Last summer, I was invited to a 60th birthday party where the post-dinner entertainment came in the form of a private set from one of Britain’s biggest male pop stars. Yet even more striking than the performance itself was the singer’s dramatically slimmer appearance. Dressed in a silver catsuit and moving energetically across the stage, he looked almost unrecognisable. The explanation, I was told, was semaglutide — better known by its brand name, Ozempic — the weight-loss drug that, according to growing chatter, seems to have become the slimming aid of choice for everyone from socialites to one of the world’s most famous supermodels.
Semaglutide was originally created to treat type 2 diabetes, but in both the UK and the US it is now widely used off-label as a treatment for obesity. Research from its manufacturer, Danish pharmaceutical giant Novo Nordisk, found that patients lost an average of 17 per cent of their body weight over 68 weeks. That is a far stronger result than older anti-obesity medications such as Metformin, which typically produce weight loss of around five to nine per cent.
In the UK, Ozempic is available on the NHS only for people with type 2 diabetes. However, it can also be prescribed privately, and some people are obtaining it online through weight-loss services without direct medical supervision — something doctors do not advise. While it is sometimes taken as a tablet, it is more commonly administered by 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
Unsurprisingly, Hollywood appears to have embraced Ozempic well before the wider public caught on. Variety recently joked that the drug deserved its own thank-you mention at the Emmys, given how many noticeably slimmer stars appeared on stage. Elon Musk has publicly praised Wegovy, a more potent sister drug, while Kim Kardashian has been widely rumoured to have used semaglutide to shed 16 pounds in order to wear Marilyn Monroe’s dress to the Met Gala. On TikTok, the hashtag #ozempic has now amassed more than 285 million views.
The attention has fuelled a sharp rise in demand, leading to shortages in both the US and the UK and prompting criticism of celebrities and influencers accused of snapping up supplies while diabetes patients struggle to access the drug. In response, the pharmaceutical industry has pushed alternatives, including tirzepatide, sold as Mounjaro and made by Eli Lilly, though it has not yet received US Food and Drug Administration approval for weight loss.
Novo Nordisk has said supplies should recover by the end of the year, but concerns have hardly eased. At least two middle-aged male friends of mine who began taking the drug in September are already worried about running out before the festive season. As one private London GP put it to me, the mood is beginning to resemble the HRT supply panic seen last spring.
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.
