This past summer, I found myself at a 60th birthday celebration that featured a dazzling post-dinner performance by one of the UK’s top male pop stars. The show was electrifying, yet it was the star’s striking transformation that truly stole the spotlight. Gracefully moving across the stage in a gleaming silver catsuit, he appeared remarkably different from his former self. His secret weapon? Semaglutide, commonly known by its brand name Ozempic, a revolutionary diet drug that’s becoming a must-have among the elite, including one of the globe’s most iconic supermodels.

Initially created to manage type 2 diabetes, Ozempic is now being used off-label to combat obesity in both the US and the UK. Research spearheaded by its producer, the Danish pharmaceutical giant Novo Nordisk, revealed that patients shed an average of 17 percent of their body weight over 68 weeks. This is a significant leap from the five to nine percent weight loss achieved with traditional anti-obesity medications like Metformin.

In the UK, Ozempic is accessible through the NHS exclusively for those with type 2 diabetes. However, it can also be acquired through private doctors, or even online via weight-loss programs, albeit without the endorsement of medical professionals. The drug is available in tablet form but is more frequently administered as an injection.

Originally developed to treat type 2 diabetes, Semaglutide is used off-label. It has been branded as a new diet drug that everybody is apparently taking

Hollywood, unsurprisingly, has been ahead of the curve when it comes to Ozempic. Variety magazine recently jested that the drug deserved its own shout-out at the Emmys, given the number of celebrities seemingly under its influence. Elon Musk has praised its more potent counterpart, Wegovy, on social media; meanwhile, rumors swirl that Kim Kardashian turned to semaglutide to shed 16 pounds and squeeze into Marilyn Monroe’s dress for the Met Gala. On TikTok, the hashtag #ozempic has amassed over 285 million views.

The mounting hype has triggered a surge in demand, leading to shortages on both sides of the Atlantic. This has sparked criticism towards influencers and celebrities who are monopolizing the supply, leaving those genuinely in need, like diabetes patients, in the lurch. In response to this scramble, pharmaceutical behemoth Eli Lilly has introduced an alternative—tirzepatide, branded as Mounjaro—though it awaits approval from the US Food & Drug Administration for weight loss purposes.

Novo Nordisk has promised to replenish its Ozempic stock by the year’s end, yet this assurance has done little to alleviate concerns. Two of my middle-aged male acquaintances, who began using the drug in September, are anxious about potentially running out before the holiday season. A private GP in London likened the situation to last spring’s hormone replacement therapy panic, highlighting the widespread anxiety surrounding these shortages.

So what exactly is this drug? Semaglutide belongs to a class called GLP-1 agonists, which not only regulate blood sugar but, as was discovered about a decade ago, also mimic the gut hormones that regulate our appetites – the ones that tell the brain when we are hungry or full. There are, of course, side effects: acid reflux, nausea, exacerbation of IBS symptoms and fatigue (but much less so than in earlier GLP-1 agonists such as Saxenda), as well as pancreatitis, gallstones and, in very high doses, it has caused thyroid tumours in rats. Meanwhile, when you stop using it the effect wears off immediately and in some cases it won’t work at all. 

‘I would describe semaglutide as an example of very smart science,’ says leading consultant endocrinologist Dr Efthimia Karra from her private practice off London’s Harley Street. ‘But it is not a panacea for everyone. Around a fifth of users do not respond to it. This is because the human body favours weight gain, thus when you lose weight the body will do anything to revert to its highest BMI. The heavier you are the harder it is to lose weight. If a patient has made no progress in three months, I will take them off it.’ 

Banker’s wife Laura, a native New Yorker in her mid-50s who had hovered between decades, started using it in January. ‘The Paleo diet, 5:2, CBT, NLP, bootcamp, diet delivery services – I’ve tried them all,’ she says from the family home in Hampshire, ‘and I’ve always yo-yoed right back. After my last annual checkup I seriously contemplated giving up. Then my doctor suggested semaglutide.’ 

After only a month she noticed her clothes had become looser. From then on, the weight started dropping off. ‘The strange thing was, I wasn’t eating anything different. I just couldn’t physically have seconds any more, and the idea of pudding after a full meal had lost its allure.’ Three months on, she is two stone lighter ‒ though occasionally she suffers heartburn if she eats too late at night or drinks alcohol ‒ and when we spoke in autumn, she was looking forward to losing another stone by Christmas. 

‘There is a niggling voice that tells me it is both risky and lazy to take a drug to lose weight, and I worry that it will all pile on again if I stop taking it. But if it does, I will seriously consider taking it indefinitely.’ 

Private London GP Dr Martin Galy has been prescribing semaglutide for about a year to clients who cannot lose the weight they gained in menopause. He has seen it have a transformational effect, too, on much younger women who suffer polycystic ovary syndrome. ‘PCOS sufferers are difficult to treat, and you can imagine how body image plays a very important part when it comes to self-esteem.’ 

But according to Tom Sanders, professor of nutrition and dietetics at King’s College London, it is not a magic bullet. Commenting on a study on semaglutide published in The New England Journal of Medicine in 2021, he says, ‘The challenge post-weight loss is to prevent a regain in weight,’ he wrote. It may prove to be useful in the short term, but ‘public health measures that encourage behavioural changes such as regular physical activity and moderating dietary energy intake are still needed’. 

That said, given our rising national obesity statistics and the escalation in accompanying health issues such as heart failure, cancer and obstructive sleep apnoea clogging up hospital beds, we’re going to need something. Semaglutide may be the rich person’s drug today, but might it be approved for more widespread use? Only time will tell.