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Oh, oh, oh, Ozempic …
If that jingle is caught in your head, you’re not alone. In 2022, health care professionals wrote more than 5 million weight-loss prescriptions for various versions of semaglutide — the generic name for the diabetes drug that’s become a fat-fighting sensation. The injectables Ozempic and Wegovy, as well as Rybelsus (a pill form), have become so popular that diabetes doctors have had to scramble to get alternative medications for their patients.
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But, to paraphrase the marketing lingo: Is Ozempic right for you?
There’s no doubt that the new anti-obesity drugs are effective at helping people shed pounds — a potential boon for the nearly 42 percent of people over 60 in the U.S. who are affected by obesity. “Many of them will benefit,” says John Batsis, M.D., associate professor in the division of geriatric medicine and the department of nutrition at the University of North Carolina at Chapel Hill. “But the older you are, the more reason you have to be cautious. Our bodies change with age, so the results in younger people don’t necessarily apply to those who are older.”
A new way to think about weight
Over the past 30 years, science has begun to pinpoint the biological underpinnings of obesity. “When you gain too much weight, the weight-regulating pathways between the intestine and the brain begin to malfunction, which makes you hungrier and prevents you from feeling full,” explains Louis Aronne, M.D., an obesity specialist at Weill Cornell Medicine’s Comprehensive Weight Control Center.
“What a relief it was when my doctor said, ‘Your weight is not your fault. This is a treatable medical condition,’ ” says Barbara Hiebel (not her real name), 65, of Chapel Hill, North Carolina. “I weighed 200 pounds and was prediabetic.”
As this new understanding of obesity as a disease began to emerge, researchers testing semaglutide — developed to help people with diabetes regulate blood sugar — noticed that many participants taking the drug were getting slimmer. Turns out, semaglutide mimics intestinal hormones, including glucagon-like peptide-1, or GLP-1, which slows digestion and tells your brain you’re full. The result: You eat less, according to the first study looking at semaglutide for weight loss. Published in 2021 in The New England Journal of Medicine, it found that half of participants lost 15 percent of their body weight in about 15 months.
The medicine has changed the lives of patients such as Hiebel. “I lost 60 pounds and have kept it off — for the first time ever.” In June 2021, the Food and Drug Administration approved semaglutide for the treatment of obesity, under the brand name Wegovy. And in November 2023, the FDA approved a similar diabetes drug, tirzepatide, for treating obesity under the brand name Zepbound.
How exactly do these drugs work?
Anti-obesity medications are FDA-approved for people with a body mass index (BMI) of 30 or more, and for those with a BMI of 27 or higher who have at least one weight-related health condition, such as heart disease or sleep apnea, says Caroline Apovian, M.D., codirector of the Center for Weight Management and Wellness at Brigham and Women’s Hospital. “They aren’t intended for healthy people who want to lose a few pounds.”
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