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Women taking the diabetes drug Ozempic may have another reason to rub their bellies: Not only has the discovery that the injectable drug can help with weight loss sparked a worldwide demand frenzy for off-label uses, but it has also been linked to an unexpected baby boom in recent months.
Now, scientists are trying to understand the mechanism behind the “Ozempic baby” phenomenon, which has also been reported by users of the drug. This is important because the drug has never been tested in pregnant or pregnant women, and animal studies of semaglutide, Ozempic’s main ingredient, have suggested a link to birth defects.
This has become an urgent health issue as an increasing number of people are now taking weight-loss drugs. They are prescribed to treat diabetes, obesity and weight-related health complications, but they also appear to improve heart and kidney health. This has led to calls for greater prescribing, for drug companies to lower prices and for insurance companies to cover the costs. But it seems presumptuous to consider weight-loss drugs essential when the long-term effects on, for example, the health of users’ babies are still unknown.
Ozempic belongs to a class of injectable medications known as glucagon-like peptide-1 receptor agonists (GLP-1 agonists). They were originally developed to treat diabetes. They control blood sugar and insulin secretion by slowing down the stomach. However, its active ingredient, semaglutide, also suppresses appetite and causes weight loss. This has led to off-label demand outside of diabetes, giving rise to similar drugs targeting obesity. There are other injectable medications approved for diabetes and weight management. Ozempic and Wegovy contain semaglutide, while Maunjaro and Zepbound contain tirzepatide.
This year, the hashtag #OzempicBabies trended on social media as mostly female users of Ozempic began sharing their stories of unexpected pregnancies. Some had struggled to conceive before, while others were on birth control at the time (as clearly recommended in prescribing guidelines). The exact number of people affected is unclear, but Novo Nordisk, the manufacturer of Ozempic and Wegoby, has launched a pregnancy registry to track babies for the first year of life. A spokesperson for Eli Lilly, which makes Maunjaro and Zepbound, said the company has not studied tirzepatide’s effects on fertility and that pregnant women or those who are trying to become pregnant should not use it. A Novo Nordisk spokesperson also stressed that semaglutide should not be used during pregnancy, and that the company does not condone, suggest or encourage its use outside of its approved indications.
Many researchers believe that the baby boom is simply due to increased fertility as a result of weight loss. Diabetes and obesity are known to disrupt menstrual cycles and ovulation. Both diseases reduce female fertility and increase the risk of miscarriage and other complications. They also negatively affect male fertility by reducing sperm quality.
But pharmacology researcher Charlotte Moffett of the University of Ulster suspects there’s more to it than that, as the same receptors targeted by weight-loss drugs are also found in the reproductive system. “These GLP-1 receptors are in the pituitary gland and the hypothalamus,” Moffett told me. “They’re found throughout the ovaries, testes and endometrium,” meaning they may be involved in hormone production, ovulation, implantation and male fertility. Her hunch is that gut hormones play a role in fertility, which could lead to fertility treatments in the future. But that’s not yet the case. Small observational studies suggest that babies born to women using weight-loss drugs appear to be healthy, but Moffett said there’s too little safety data to be reassuring.
So where does this leave us? Weight loss drugs are increasingly being seen as wonder drugs that can reduce obesity, diabetes, and more. This brings immediate benefits to individuals, employers, health care providers, and society. This is a good thing. But the long-term effects, including on fetal development, have not been quantified. More targeted research needs to be prioritized, and clearer risk warnings are needed.
This is especially urgent now, as many young women cruise social media platforms to access health information and online pharmacies. Weight-loss drugs may be seen as a solution to two deep parts of a woman’s identity: body image and motherhood. For those desperate for children, the hashtag #OzempicBabies will be a call to action, not a red flag.
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