here once before – when looking thin and sickly was desired. Is America going back?

Big Pharma

It’s important to remember where Ozempic came from. The original intended use for Ozempic was to aid in treating Type II Diabetes. Ozempic is now used off-label, meaning it’s not approved by the FDA for weight loss. 

The Health Care Cost Institute reports that, “In 2018, 92% of new Ozempic users had evidence of a diabetes diagnosis; by 2021, this share had fallen to 77% of new Ozempic users.” Nearly four years later, Ozempic has only grown in popularity for weight loss. Forbes states that in 2023, only 58% of those taking Ozempic had Type II diabetes. Therefore, the other 42% of users were taking Ozempic off label purely for cosmetic purposes – leading to some devastating supply chain issues. 

Simply put, pharmacies have run out of Ozempic and other widely used  GLP-1 agonists. Pharmaceutical correspondent Sydney Lupkin wrote an article on NPR with first hand accounts of Type II diabetics who can’t get the medicine they need. 

Jim Cox is one of the people Lupkin interviewed. Cox explains that he couldn’t renew his prescription for Trulicity, which is a GLP-1 agonist, and was forced to ration his medication. Unfortunately, Cox isn’t the only person who’s experienced this shortage firsthand. 

To demonstrate how many people are being harmed by the scarcity of GLP-1 agonists, Lupkin references the platform Ro. Ro is an online platform where people can report prescription shortages. Within the first two weeks of Ro’s launch, there were 35,000 reports of shortages. 35,000 people who couldn’t get the medicine that saves their lives – due to its popularity as a weight loss drug. Ozempic is an expensive drug that is within the reach of the wealthy, perpetuating the idea that thinness is something to be achieved rather than prioritizing the health of our citizens. In an NPR article published in early 2023, writer Stacey Vanek Smith describes Ozempic as, “the worst-kept secret in Hollywood.” As further proof of the idea that the wealthy have an easier time obtaining Ozempic, Dr. Jorge Rodriguez, a gastroenterologist in LA, explains his issues with Ozempic. Rodriguez states, "I won't prescribe it for weight loss. Using it in any other way restricts and harms the people that really benefit from it, which are the diabetics." He refuses to prescribe it off-label because Ozempic isn’t always covered by insurance – meaning only the people who can afford $1600 per month can obtain the drug. 

For a millionaire, $1600 could be spent on one dinner without a second thought. The rich buying Ozempic to look skinnier at their next premiere isn’t a major cost to them – meanwhile, they are also unaffected by the shortages as they are the ones who can afford to pay full price no matter what. The question remains: At what point does Ozempic usage purely for weight loss begin to become unethical?

Health Issues and Side Effects 

Morality isn’t the only question faced with Ozempic, health officials are also beginning to question its safety. Ozempic is linked to some pretty serious potential side effects, and the effects of long-term use are just beginning to be studied. With the amount of people taking Ozempic purely for cosmetic purposes, they may be in for a rude awakening. 

Kristianne Hannemann, an editorial pharmacist for Drugs.com, reviewed the article explaining the dangers of Ozempic. Some of the potential long-term effects include pancreatitis, vision problems, kidney issues, gallbladder problems, intestinal obstruction, and thyroid tumors. The concern with these potential side-effects is that most, if not all, of these side effects have been tested and found in animals.  Medical professionals cannot say for certain how these symptoms will show up in humans. However some doctors are beginning to see the harmful effects of Ozempic firsthand. 

Dr. Meera Shah, an endocrinologist at the Mayo Clinic, explains some of her findings in a CBSNews article. Shah says that the most common side effects she sees are nausea, stomach pain and diarrhea. According to her, at least 10% of patients have to be taken off the medication due to the intensity of these side effects. Some of the more severe side effects Shah sees are the pancreatitis and gallbladder issue previously mentioned, both of which can lead to hospitalization. 

Ozempic has been on the market for less than a decade. The true long-term effects won’t be known for another twenty years. As more people demand Ozempic for their cosmetic purposes, not only are they complicit in harming type II diabetics, but they are complicit in potentially harming themselves. 

Conclusion

The rising popularity of weight loss drugs like Ozempic have the potential to cause enormous problems in American society. Unfortunately, America is already beginning to see the consequences of wide-spread off-label use of weight loss drugs. From exacerbating shortages for those who rely on them for medical necessity to potential long-term health risks that remain somewhat mysterious, the popularity of these drugs showcases a deeper prioritization of aesthetics and thinness over public health. As America navigates this resurgence of "heroin chic" beauty standards and the ethical dilemmas posed by Big Pharma, it’s becoming more and more crucial to analyze why our society is so obsessed with thinness, and why we are devaluing the people who actually need these drugs.