​Magic or the portrait of a skinny Dorian Gray?

The drug that keeps re-purposing itself

By Ellie Liverani

eli.liverani.ra@gmail.com

There is a drug that is getting a lot of attention nowadays all over the world. It has various commercial names (Ozempic, Wegovy and Rybelsus), but the common scientific name is semaglutide.

It is not a new discovery. In fact, it has been studied since the 70s. But in time, it has been more and more re-purposed, similarly to Viagra, but even more so.

The amount of content (and drama) you can find on social media about semaglutide is overwhelming. This drug clearly gets a lot of views. The more we read and watch, the more confusing it gets. But PubMed provided scientific tranquility.

Semaglutide was initially developed to treat type 2 diabetes in the 70s and 80s. It was approved by the U.S. Food and Drug Administration (FDA) in 2017. This drug seems to enhance the natural response of the body to insulin. It stimulates insulin release, reduces glucagon production and slows down gastric emptying. It was then approved to treat obesity in 2021.

Both type 2 diabetes and obesity are complex diseases on the rise, so a new effective drug is always welcome. Semaglutide seems to work quite successfully for both. More recently, it has also been studied as an anti-inflammatory drug for neuroinflammation as well as gastric diseases.

What is all the semaglutidedrama?

The drug has been re-purposed for a “vanity use”: losing the last extra, stubborn pounds. (Hollywood first, as usual.) And it works quite well.

Semaglutide decreases your appetite, so you tend not to eat much. In fact, some people claim that they forget to eat. As some people described it, semaglutide decreases “food noise.” Junk food loses its appeal almost immediately. So, the “magic” is that you eat less.

Apart from Hollywood, it is not only about vanity. In fact, people reported an improvement in their health, such as decreased joint pain, lower blood pressure and lower cholesterol levels.

Other effects of semaglutide

Interestingly, the effects do not stop at food.

In some cases, people were less attracted to alcoholic beverages and less prone to other forms of addiction, like shopping, which is convenient, as the drug is not cheap and not always covered by insurance.

However, despite these promising stories, so far, the effects are only anecdotal. In fact, some people found quite the opposite. It is a possibility to re-purpose the drug as a treatment for addiction, but there are no conclusive studies.

The list of side effects and complications of semaglutide is long, but in fairness, it is not different from other drugs. At the beginning, it is normal to experience gastrointestinal problems. In some cases, they disappear. But in other cases, people are forced to stop. Muscle loss and loose skin have been observed also. But these are not any different from losing weight quickly using other methods. There are serious side effects (loss of vision, acute pancreatitis, kidney failure and so on), so it is always advised to be careful and talk with your healthcare provider.

On the wild web, I found a lot of fascinating stories about how losing the last ten to twenty pounds change people's lives, not only physically (less joint pain, more mobility, lower blood pressure) but also emotionally. They gain self-esteem and therefore start questioning their choices and relationships. Some people felt that at a lower weight, they had more opportunities and society treated them differently.

Reassessing your goals and your surroundings is always positive, but it is interesting to see that something so superficial as weight seems to have such a high impact on how we feel about ourselves. What does that say about our society?

Science does not have an answer. But it would be interesting to find one for ourselves.

Dr. Liverani is an assistant professor at the NDSU School of Pharmacy.