Shauna Bookless never imagined she would become her own pharmacist. But after gaining more than 20 pounds between undergrad and graduate school and becoming dissatisfied with her weight, the Hollywood resident found herself mixing vials in her kitchen to make her own version of the popular weight loss pill. I noticed.
“I’m playing doctor,” Bookless says of the do-it-yourself GLP-1 treatment, an injectable drug developed to control diabetes and now also used for weight loss. explained about its expansion into the world.
Her journey began quite normally. She first heard about Novo Nordisk’s GLP-1, Wegovy, through a friend’s success story. Bookless then consulted her doctor and was told that her insurance would not pay for the cost because it was not medically necessary and her BMI was not high enough to warrant coverage (without insurance, the cost would be That could be $1,300 per month). So Bookless took matters into his own hands. And that puts her on the fringes of the burgeoning weight-loss drug market.
First, she considered alternatives. She could go to a medical spa, but it costs about $1,000 a month, still too expensive for a new therapist. Then another friend at work told her that she could get the product directly from the lab that makes it. Bookless wasn’t sure about this method. That means you don’t have a doctor to turn to when you have questions. But her friend assured her it was legal and a much cheaper method. She ordered, paid $130, and two days later, in August, a package arrived in the mail containing a vial of white powder, sterile water, and a needle. It was semaglutide, a drug sold under the trade names Ozempic (for diabetes) and Wegovy (for weight loss).
She followed the instructions on the package, mixed the powder with water, put it in the refrigerator, then removed 1/4 to 0.5 milligrams and injected into her stomach once a week.
Rather than consistently increasing her dose to the target dose of 2.4 mg as per the manufacturer’s instructions and the FDA’s guidance, she is sticking close to her starting dose. Even at lower than recommended levels, her appetite quickly won over and she began to lose weight. Bookless used two months’ worth of semaglutide over a three-month period of injecting herself weekly.
After losing 23 pounds, she’s wondering how much lower the dose she can use.
“I don’t want to lose any more weight,” she said. “But I don’t want to gain the weight back. This will be an experiment to stop it.”
As demand for popular weight loss drugs like Wegovy and Zepbound soars, Bookless’ DIY approach highlights the willingness of some people to slim down while saving money. Some patients, with or without their doctor’s help, “microdosing” by using lower than recommended doses to increase limited supplies, reduce costs, and even limit side effects. Experimenting with weight loss drugs.
Meanwhile, medical experts have expressed concern that there is not enough data on the effects of these weight loss drugs on people with a low body mass index, and that the effects of such off-label use remain largely unknown.
“The risks of using it in people who don’t meet the criteria have not been clearly identified,” said Dr. Alyssa Dominguez, an expert in endocrinology, diabetes and metabolism at the Keck School of Medicine of the University of Southern California. “But we don’t know because we haven’t looked at those people in a scientific way.”
read more:New beauty method: Lose weight with Ozempic and tighten with cosmetic surgery
When the semaglutide drug Wigovy first hit the market in 2021, it quickly became the go-to weight loss treatment, becoming the first weight loss drug to receive FDA approval since 2014. At the heart of these drugs are two important hormones: GLP-1 (glucagon-like peptide-1) and GIP (glucose-dependent insulinotropic polypeptide), depending on the drug. These naturally occurring hormones play important roles in regulating insulin, appetite, and metabolism.
Initially, these drugs were used to treat diabetes. But when the FDA finally gave permission to pharmaceutical companies to use these same drugs for weight loss purposes, demand for the drugs skyrocketed.
That passion wasn’t just about losing weight. a groundbreaking research In 2023, semaglutide was found to reduce major cardiovascular events by 20%, even in patients without diabetes. Perhaps most notable was a 19% reduction in all-cause mortality. With more than 70% of American adults suffering from obesity or being overweight (conditions that increase the risk of heart attack, stroke, and premature death), these findings make Ozempic and other brands of semaglutide available. The study suggests that injecting yourself with the drug may have the following effects: Great long-term health benefits.
Its popularity has led to soaring prices, shortages and, in some cases, desperate measures by people trying to lose weight.
Microdosing of any drug is an imprecise technique. Weight-loss drug users and doctors The Times spoke to for this story all had slightly different views. They can stay close to their starting dose of 0.25 milligrams, reduce to 0.1 milligrams, or simply forego injections of the drug every seven days. As recommended. “Microdosing Ozempic” has joined the lexicon of mild-sounding beauty terms, including:baby botox” and “mini face lift”, which makes the procedure seem more approachable, but the reality is that some people experience benefits at lower doses.
Despite the popularity of this approach, drug companies advise patients not to adjust their doses.
“We do not condone this kind of behavior. It is important to understand that in the case of Ozempic, only the doses listed on the pen (0.25, 0.5, 1.0, 2.0 mg) are approved for use. (0.25 mg is only approved for initiation, not for maintenance), a Novo Nordisk spokesperson said in an email: “The approved dose is in our Phase 3 clinical development. “This is the only dose strength studied as a maintenance dose in the program.”
“The products are not interchangeable and should not be used outside of their approved indications,” the spokesperson added.
Dr. Vijaya Surampudi, associate director of the UCLA Medical Weight Management Clinic, works with patients who want to take lower doses. She emphasizes that patients’ responses to these drugs vary widely, and the need for higher doses does not necessarily correlate with how much weight they need to lose. Instead, she carefully monitors each person’s response to the drug and adjusts her approach based on the body’s unique response.
“There is no one size fits all,” she said.
But there are practical limits to microdosing weight loss drugs, she says. Brand-name GLP-1 drugs come in fixed-dose pen syringes, which precludes individualized dose adjustment.
Bookless has found a way around this obstacle by obtaining a compounded version of the drug, a copy of the branded drug. Federal law generally prohibits pharmacies from manufacturing counterfeit versions of over-the-counter drugs. But when medicines are in short supply, regulators do not consider them “over-the-counter” and open the door to pharmacies. To create and sell similar products.
read more:Cheaper alternatives to Ozempic are flooding the weight loss market. are they safe?
Dr. Tasneen Bhatia, an integrative medicine physician and wellness expert known as Dr. Taz, offers formulated GLP-1 to her clients. her Los Angeles officewhere she estimates that about 10% to 20% of her clients are microdosing drugs.
Bhatia recommends microdosing for clients who come into the office with the goal of losing weight to 20 pounds or less, or for patients who are known to be sensitive to GLP-1 side effects such as nausea, constipation, lack of energy, and diarrhea. I think that is one of the options. .
because early research Many patients have been shown to regain weight when they stop using GLP-1, and many doctors expect patients to continue using these drugs for the rest of their lives, Bhatia says. But while Bhatia sees a future where people microdosing drugs intermittently as needed, she admits that this is not yet conventional wisdom.
“I think you’re challenging your metabolism a little bit by changing your intake, so increase your intake maybe once a quarter to get back on track,” she said. “The goal should never be for someone to do something forever.”
Dr. Suzanne Trott, a board-certified plastic surgeon in Beverly Hills, started her microdosing clinic because her patients wanted to use drugs to reach their goal weight and maintain it. She only uses tirzepatide, the drug behind Zepbound, which uses both GIP and GLP-1. In her experience, this has fewer side effects. She sources her drugs from a compounding company with facilities in Southern California. Trott said he works with patients to figure out their doses and schedule shots if needed.
“They can try microdosing if they want,” she said. “Not all of medicine is science; some of it is art.”
She said microdosing works so effectively that it has made inroads into the plastic surgery side of her business. She recommends it as a safer alternative to liposuction for some patients.
No matter how effective microdosing of weight-loss drugs is by doctors and patients, this form of medical experimentation may not last. Companies selling these substitutes could face a crackdown once the shortage eases. Last week, the Food and Drug Administration announced that the shortage of Eli Lilly’s Zepbound has ended, but Wegovy remains in short supply. Eli Lilly I then sent a cease and desist order. We have written to a number of companies that offer combined versions of tirzepatide.
Immediately after a lawsuit was filed by the Outsourcing Facilities Association, a conglomerate industry group, the FDA overturned that decision And it said it would allow pharmacists to continue manufacturing compounded versions of the drug while it reviews the shortage.
Semaglutide combination could be next: Novo Nordisk Contacted FDA The ban would prohibit compounding pharmacies from making the combination weight loss and diabetes drug, saying the drug is too complex for other companies to make safely.
read more:For brands looking to enter the Ozempic weight loss industry, it’s survival of the fittest.
Because the compounded version is still available (for now), Trott said his clinic is nearly full with a few dozen patients. She remains optimistic about the broad appeal of these treatments.
“It’s something that’s part of many ordinary people’s lives,” she said. “It’s similar to how plastic surgery used to be something only celebrities had, but now it’s something anyone can easily do.”
This story was originally Los Angeles Times.
