It’s a drug billed as revolutionary for the treatment of type 2 diabetes, but that’s not why demand for the medication is surging. At a higher dose, the drug can be used to treat obesity, which has led to its recent popularity on social media as a weight-loss solution.
Online commentators have speculated that Kim Kardashian used the diabetes drug to fit into Marilyn Monroe’s dress for last year’s Met Gala. Host of this year’s Critics Choice Awards, Chelsea Handler, joked that “everyone” in Hollywood is on Ozempic. TikTok videos tagged #ozempic have amassed at least 423.1 million views — most of these videos detail how much weight users lost while taking the drug.
Ozempic’s viral rise has caused shortages of the drug in the U.S. and Australia, and now consumers are turning their eyes to Canada as a cheap place to get the out-of-stock medication.
But Ozempic isn’t approved for weight loss, it’s meant to treat diabetes. So how did we get here?
Ozempic vs. Wegovy
Ozempic is a brand-name diabetes medication manufactured by Novo Nordisk, but the medical ingredient in it is called semaglutide. Semaglutide works by mimicking a hormone called glucagon-like peptide-1 (GLP-1), which stimulates the release of insulin and helps to reduce blood sugar spikes.
But that’s not all that semaglutide has been shown to do; it’s also effective at regulating diet by targeting areas of the brain that make a person feel more full.
Novo Nordisk actually manufactures two drugs where semaglutide is the only medical ingredient: Ozempic for type 2 diabetes, and Wegovy for obesity. Both drugs have been approved for use in Canada, Ozempic since 2018 and Wegovy since 2021.
Both Wegovy and Ozempic are administered through injections. The only apparent difference between the two drugs is that Wegovy has a slightly higher dosage of semaglutide, according to Novo Nordisk medical factsheets.
Both drugs also warn of the same serious potential side effects — thyroid tumours and cancer — and have similar common side effects, which include nausea, diarrhea, vomiting, constipation and abdominal pain.
Another side effect is that once patients stop using semaglutide, they are likely to put weight back on, and possibly even more than they lost in the first place.
A study published in the journal Diabetes, Obesity and Metabolism indicates that once patients stop using Wegovy and Ozempic, any weight lost is likely to return.
Despite the similarities, Novo Nordisk told Global News that it “does not support the use of Ozempic for anything other than the treatment of type 2 diabetes.”
So if Wegovy exists as a treatment for obesity, why are people scrambling to get their hands on Ozempic? Because Wegovy is in even more short supply than Ozempic.
Wegovy was dubbed a “game changer” medication by Obesity Canada, hailing it as an effective drug for an often under-treated and stigmatized chronic condition.
In a blog post, Dr. Ian Patton, director of advocacy and public engagement for Obesity Canada, wrote that Wegovy’s approval in Canada was significant because of the current inaccessibility of evidence-based treatments for obesity.
“This lack of coverage and accessibility of effective treatments is rooted in not recognizing obesity as a chronic disease and rather incorrectly labeling it a ‘lifestyle’ condition or in other words, something you have done to yourself making you not worthy of treatment,” Patton wrote.
The only other treatment for obesity that has around the same effectiveness as Wegovy is bariatric surgery, Patton wrote, though the procedure often comes with “unacceptably long wait times.”
It’s been a year and a half since Wegovy was approved for use in Canada, but no prescription for the drug has ever been filled here because it is still not available. Novo Nordisk said they had to postpone the drug’s release in Canada due to “unprecedented demand.”
“We are working towards commercial availability for Wegovy in Canada, however, we are not yet able to confirm timing,” the company told Global News.
In the U.S. where Wegovy was first approved, shortages began soon after Novo Nordisk started marketing the drug, and have persisted until today.
“There were a number of patients who were started on Wegovy who couldn’t continue it,” said Dr. Kimberly Gudzune, medical director of the American Board of Obesity Medicine, in an interview with CNN.
“And so, as a result of the kind of inability to get Wegovy, a lot of physicians started prescribing Ozempic off-label, which they’re permitted to do, for the treatment of obesity,” she said.
The FDA lists Ozempic as “currently in shortage,” citing an increase in demand for the drug.
Will there be an Ozempic shortage in Canada?
There is no current shortage of Ozempic in Canada, according to statements from Health Canada and Novo Nordisk. That’s not to say Canadians won’t see supply challenges if demand for the drug remains high.
Health Canada notes that “provinces and territories are able to use authorized health products outside the scope of the product’s label,” meaning that Canadian doctors can prescribe Ozempic to treat ailments besides type 2 diabetes.
While there’s no official data on how many off-label prescriptions of Ozempic have been filled in Canada, media reports and social media posts show that non-diabetic Canadians are getting their hands on the drug to treat things like obesity and polycystic ovary syndrome (PCOS).
Novo Nordisk told Global News that in order to “ensure a continuous supply of Ozempic, we are asking physicians to only use Ozempic for patients with type 2 diabetes.”
Shortages of Ozempic in the U.S. may be driving consumers to get their prescriptions filled in Canada, according to the B.C. Ministry of Health.
The provincial agency told Global News that in the past year ending on Aug. 31, “83,188 prescriptions for Semaglutide (Ozempic) were filled across the Province… with Americans filling 22 times as many doses of this drug as they typically do of other pharmaceuticals.”
“Given the drugs’ heightened profile due to recent social media trends and shortages in the United States, we will continue monitoring the situation,” wrote a ministry spokesperson.
On Twitter, discussions about Ozempic often bring up that Americans are allowed to buy Ozempic in Canada, and can do so at a much cheaper price.
“There is a desire for quick-fix weight loss products, and Ozempic shortages for type 2 diabetes treatment medication are in part because of TikTok,” the company wrote. “This prescription medication may be increasingly hard to find, but it is more readily available from Canada.”
In Australia, where there are also Ozempic shortages, the national drug regulator is investigating social media videos and media reports that illegally promoted Ozempic as a get-thin-quick strategy. Last year, amid shortages, the drug regulator urged doctors to “limit prescribing and dispensing of semaglutide to its approved use,” in a press release.
B.C.’s health ministry said it is “taking measures to ensure adequate supplies” of Ozempic, but did not provide an answer to a Global News question about whether the province will urge doctors to curb off-label prescriptions.
While some may be quick to blame people with obesity for shortages of this diabetes drug, obesity advocacy groups are urging people to not vilify the use of Ozempic for weight loss.
In a May 2022 joint statement, The Obesity Collective and Weight Issues Network argued that though Ozempic is not cleared for obesity treatment, doctors are prescribing it for weight loss for a good reason.
“People with obesity who have been using Ozempic have been doing so because their doctor has deemed it clinically important for their healthcare and has prescribed the medication,” the statement reads.
“Obesity is a chronic, relapsing health condition, with many different drivers and causes — including social, genetic, biological, and environmental — and often diet and exercise alone may not be enough for management.”
In the statement, Chair of the Weight Issues Network Dr. Divya Ramachandran urged people to have “compassion” for people using Ozempic for obesity.
“Those taking Ozempic have had it prescribed by their doctor for a whole cluster of health issues alongside their obesity,” she said. “Please exercise compassion. Please do not place unfair blame or hate people when they are simply seeking healthcare for their health problems.”