Tim Lanier  

Ozempic (semaglutide), Trulicity (dulaglutide), Wegovy (semaglutide), and Mounjaro (terzepatide) are the most prominent and popular of the injectable medications indicated to treat type 2 diabetes that droves of people are scrambling to get their hands on because of its potency for weight loss.  These medications are indeed potent- for what they are intended to do (lower A1c) and what they aren’t necessarily intended to do (weight loss).  While the weight loss component was always present, it wasn’t until videos on social media platforms caught wind of it and spread it like wildfire.  As a result, everybody that wanted to lose weight rushed to their PCP requesting Ozempic. With such a high demand, Ozempic became almost impossible to find and was placed on a nationwide back order forcing many providers like myself to seek alternative treatment options for patients that actually needed the medication.  The first option was Trulicity which, in its own right, is highly comparable with Ozempic.  In fact, based on my own observation, I’ve seen it go both ways:  some patients started on Ozempic and saw little to no improvement but after switching to Trulicity, their A1c dropped, and they achieved their desired weight loss and vice versa. 

In clinical trials, Ozempic, Trulicity, Wegovy, and Mounjaro have all performed very well in producing weight loss and decreasing A1c levels yet only Wegovy is indicated for weight loss.  When the secret was out about how well these medications promote weight loss, all but Wegovy added a diagnosis of Type 2 diabetes as a requirement before providers could order them for patients.  In addition to this requirement, insurance companies have also required an unsuccessful trial of Metformin before authorizing either of these injectable medications.  While most feel that these changes were implemented to prevent further shortages and back logs so that people that actually need the medications to lower their A1c and fight diabetes, I feel that these changes were vital to saving lives.  You see, if people who have normal A1c levels and no type 2 diabetes use medications with the potency to lower A1c levels like these injectables, the potential for danger is as real as the desire for weight loss.  Hypoglycemia can be deadly therefore use of these injectables by persons who do not meet the criteria for use could be fatal. 

In my opinion, the weight loss benefit of Ozempic, Trulicity, Wegovy, and Mounjaro in patients that do not have Type 2 diabetes does not outweigh the risk.  I’ve had patients walk out of my office upset and vowing to go elsewhere, not understanding that the loss of their patronage is still a gain for me because I would much rather know that I protected a life than wonder if I placed one in jeopardy.  There are many potent options to aid in achieving weight loss that don’t carry the same potential for danger that these injectables have for those that don’t meet the qualifications for use.  Be sure to speak with your PCP about safe, available options for weight loss.