My fasting blood sugar level was at 170 in February, a sign of uncontrolled diabetes. Last November, my doctor gave me a sample of an injectable medicine called Ozempic. I got used to the weekly jab and the occasional bruise near my belly button and watched my fasting glucose drop to an acceptable range. After four weeks, my diabetes was better controlled and I lost eight pounds - a happy bonus. A happy bonus that lots of other people - who didn’t have diabetes - were also pursuing. The increase in demand caused a national shortage. It took three months for me to get Ozempic again.
Ozempic isn’t the only point of tension between those seeking aesthetic weight loss and people with diabetes. Continuous glucose monitors (CGMs) help people with diabetes monitor blood sugar. They also can help others use data to make better choices about what they eat. A company called NutriSense runs ads full of models who eat pasta and watch their glucose levels shoot up. These effective ads sell CGMs as a behavioral tool to help lose weight.
They also drive up costs and can keep people with diabetes from getting the care they need.
A recent article in The Cut paints an uncomfortable picture. For months, I struggled, calling up different pharmacies to get Ozempic only to be told that they were still out of stock. Meanwhile, weight-loss seekers and the professionally beautiful were getting their hands on this medication by any means necessary. Some who couldn’t get a doctor’s prescription were going to medi-spas.
Ozempic seems to be a strong weapon in the fight against a serious medical condition. However, people seeking it for cosmetic, non-medical purposes are disrupting the supply chain for those of us who really need it. These folks, like the actress interviewed in the Cut story, seek it out because “thin is power.”
THE SCIENCE BEHIND OZEMPIC
Ozempic’s silver bullet alters brain chemistry. Its active ingredient is the same as the one in its sister drugs, Wegovy and Mounjaro.
Ozempic is a lab-produced molecule that binds to a receptor and boosts insulin production. That, in turn, reduces glucose levels and affects natural hunger and satiety hormones. All of this helps to slow stomach emptying, leading to a longer feeling of fullness. According to the manufacturer's website, it is a medicine for adults with type 2 diabetes that can lower blood sugar levels, reducing the likelihood of stroke, heart attack or even death due to complications.
Ozempic’s active ingredient, semaglutide, was found in a Danish study to be more effective in reducing HBA1c levels and increasing weight loss than other, similar compounds including liraglutide, the active ingredient in Victoza. Novo Nordisk, the maker of Ozempic, funded the study and provided the trial samples.
MY OZEMPIC STORY
My doctor suggested Ozempic to me a year ago, before the world caught wind of this “magic” weight loss pill. I chose to try diet and exercise instead. Weight loss for people with diabetes can lower blood sugar and blood pressure, and help with other metabolic issues. I wanted to take control of my health without adding a third diabetes medication.
I also was afraid of needles; I didn’t want to face weekly self-injections for the rest of my life. I had some experience with it: 11 years ago, I developed gestational diabetes during pregnancy. My husband jabbed my growing stomach every night in a dreadful, tear-inducing ritual. Not to mention that I undergo blood tests every six months to track my diabetes.
I agreed to a CGM called FreeStyle Libre, a device with a small needle and heavy-duty adhesive that I had to essentially staple to the back of my arm twice a month. The device sent glucose readings to my doctor that she analyzed and discussed with me during my quarterly check-ups. It helped us both understand the impacts of my lifestyle and medications. While I lost some weight, it wasn’t enough. Deeply disappointed and feeling like I failed, we talked again about Ozempic.
When I asked about side effects, she looked at me with a level gaze and said, “Well, not as bad as uncontrolled diabetes.” She had been prescribing it since 2017, and the worst her patients reported was some nausea and dry mouth in the beginning.
She sealed the deal by telling me that most of her patients were in their sixties and seventies. I was way too young to be going to an endocrinologist. When she said wanted to see an A+ instead of a B+ as far as my test results, I felt the push that can only be fully appreciated by an understanding of the “tiger mom”: my doctor and I are both of Asian descent, and there was definitely some mutual cultural dynamic at play in her office that early November afternoon.
I felt like a chastised teen and accepted a one-month sample of Ozempic. A few days after my first injection, my blood sugar levels were at an acceptable range. Three weeks later, I had l dropped a dress size. I was hooked. Then the sample ended. For three months, the drug was unavailable thanks to its off-label use as a miracle weight loss pill.
OUT OF REACH TREATMENTS
Beginning last year, demand spiked so high that Novo Nordisk couldn’t keep up, sparking a worldwide shortage. The Cut reported that “Komodo Health, a firm that tracks health-care data for 330 million patient files, notes an uptick in people with no prior record of diabetes receiving these drugs — a fourfold increase in California alone.”
Meanwhile, CGMs are ridiculously expensive ($160-$500 a month) and most insurance plans don’t cover them for Type II diabetes. People who want to lose weight want them too. Health and wellness companies like Nutrisense and Signos charge between $134 and $399 a month to subscribers.
Clearly, the interventions designed for those living with type II diabetes are growing increasingly out of reach. Another facet that hasn't been explored much is the socio-economic factors that surround access to life saving interventions like Ozempic and CGMs. The majority of Americans who are living with diabetes are from underserved black and brown communities. According to government findings, race is a risk factor for Type 2 diabetes. Class and education further widens the divide between those who can get these treatments and those who cannot. Aside from lack of knowledge that these interventions even exist, the high cost of these medications is another hurdle that can be insurmountable to some.
UNPALATABLE TRUTHS
Weight loss with minimal effort is seductive. No wonder there is such a buzz around Ozempic. It’s become a household name in the same way as Viagra and Botox.
But this “wonder drug” has a dark side, including severe consequences when those with diabetes stop taking it.
“Ozempic is a diet that’s not a diet, wellness that’s only wellness for the person you’re taking it from, whose ease feels like a cheat,” writes Matthew Schnetter for The Cut. I was cheated out of a drug that helped me significantly. While I dealt with the risk of uncontrolled diabetes and a potential heart attack for three months, Real Housewives and some gay men on Tik Tok got to lose weight just to improve their appearance.
LOOKING AHEAD
Three months after restarting Ozempic, my HBA1C is at 6.8%. I’ve lost about 15 pounds. My CGM readings are back within an acceptable range. At my last appointment, my doctor beamed with pride. When she told me a higher dose would help me lose more weight but wouldn’t lower my HBA1c much, I had to stop myself. Did I want to be like the Hollywood drug-seekers I resented? Was losing weight more important than someone else being able to control their diabetes?
I am grateful for interventions like Ozempic and FreeStyle Libre. I’m lucky to be able to afford these treatments. The national shortage has eased up to some extent. And, I admit, I’m thrilled I can fit into my vintage Diane Von Fustenberg dress that I haven’t worn in twenty years.
