Ozempic is approved for use in the treatment of type 2 diabetes in Canada, but will now be used off-labeled to treat obesity.Holly Adams/Reuters
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Ozempic is the only medicine my patients seek by brand name. It joins a drug exclusive club widely known for what they handle. In the 80s, there were Prozac and Viagra from the 90s. But unlike mood disorders and erectile dysfunction, it’s more than you can talk to the patient – requests for Ozempics and similar medications stop me in my tracks.
In Canada, Ozempic is approved for the treatment of type 2 diabetes, but will now be used off-label to treat obesity. Made by the same manufacturer, Wegovy is approved for weight loss in obese patients. Both drugs contain semaglutide, known as glucagon-like inhibitors (GLP-1 inhibitors). Glucagon is a naturally occurring hormone that stimulates the release of glucose in the bloodstream. GLP-1 drugs act on the stomach to block glucagon and slow digestion, and are absorbed from food due to low glucose and were developed to regulate blood glucose levels in type 2 diabetes patients. The byproduct is weight loss, as it makes you feel bored before. However, this weight loss only persists while remaining on medication. Stop taking it and your weight will return.
A cheaper and more popular version of Ozempic could come to Canada as soon as next year
Despite the growing popularity of GLP-1 drugs, when my patients request them, I become the medication police and question their intentions. Lifetime medication treatment for certain conditions (such as thyroid dysfunction or seizure disorders) is easy if you have decades of safety data. Guiding decisions as a physician. In contrast, Ozempic and its cousins have been on the market in less than a decade. Safety data is overwhelmingly positive for GLP-1 drugs, but no drugs are available without risks and side effects. Research published in the journal Natural Medicine In January, we tracked people taking GLP-1 medications for diabetes and discovered some potential health benefits beyond diabetes and obesity, but also found potential risks such as nausea and vomiting. I don’t want to prescribe unnecessary medications that can cause harm to my patients.
Another reason I hesitate to prescribe these medications is their price. Wegovy costs around $400 a month. As previously reported, Canada’s Public Drug Plan has refused to cover Wegovy so far as it has limited coverage of Ozempic for diabetics and is being sold as a weight loss drug.
But there was something else behind my hesitation. “Obese medication is the only thing we audition for patients,” said Dr. Ali Zentner, an obesity specialist and thought leader in obesity care at a Vancouver-based revolutionary therapy clinic. “Ozempic really shows the complete conflict between culture and medicine. You’ll start asking the question, “What is health?” ”
I take pride in my recognition of bias: I have completed two online courses on weight bias. My clinic posters portray people of all sizes who declare, “This clinic is not a bias zone,” and who declare that obesity is about science and not a will. Still, I think I might still be a patient. Requesting medication for weight loss requires eating properly and exercising more. The reality is that many people suffer from healthy weight despite doing all the right things. For some, years of boring diet and compulsive exercise have led to pathology The relationship between their body image and self-esteem.
Furthermore, the line between “healthy weight” and “unhealthy weight” is something I still struggle with. Body Mass Index (BMI), which is used to measure weight compared to height and screen for weight loss, overweight, or obesity, is an outdated and misleading measure. But despite other factors such as how patients feel, we still use it with the medication. When patients seek erectile dysfunction medication, I believe their self-reports really need a better erection. Why don’t you respond the same way to help lose weight by seeking GLP-1 medication?
Research finds that Semaglutide, or Ozempic, reduces symptoms of feared diabetes complications
Ultimately, these drugs place doctors at the heart of the weight-health conversation, which has previously been relegated to a profit-driven, unregulated diet industry. This is a progression for patients, but it is an area that has not been cancelled for many primary care physicians. It is realistic for many people to need medication to help lose weight, which highlights the opportunity for doctors to work through individual weight bias.
So, what should I do if I want to ask my doctor about GLP-1 medications? Here are five tips on how to approach conversations:
1. Please make a reservation just like this
Make sure you have enough time to discuss weight, health and the role of your medication. Adding this to your laundry list for other things reduces the chances of you leaving it with the game plan that is perfect for you. Be honest with your doctor about your intentions, struggles and goals.
2. Financial costs will be realistic
Currently, the state’s drug plans offer limited coverage for diabetics. Private insurance companies may require additional documentation from their doctors.
3. Discuss side effects and lifestyle
These medications can have side effects such as nausea and loss of muscle mass. Ask your doctor about lifestyle changes that will help reduce side effects.
4. Be honest with your doctor
If you are not asking your primary care physician for a prescription and not asking them to be available elsewhere, such as online health platforms, advise your regular doctor to use this medication. It is important that they have this information, so they can confirm that there is no drug interaction with other drugs, or provide counseling on when to stop taking GLP-1 medications (for example, before a common anesthetic for surgery).
5. If you don’t have a family doctor, seek consistent face-to-face care
If you are one of the Canadians without a family doctor, consider going consistently to the same walk-in clinic so that they have your records for a long time. It would be desirable to visit the clinic in person compared to a virtual provider, compared to a virtual provider who cannot ensure that there are no complex factors before starting treatment.
Dr. Tahmeena Ali is a family doctor, medical director and co-owner of Catalyst Kinetics Medical in Surrey, British Columbia. She is also a hospitalist at Peace Arch Hospital in White Rock, British Columbia, and is a mental health consultant and clinical lecturer for children and adolescents at the Faculty of Family Medicine at the University of British Columbia.
