‘The quest for a slimmer figure is driving some people to do anything to get their hands on Ozempic’

Jean-Luc Faillie is a pharmacologist and the head of the pharmacovigilance center at Montpellier University Hospital. He is responsible for nationwide pharmacovigilance monitoring of GLP-1 analogs, a hormone that regulates glucose and appetite.

Weight-loss drugs always become a craze. Today, it’s the turn of Ozempic, an anti-diabetic drug reappropriated for weight loss. How do you perceive this frenzy?

First of all, if this drug is used for obesity that is severe, complicated or at risk of complications, notably cardiovascular problems, one can speak of reappropriation but it can be explained and justified on medical grounds. It wouldn’t be the first time that a product initially designed for one disease has been shown to work for another. Today, we know that GLP-1 analogs [a natural digestive hormone] have an effect on weight and that they have a clinical benefit in patients suffering from severe obesity.

According to consumption data from France’s social security, around 1.5% of the 230,000 Ozempic users in France are not diabetic. Although this figure is probably underestimated, the phenomenon remains rare in France today. On the ground, there is a very strong demand for this drug with a desire to lose a few kilos amplified by social media, such as TikTok, and influencers who act as sounding boards. And this quest for a slimmer figure is driving some people to do anything to get their hands on the product.

Any examples?

We’ve seen falsified prescriptions; there are online sites offering sales without a prescription; fake Ozempic pens containing insulin have been seized; a member of a research team stole the product… Another drug, Rybelsus [in tablet form], which is not marketed in France, has even been trafficked from Belgium. When these drugs are used for aesthetic purposes, the risk/benefit ratio is unfavorable as the risk of side effects is not offset by a proven clinical benefit. What’s more, using these drugs outside the medical framework can lead to mistakes that can increase the risk of side effects especially when doses are increased to lose weight quickly. In fact, we know that it’s necessary to start with low doses and gradually increase them.

What are these side effects?

There are frequent, mild side effects, mainly gastrointestinal: nausea, vomiting, constipation. Clinicians tell us that they are very frequent: up to 10% of patients. Some go so far as to stop the treatment because they cannot tolerate it. There have also been reports of severe fatigue, tachycardia and hair loss [from 2% to 3% of cases].

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