The ’90s were filled with bizarre weight loss trends. From Fletcherism to eating a grapefruit at every meal, people pursued a variety of strategies to shed some extra pounds. With only a few known medical advancements in obesity management — many of which quickly fell out of favor with the Food and Drug Administration — the diverse array of weight loss tactics was inevitable. Going to work with ankle weights, a cup of coffee and a frozen WeightWatchers meal for lunch (with Kelly Ripa and her “Dancin’ on Air” workouts) took effort that isn’t present in today’s weight-management trends. But why has progress been so slow?
The figurative pendulum of science swung toward shortcuts — things like pills, surgeries and even engineered food. Truly taking off in the early 2000s, physicians and scientists have collaborated on groundbreaking technologies to combat the growing obesity epidemic in a cost-effective and accessible way. For example, a sleeve gastrectomy, a popular bariatric surgery for people with a body mass index over 35, is covered by the vast majority of health insurance providers.
However, nearly half of Americans are now classified as obese, and that figure is only on the rise. It was only a matter of time until the conditions of a larger-than-normal population invited a new weight loss trend that is markedly different and dangerous from the rest: semaglutide injections.
Semaglutide, commonly known by the brand name Ozempic, is a type 2 diabetes medication that works by increasing insulin secretion, which in turn decreases blood sugar levels. Originally created and manufactured by the pharmaceutical company Novo Nordisk in 2012, Ozempic demonstrated incredible results for the treatment of type 2 diabetes. The significant side effect of weight loss, however, did not go unnoticed. Participants in Ozempic clinical trials showed a 15% decrease in their overall weight coupled with an improvement in physical functioning.
Unsurprisingly, the FDA recently approved semaglutide, under the brand name Wegovy, for weight loss management in obese people. Since its stamp of approval during the summer of 2021, semaglutide has skyrocketed in popularity. A chunk of that popularity, however, comes from the wrong crowd.
Without health insurance coverage, one monthly dose of semaglutide (sold as a pen injector) can cost almost $1,000 out of pocket. This price tag is not out of reach for the Hollywood A-listers using semaglutide to take off the last few stubborn pounds. While few celebrities publicly reveal their recreational use of semaglutide, Elon Musk took to Twitter to display a markedly slimmer body due (in part) to Wegovy. The injections have even made their way onto the largely Gen-Z platform TikTok as a weight loss trend.
Recreational semaglutide use is not inherently selfish. But when there’s a massive shortage of Ozempic and Wegovy, that strikes a bad chord with me. Diabetic and obese people who were relying on semaglutide prior to its claim to fame are now left in the midst of a shortage they did not cause.
Insurance also has a role to play in this crisis. Insurance companies are transitioning to a stingy scheme that only covers small doses, forcing non-recreational users to ration doses. Furthermore, unprecedented indicators of advanced diabetes are required to sustain coverage. To make matters worse, people are turning to telehealth companies for non-FDA approved Ozempic substitutes.
The Ozempic and Wegovy crisis is quite the slap in the face for everyday people who need semaglutide for their health. University of Michigan college students with semaglutide-indicated health concerns are no exception either.
Both the State Street Walgreens and CVS, two popular pharmacies for U-M students, have experienced periodic inability to fill semaglutide prescriptions. In an interview with The Michigan Daily, pharmacist technician Derek Plew shared the impacts of the popularity of the drug on those who are reliant on prescriptions.
“There isn’t much we can do at this point,” Plew said. “We have to honor semaglutide prescriptions as they are sent by physicians, regardless of whether the person number 42 on the list ‘needs it’ more than person number 3.”
The Ozempic shortage eerily resembles the Adderall shortage of 2019, when college students who needed the medication could not receive it. It is clear that University Health Service should step in to ensure that students, especially out-of-state students who are obese and diabetic, are able to source semaglutide in Ann Arbor during the shortage. Without it, uncontrolled diabetes has been shown to cause glaucoma, heart disease and painful neuropathy; it is simply inequitable for the University to provide pharmacy services on paper and not safeguard medications necessary to help parts of our student body lead healthy, successful lives.
At the national level, the confidence that Americans can have in timely resources for marginalized health conditions is undoubtedly declining. In an age where false misconceptions surround the “self-inflictedness” of obesity and diabetes, it is critical that these medications are available for their original, protected use. The time is now for the government to step in with regulations that have previously ensured the supply of other medications. Prior policy resolutions such as regional drug distribution by the Department of Health and Human Services and termination of preauthorization requirements for minors provide a promising start to preserving the circulation of weight loss medications for those it is intended for. It is a travesty that the urgency and commitment to protect obese and diabetic people is lacking from those who have the authority to help.
Human psychology is not going to change. We cannot rely on people’s moral compasses to self-assess their true need for semaglutide. Actionable steps at the government and U-M level must be taken to prevent a future shortage of the next in-demand drug. Ozempic led to public health crises colliding in a time of limiting resources: uncooperative insurance companies, prescription shopping from the wealthy and the lack of government intervention. A healthier America is at a standstill so long as the responsible distribution of all drugs is on the periphery of the government and Big Pharma’s agenda.
Moses Nelapudi is an Opinion Columnist & can be reached at email@example.com