What are you talking about? Denying obesity? I’m the one showing red states are full of obesity.
Blue Ridge Mountains, Shenandoah River, Life is old there, older than the trees…
And the one admitting he himself is.
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And the one admitting he himself is.
Remember, just pages ago, you swore allegiance and fealty to all doctors.
Ozempic: The latest weight loss craze and how over-prescribing is harming patients
Publish date: March 20, 2023By Linda Girgis, MD
Social media and mainstream media websites are full of stories on the new wonder weight loss drug: Ozempic. Even Hollywood stars are talking about it.
Recently, the zealous prescribing of this diabetes medication fueled a 6-month shortage making it difficult for anyone to get it. Part of the problem stems from digital access to these medications where a patient can get a prescription online or via a telemedicine platform. Additionally, certain weight loss programs contributed to promoting the weight loss benefits.
It is important to remember when prescribing Ozempic that it has not received FDA approval to serve as a weight loss medication but rather as a medication used to treat type 2 diabetes mellitus. Doctors use many medications off label, but this must be done with the whole picture in mind.
Ozempic is a glucagon-like peptide-1 (GLP-1) agonist, with the generic name semaglutide, that lowers hemoglobin A1c in patients with diabetes and lowers the risk of cardiovascular events. Semaglutide is also sold as Wegovy, which is indicated for weight loss. Both Ozempic and Wegovy are sold in multiple doses, but the target dose for Wegovy is higher.
Weight loss with Wegovy is, on average, higher than that seen with Ozempic. However, it is often more difficult to get Wegovy covered by health insurance companies.
As doctors, we must be stewards of the medications we are prescribing. Clearly, the Internet should not be driving our prescribing habits. Prescribing Ozempic for weight loss can make it more difficult for patients with diabetes to receive it, and we should consider other options until it is more available and/or receives FDA approval for treating obesity.
Most of us have seen our patients with diabetes having difficulty getting a prescription for Ozempic filled, either because it is on back-order or because of a lack of coverage. Insurance companies have no incentive to lower the cost when it is in such high demand at its current rate. For these patients, lowering their A1c can be life-saving and prevent complications of diabetes, such as kidney failure and heart disease. In our current environment, we should reserve prescribing Ozempic for our patients with diabetes who need it more. Wegovy is available and can be prescribed for patients wishing to lose weight.
Many patients are looking for a magic cure. Neither medication is that. Patients need to start with making lifestyle changes first. In primary care, advising on and helping patients implement those are often our most difficult tasks. However, no medication is going to work unless the patient makes adjustments to their diet and amount and type of movement they are doing. In patients who have a hard time changing their diet, lowering carbohydrate intake may be a good first step. Exercising, or being more active if a patient is unable to formally exercise, is an important therapy.
As we all know, metformin is the usual preferred method for the treatment of type 2 diabetes unless contraindicated in a given patient. There are many oral diabetes medications available, and which of these and how these are prescribed need to be tailored to the individual patient. Ozempic can be used when a patient is failing on metformin, or other oral meds, or if they would rather do a weekly injection rather than remembering to take daily pills, for example.
Obesity has reached epidemic proportions in the United States. According to the CDC, more than 40% of the U.S. population is obese. Additionally, millions of children between the ages of 2 and 19 are now considered obese, and the medical complications for these individuals ares yet to be seen. Plus, many of us are seeing higher frequencies of diabetes, hypertension, and other chronic medical conditions in adolescents in our daily practices.
Our war against obesity is a fight for future lives and having more tools available is definitely a help. Like with patients with diabetes, all treatment regimens should start off with lifestyle modifications. Fad diets rarely result in long-term weight loss.
There are several medications now available to help with weight loss, Wegovy being just one of them. Patients often come to us with their own personal preferences, and it is our job to guide them on the best course to take. Some people may prefer a weekly injection. There are oral medications available, such as Contrave and Phentermine, and the best one should be decided upon by the patient and doctor after a discussion of the risks.
Let’s stop prescribing Ozempic for weight loss because nonphysicians say we should. Leave it for our patients with diabetes, those whose lives may depend on taking it. If we didn’t have other medications available, it would be a very different story. But, we do, and we need to resist the pressure others place on us and do the right thing for all of our patients.
Meanwhile....
“My excitement is balanced with the experience that these drugs are potentially dangerous and they’re very powerful and they should be treated with respect,” Heymsfield said. “This rebound phenomenon is more than I’ve seen in the past. Relapse is universal when people stop obesity treatment, but this one seems to be associated with a more rapid rebound.”
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Hardly. Like I said, I could lose 10 or 15lbs. But I have a 34” waist and a 19” neck. My dress shirts have to be custom tailored.
We already know some of the dangerous side effects. We don't know all of them.
I suspect a healthy lifestyle is better than consuming Ozempic via shot weekly while continuing to eat fast food.
For one, it's kept diabetics who need it from getting it. Surely you have heard about this phenomenon due to the overprescription of Ozempic?
Two, I just posted some articles that discuss some of these issues. Like the rebound effect with Ozempic. You have to be on Ozempic for life, otherwise you get all of the weight back PLUS more. You commit to the drug for life.
Three, we don't know all of the side effects YET for Ozempic. Given you have to be on it for life, you are susceptible to these more serious side effects:
- diabetic retinopathy (damaged blood vessels in the eye)
- gallbladder disease, including gallstones or cholecystitis (gallbladder pain and swelling)
- kidney problems
- pancreatitis* (swelling of the pancreas)
- increased risk of thyroid cancer*†
- allergic reaction*
- hypoglycemia* (low blood sugar)
If you say so Barney Rubble
Your Stepfather lost 100 pounds on Ozempic? That's way outside the norm, but good for him.
I'm not so concerned about side effects, other than the common diarrhea, constipation and nausea, the rest are fairly rare.
But the over use for weight loss can certainly create a shortage in the market for those needing it to control their blood sugars.
You are also correct that it could be a life long treatment, unless the patient works really hard at maintaining their weight after stopping the Ozempic.
Same holds true with those that opt for gastric bypass surgery, unless you alter your eating habits and consume less the surgery is worthless.
Add to the fact that without insurance the last I remember Ozempic was around $900 a pop, or about $47,000 a year. Even if insurance covers the injections, it will
still affect insurance rates for everyone.
Actually long term Tylenol use, especially combined with alcohol consumption can do a number on the liver.
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It was a combination of things, but it was a huge part. So was being in and out of the hospital and not having easy access to the cupboard.
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I am $200 away from my deductible already. Luckily Discount cards apply after it hit my insurance, so I have actually paid less than half of that amount out of pocket. Thank god for having cash in my HSA.I'm not so concerned about side effects, other than the common diarrhea, constipation and nausea, the rest are fairly rare.
But the over use for weight loss can certainly create a shortage in the market for those needing it to control their blood sugars.
You are also correct that it could be a life long treatment, unless the patient works really hard at maintaining their weight after stopping the Ozempic.
Same holds true with those that opt for gastric bypass surgery, unless you alter your eating habits and consume less the surgery is worthless.
Add to the fact that without insurance the last I remember Ozempic was around $900 a pop, or about $47,000 a year. Even if insurance covers the injections, it will
still affect insurance rates for everyone.
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I think it's more of this analogy....
If a person is living in a house full of broken glass on the floor, and they only walk around bare footed all day, eventually they're going to cut their foot and/or get glass embedded in their foot.
This person eventually will need to stop the bleeding and get the glass out so they go to their doctor.
Now, the doctor is going to remove the glass, stitch them up, put some bandaging on it, and send them on their way. The doctor has cleaned the wound and stopped the bleeding. They've done the bare minimum to help this patient, but they've nonetheless done their job.
Now, this same person goes home, kicks off their shoes, and doesn't clean up any of the glass. Back to the doctor.
At this point, a 1/2 decent doctor worth their paycheck would ask this patient what the heck is happening that they're back this soon with the same exact problem, while they patch them up again. And this doctor would now recommend the patient to put some shoes on, sweep up all the glass, take a vacuum out and make sure they got ALL the pieces, and don't haphazardly walk barefoot on top of broken glass anymore.
Now, can the doctor force the patient to do this? Can the doctor hold their family hostage at gunpoint and tell the patient if they don't follow their instructions, they'll start plugging their family members until they do?
There's this thing called PERSONAL RESPONSIBILITY.
Your doctor, your family, your friends, etc. can point out the things that are hurting you.
But if you don't listen and don't make the necessary changes yourself, nothing will change.
And somebody above said some comparison along the lines of What's more unhealthy, taking a pill or eating a fast food combo?
Isn't it unhealthy to continue to eat the combo meals AFTER being prescribed the pill?
The pill is a band-aid. It's not a panacea.
It's the reason why I LOATHE things like "Race for the Cure" and anything else that wants to find a cure for something.
Why isn't there the "Race for the CAUSE"?! Why can't why find out what's causing these things to occur and work on eliminating those things?
And the answer to that riddle is the money is in the treatment, and continued treatment. There's no money in elimination or cure.
My family physician retired after treating me for most of my life and I was forced to find a new doctor.
I went to several that saw me as a paycheck and showed no interest in my actual health, and just wanted the income.
But I recognized this and kept looking until I found one that I actually thought put my health above all else.
I have no way of quantifying how many doctors are out for money vs how many are truly trying to help. But to think there aren't doctors that just seek a paycheck and don't actually care doesn't exist is foolish.
Turds come in all shapes, sizes, colors, political affiliation, gender, sexual preference, religious beliefs, and occupations.
Some people with seemingly benevolent jobs can actually not have your best interest at heart.
This is not a one size fits all broad swath against doctors.
But I work with thousands of doctors. It's easy to distinguish which ones care about their patients, and which care about their bank accounts.
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Here’s one cause and it’s a ******* disgusting one at that. I’ve been on a few road trips this past year through Appalachia and you can drive for an hour and the only business you see is a dollar store.
I'm not so concerned about side effects, other than the common diarrhea, constipation and nausea, the rest are fairly rare.
But the over use for weight loss can certainly create a shortage in the market for those needing it to control their blood sugars.
You are also correct that it could be a life long treatment, unless the patient works really hard at maintaining their weight after stopping the Ozempic.
Same holds true with those that opt for gastric bypass surgery, unless you alter your eating habits and consume less the surgery is worthless.
Add to the fact that without insurance the last I remember Ozempic was around $900 a pop, or about $47,000 a year. Even if insurance covers the injections, it will
still affect insurance rates for everyone.
The people I know on it spend $500 a month. Steep.
What in the hell are you on about? Talking to yourself again? Lost the point again?
We are discussing drugs like Jardiance and Ozempic and the mass-overprescription of those drugs. And you're posting links about dollar stores? To make what point, exactly Barney?
Obviously you haven't driven through central FL, much of TX, or even parts of central PA.
We are discussing drugs like Jardiance and Ozempic and the mass-overprescription of those drugs. And you're posting links about dollar stores? To make what point, exactly Barney?
Obviously you haven't driven through central FL, much of TX, or even parts of central PA.
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somebody got their feelings hurt again. So much anger. So much derangement.In his rambling post Fedderone mentioned cause vs cure. What’s causing obesity? Yes, when the dollar store is the grocery store and all a person is eating is processed garbage, that can absolutely cause obesity.
I’ve driven through all of those places, what does that have to do with anything?
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So the cause for obesity is ............ Dollar General?
So you drove through Appalachia this past year.
Because this is anecdotal, for clarification -
So your destination was not in Appalachia? You were just passing through?
In passing through, did you cover all the roads in that area seeking out possible grocery stores?
Was this through all 13 states that make up Appalachia, or just a particular state/region?
Is your point that America hates Appalachia and greedy evil corporate America wants the people of Appalachia to get sick, fat, and die?
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Uh, why not read the study I provided and reply in an articulate manner… or just another bizarre rambling house with broken glass on the floor analogy.
Only if they're red states.
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The report you linked doesn't have answers to any of the questions I asked you about your passing through Appalachia.
An analogy is given when a person doesn't understand the information presented in its original form.
But hey, you keep on being you and avoid answering any question asked of you or trying to engage in meaningful dialogue.
We ALL get it. You are obtuse and incorrigible. You operate in absolutes like a Sith.
In his rambling post Fedderone mentioned cause vs cure. What’s causing obesity? Yes, when the dollar store is the grocery store and all a person is eating is processed garbage, that can absolutely cause obesity.
I’ve driven through all of those places, what does that have to do with anything?
Someone is simply trying to make sense of your mindless meanderings.
You're now saying the Dollar Store is the cause of obesity. No regard for processed/cheap/low calorie foods purchased at Safeway, PigglyWiggly, 7-Eleven, WaWa, Racetrak or any of a million other convenience/food stores. No regard for lack of exercise.
For Flogtard, obesity is due to Dollar Stores.
The world of You Can't Make this **** Up
being 6'1", 230 pounds, your fat *** obviously made quite a few stops to get your powered donuts and Mtn Dew.
In his rambling post Fedderone mentioned cause vs cure. What’s causing obesity? Yes, when the dollar store is the grocery store and all a person is eating is processed garbage, that can absolutely cause obesity.
I’ve driven through all of those places, what does that have to do with anything?
Yep. Evidence Floggy provides (when he rarely does) is typically non-sensical like this.
He broad-brush generalizes then says dumbass **** like "you can drive for an hour and the only business you see is a dollar store." Yeah, when you're passing through and observing cities and towns from an interstate or highway (without stopping off and driving around) and you have no spare brain cells to rub together, you conclude "I saw a Dollar General and nothing else so there are no grocery stores."
The proper term is not fat ***, it is clinically obese. He only needs to lose 10-15lbs though, he says.
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What difference does it make which part of Appalachia? Drove through all of them north of Georgia. Are you denying Appalachia is largely rural and poor?
Floggy tryna say that people in 13 states aint be poor to some extent.
Floggy world wise.
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