In the third decade of the 21st century, pluralistic aesthetics have become mainstream. No matter what kind of appearance you have, you should reject appearance and body anxiety and strive to #loveyourself #beyourself. But in the past two years, with the popularity of a hypoglycemic drug known as a "miracle drug for weight loss", the desire for a slim body has returned strongly (perhaps never disappeared). This will undoubtedly trigger a new wave of body anxiety, accompanied by health concerns caused by drug abuse.
Recently, around the world, there is a "weight loss drug" that has received a blowout level of attention, and celebrities have endorsed it on social media.
Tesla founder Elon Musk claims to have lost more than twenty pounds a month on a drug called Wegovy and dieting.
American comedian Chelsea Handler admitted in a podcast that she used Ozempic, which she claimed was given to her by an anti-aging doctor, and she didn't even know what she was using, let alone that the drug was linked to treating diabetes.
Hollywood actor and host Andy Cohen shared information about Ozempic drug weight loss on social media, and the tag has exceeded 274 million views on Tiktok and continues to increase.
Does this "special drug" really have such a miraculous weight loss effect that makes all the stars flock to it?
Paul Jarrod Frank, MD, a dermatologist in New York, told VOGUE: "Aside from Viagra and Botox I have never seen a drug that has gained explosive attention so quickly, and it is considered a special drug by people who want to lose weight." Paul and many other doctors have noticed that more and more patients have been consulting about the drug recently. Whether it's social media or real life, the drug quickly became an internet celebrity because of its obvious and rapid weight loss effects. In China, there are not a few people who use this drug to lose weight, and the degree of discussion on social media continues to rise.
Nowadays, "skinny" is once again receiving a lot of attention in the fashion industry (of course, it may never really disappear). This reminds us that weight is easily affected by trends. If many people are willing to get regular injections of this diabetes injection and endure its possible side effects, just to conform themselves to the criteria for a leaner body, there is indeed a concern about whether it is a cultural and aesthetic step backwards.
Ozempic Chinese called Novotec, is a new injectable prescription drug from pharmaceutical company Novo Nordisk, the industry's broadest range of diabetes treatment products, designed to improve type 2 diabetes in conjunction with diet and exercise, containing a key active ingredient, Semaglutide (Chinese is semeglutide). The Wegovy mentioned by Elon Musk also contains this ingredient, but in different doses, more expensive, and specifically for weight loss indications.
The key ingredient, semeglutide, belongs to a class of drugs called GLP-1 receptor agonists, a complex that replicates a hormone produced in our body's gut, a hormone that is released after we start eating. Dr. Ariana Chao, assistant professor at the University of Pennsylvania School of Nursing and medical director of the university's Center for Weight and Eating Disorders, said: "Semeglutide increases insulin release due to glucose intake and causes a slowdown in gastric emptying. "Not only that, but it also acts on areas of the brain that regulate appetite and food intake, and also makes the body more sensitive to the insulin it produces." It helps make the body's fat cells shrink over time."
Novo Nordisk manufactures Ozempic and Wegovy, two drugs containing semeglutide, which are approved for two different uses but are actually similar. Due to the shortage of Wegovy and the relatively higher out-of-pocket costs, many people tend to choose Ozempic to lose weight, which also leads to some diabetics who really need it not being able to buy medicine.
Simply put, it suppresses appetite and induces the body to feel full. Clinically, it can play a role in lowering postprandial blood sugar, but also has a part of the effect of lowering fasting blood sugar, and there is also a significant effect of suppressing appetite and reducing weight, so GLP-1 receptor agonists are used in type 2 diabetes to reduce weight and reduce blood sugar at the same time.
Dr. Rahnama told us: "The hormones produced by the body's natural response only keep us full for a few hours, whereas under the influence of such drugs, satiety lasts for 24 hours. "After each injection, you get a feeling of fullness within six to seven days, and that feeling gets worse over time. Dr Lofton said: "I have patients who tell me that they are only one-third of their usual full, stay full longer and no longer crave snacks. ”
"From 2017, when the U.S. Food and Drug Administration (FDA) approved semeglutide for the treatment of diabetes, the guidelines were 1 mg/week injection. In early 2022, the FDA approved a higher 2mg/week dose, and Wegovy approved a maximum dose of 2.4mg/week for the treatment of obesity in July 2021. W. Scott Butsch, MD, medical director of obesity at the Cleveland Clinic Institute for Obesity and Metabolism, said.
Wegovy is approved by the FDA for weight loss use in adults over the age of 18 with a BMI above 30, or a BMI of 27 or more with obesity-related conditions such as high cholesterol or high blood pressure (note!). Nor are they weight-free diet pills). Dr Butsch said: "Wegovy marks the beginning of a new generation of highly effective anti-obesity drugs. ”
The reason why it is so popular is that these drugs can indeed achieve rapid weight loss. "In a 68-week randomized controlled trial of more than 1900 people with an average BMI of 37, they lost an average of 12.4 percent of weight, outperforming all weight loss drugs currently on the market. In addition, more than half of the study groups (55%) lost more than 15 percent of their body weight and 35 percent lost more than 20 percent of their body weight. Dr. Rahnama said the large number of people who did not meet the criteria for obesity used the drug to lose weight leading to its abuse.
In China, Semeglutide injection was officially launched in August 2021 under the trade name of Novotech Chinese, and it is indicated for weekly subcutaneous injection to supplement diet and exercise to improve blood sugar control in patients with type 2 diabetes mellitus (T2DM), and has not been approved in the field of weight loss, so it is not a diet drug. According to the report of "Drug Research and Development", in September last year, the indications of semeglutide oral tablets for weight loss were approved for clinical trials in China.
The most common side effect of Ozempic is gastrointestinal adverse reactions, as noted in the drug description nausea, vomiting, constipation and loose stools have been widely reported, and some people can even be severe enough to stop the drug. Dr Chao said: "Semeglutide has been reported to have rare but serious side effects, including pancreatic inflammation, diabetic retinopathy, kidney problems, gallbladder problems and allergic reactions. ”。 For some people, Ozempic is contraindicated: it is not recommended for people who are pregnant or breastfeeding, or for people with a personal or family history of medullary thyroid cancer or multiple endocrine tumors.
And a study of Wegovy clinical trials published a few weeks ago in the New England Journal of Medicine showed that it is a safe method of weight control if used correctly, even for teenagers. Dr. Rahnama says that if semeglutide is used appropriately, appetite is never completely suppressed, but better controlled. But if used improperly, appetite is completely suppressed, which can cause or worsen eating disorders.
Dr. Lofton says all patients are closely monitored while taking Ozempic, which is why we are very concerned about the global prevalence and the fact that many people get medicines from friends or other illegal sources. "It's a problem for inexperienced prescribing doctors to dispense casually," she told us, "and it should be used under medical supervision because it carries the risk of adverse side effects that could put you in the hospital." ”
If you search casually, you will find that there are many people on the Internet who share cases of severe vomiting after use. "Anyone in this case should stop using it, or lower the dose and have an ultrasound exam."
In the United States, despite FDA guidelines for the use of Ozempic to treat type 2 diabetes, numerous doctors are prescribing Ozempic and the drug is being abused. Dr Chao said: "I am concerned that this drug is being used for other purposes because it has not been well studied in people who have not developed diabetes or who have not met the criteria for obesity. "A lot of people with a doctor's background are worried about this, "If someone just wants to lose a few pounds, I mean, come on, this drug isn't right for them," Dr. Passler says bluntly. But using the BMI as a determinant of who qualifies is inherently problematic, Dr. Lofton says, "BMI is not perfect, it's not directly related to morbidity and mortality," and he often relies on other health indicators, such as waist circumference, or whether you have heart disease.
There are many studies on the efficacy of Ozempic, but since it is still a fairly new drug, there are no studies on the effects of long-term use. However, your baseline weight and blood sugar levels may return once you stop taking it, so experts stress that dietary changes while taking medication are just as important as lifestyle.
TikTok influencer Remi Bader, who started taking Ozempic because she has diabetes and insulin resistance, said she felt "mixed" about the drug. Because she doubled her weight again after stopping taking the drug. "I went to the doctor and he told me (regaining weight) was 100 percent because you took Ozempic," she said. This medicine tricked me into feeling like I wasn't hungry for so long, I lost weight, but I didn't want to rely on this drug all the time. As soon as I stopped it, the feeling of hunger came back, my bulimia got worse, and I kind of blamed Ozempic for turning me into this. ”
In the first six months of Wegovy's introduction to obesity treatment in the United States in July 2021, there was a supply shortage due to demand and factory capacity, leading many to use Ozempic instead. Dr Butsch said: "Many new providers are now using lower doses of semeglutide to treat obesity, but this is clearly exacerbating the supply shortage for diabetics. "This is happening in other countries as well. In China, because Wegovy is not on the market, many people can only grab Ozempic with diabetics.
But with the popularity of this drug, a new skin problem quickly appeared, called "Ozempic face", and many people found that after taking the drug, "the body looks thin, but the face looks old and tired".
"Rapid weight loss leads to a rapid loss of facial fat, which also affects collagen and elastin in the skin." Dr. Levine said, "The face and skin look shriveled, saggy and saggy and the whole person looks haggard, unenergetic and senile, which are common features of Ozempic's face." Think raisins, not grapes. ”
According to aesthetic doctor Dr. Sophie Shotter, it is not the drug itself that causes these skin changes, but rapid weight loss. With the rapid loss of weight, it is difficult for the skin to contract and rebound quickly, which also causes the facial skin to become loose and saggy. "Facial fat does help us fight aging, and people with more fat have relatively fewer wrinkles," on the contrary, excessive facial fat can also have problems, such as creating obvious lines on the face, such as marionette lines (around the mouth). It's a cliché that balancing your weight is the key to keeping your skin healthy.
If you see this, you should also be shocked by the madness of mankind. Ava Shamban, a dermatologist in Los Angeles, said: "I am worried that the distortion of the body aesthetic will set an example for the younger generation of women, whose aesthetics are indeed vulnerable to unrealistic filters." ”
Long-term use of this drug is not for health reasons, but to achieve the ideal body, which is tantamount to advocating a weight loss culture. Only the era of thinness for beauty is not nostalgic, we can face our body type more confidently and honestly, and we can sincerely praise the beauty of multiple body types, which is an improvement, isn't it?
Edited by Valerie Zhang
摄影：Jeff Harris、Simon Emmett、Barbara Donninelli、Pawel Pysz、Sophie Delaporte
Written by: Fiorella Valdesolo and Shan Huang
Design: Bingbing