New Delhi: The increasing use of drugs Ozempic and Wegovy for weight loss has been witnessing rapid and massive backlash, fuelling a new form of weight-associated stigma — Ozempic shaming.
For every celebrity who has admitted to using these drugs — be it Elon Musk or Oprah Winfrey — there is an equal number of naysayers. On social media, self-proclaimed health gurus caution against what they call “quick fixes”, urging followers to adopt more traditional methods of fat loss, such as diet and exercise.
While both Ozempic and Wegovy are semaglutide injections, the former is prescribed for type 2 diabetes and the latter, a higher-dose version, for obesity. Semaglutide mimics Glucagon-like peptide 1 (GLP-1) — a hormone that regulates blood glucose levels and metabolism, is released in response to food, and suppresses appetite and the release of insulin. In this way, semaglutide offers a potential option for those struggling with weight management and associated health complications.
“Give A Trophy Today! A little encouragement goes a long way. WIN with Nutrition & Exercise!” an X user wrote on the microblogging platform, as a veiled jab at weight loss drugs.
Meanwhile, conspiracy theorists are accusing pharmaceutical giants of colluding with media outlets to drive profits from these drugs.
When big pharma is paying mainstream media this is what it looks like, @MailOnline can’t even wait a minute between propaganda for #Ozempic pic.twitter.com/iqHHkA3W4Y
— Prince Carlton 🇺🇸 (@_PrinceCarlton_) September 10, 2024
In an interview to The Harvard Gazette earlier this year, Dr Chika Anekwe, an obesity medicine physician at the Mass General Weight Center in Massachusetts General Hospital and instructor at Harvard Medical School in Boston, attributes the backlash to fear and bias.
“Mistrust of the medical community is another potential explanation for the vigor with which people are so opposed to the use of medications for weight management,” she said in the interview.
She further explained that much of this criticism overlooks the struggles faced by those battling metabolic conditions that contribute to obesity, many of which are often beyond their control.
“The belief that has been so ingrained in our minds is that you should be able to maintain a healthy weight by yourself and anything you’re using, other than a healthy diet and exercise, to help is considered cheating or evidence of a lack of willpower,” said Anekwe. She emphasised the importance of medical interventions like pharmacotherapy and bariatric surgery.
Obesity not yet recognised as chronic disease
Criticism of weight loss drugs like Ozempic and Wegovy often stems from a lack of understanding in society, where obesity is not yet widely recognised as a disease. Many still hold the ingrained belief that using anything other than diet and exercise for weight management is “cheating”, overlooking the fact that similar to diabetes, hypertension, and dyslipidemia, obesity is also a chronic metabolic disorder.
Doctors in India acknowledge that lifestyle factors play a significant role in obesity. But it is also a chronic disease requiring long-term management strategies, similar to other persistent health conditions, Dr Himika Chawla, senior consultant endocrinologist at PSRI Hospital in New Delhi, told ThePrint.
“Obesity needs to be addressed and treated beyond just lifestyle modifications. Genetics play a critical role in managing obesity, and many patients visit hospitals after struggling to maintain a healthy weight despite adhering to strict diet and exercise routines,” she said.
For such patients, oral or injectable drugs can facilitate long-term weight management. Dr Chawla warned, however, that such treatments must be taken under strict medical supervision.
“When combined with closely monitored dietary interventions and exercise routines, these medications can help patients with obesity — who are at higher risk for conditions like diabetes, hypertension, and even cancer — maintain better overall health,” she added.
Dr Chawla said doctors have been receiving queries on weight loss drugs from patients, and while these drugs can be helpful for weight management, they can lead to several side effects. “These include nausea, vomiting, severe appetite loss, constipation, and diarrhoea, among others.”
Hype for weight loss drugs in India
Semaglutide has created a lot of buzz in India as well.
In other countries, Denmark-based pharmaceutical firm Novo Nordisk’s Ozempic and Wegovy have garnered attention for managing type 2 diabetes and weight loss, respectively. Meanwhile, Indian regulators have so far approved type 2 diabetes and obesity drug tirzepatide only for diabetes treatment.
In July, the Central Drugs Standard Control Organisation (CDSCO), India’s apex drug regulator, recommended regulatory approval to import and market tirzepatide in the country.
Indianapolis-based pharmaceutical firm Eli Lilly, which sells tirzepatide under the brand names Mounjaro and Zepbound, has received marketing authorisation for type 2 diabetes indication for the drug in India. The application for obesity indication is undergoing review by the CDSCO, an Eli Lilly spokesperson told ThePrint in July.
Mounjaro has been available in the US since 2022, and is indicated for diabetes. Zepbound was approved as a drug for weight management by the US Food and Drug Administration (FDA) in 2023.
Mental toll of weight stigma
Weight stigma, which often causes people to loathe and doubt themselves, has to be addressed first, experts say.
“When people are looking down on or judging somebody for their excess weight, that’s weight stigma. Self-stigma occurs when those perceptions are internalized, causing individuals to believe they possess the negative traits associated with excess weight,” Dr Anekwe had said in the interview to The Harvard Gazette.
Apart from the stigma attached to excess weight, the points highlighted by Dr Anekwe included the need for greater awareness of the concept of excess weight. Currently, Body Mass Index (BMI) is often used as a measure for weight management, but this needs to change, she said.
The real concern is excess fat, not excess weight, as individuals such as bodybuilders may have higher body weight without the associated health risks of obesity. Dr Anekwe urged those concerned about their weight or health to first consult their primary care doctor, rather than relying on BMI or unverified information. Building trust in the medical community is key to addressing these issues effectively.
(Edited by Radifah Kabir)