3 New Facts Patients Need to Know About Semaglutide (Ozempic ®) for Weight Loss

Semaglutide (Ozempic®) has been a weight game-changer for patients.Here are some important new facts patients need to know, courtesy of Bariatric and Laparoscopic surgeon Mr Jason Winnett from the Winnett Specialist Group.

1. Semaglutide “compounding” is now banned in Australia

Following a Four Corners investigation in April, the production of semaglutide by compounding chemists will effectively be banned by October this year. The investigation found a compounding pharmacist illegally shipped replica products of semaglutide (Ozempic ®) overseas, creating widespread public safety concerns.

Semaglutide, a medication approved only for Type II diabetes in Australia, is also in huge demand world-wide for weight loss, and is often prescribed off-label for that purpose. vThe Four Corners report found that the unlawfully compounded drugs caused extra side effects (including loss of nerve sensation) due to elevated levels of Vitamin B 12 and L-Carnitine.

“It is important to use a trusted prescriber such as a GP, bariatric physician or bariatric surgeon and to use a reputable pharmacy when using semaglutide or any weight loss drug,” says Mr Winnett. “Medical oversight and pharmaceutical expertise is just as important as the medication itself.”

2. Health Benefits of Semaglutide

The potency of semaglutide was first confirmed in 2021 in The New England Journal of Medicine resulting in 14.9% weight loss compared to 2.4% placebo in 1961 subjects over 68 weeks.

A third of semaglutide group patients lost 20% of weight. Furthermore, 84% of patients with pre -diabetes returned to normoglycemia, compared with 47.8% in placebo.

Weight circumference in the semaglutide group was -13.4cm, compared with -2.4cm in placebo.

The dosing in the study was slightly higher than the dosage used in Australia and was 2.4mg weekly (Wegovy ® not yet in Australia) compared with 1 mg weekly (Ozempic).

“The reason why semaglutide is constantly in shortage globally is because it is a very effective short-term weight loss solution. It also helps keep blood sugar under control for patients with diabetes,” says Mr Winnett.

“Weight loss surgeons also tend to use it as a pre-surgery adjunct to enhance weight loss before surgery; thus making it easier and safer to navigate through less fat.”

In May 2024, as second study in the New England Journal of Medicine, found that the risk of a primary heart or kidney event was 24% lower in the semaglutide group. This study followed 3533 participants with Type II diabetes for 3.4 years.

“These studies show us that for people with diabetes there is significant risk reduction of heart attack and kidney disease with semaglutide,” says Mr Winnett.

3. Risks and Considerations with Semaglutide Use

Some patients may see Semaglutide as a fast fix. Apart from weight loss, improved diabetes and reduced cardiovascular disease, a new study in Science News recently found Semaglutide may potentially reduce addiction to alcohol, nicotine and heroin through a dampening effect of the brain’s reward centre. But there are certainly some big downsides to consider.

Firstly, although patients save money in food costs, the drug costs more than $130 a month on a private script in Australia.

Secondly, much of the lost weight tends to pile straight back on after you stop taking it according to one study of 1961 patients in the Diabetes, Obesity and Metabolism journal.

“Semaglutide is not a ‘magic pill’. The first landmark NEJM study in 2021 found that while there are significant weight and diabetes benefits, there is also a higher risk of pancreatic inflammation. In the semaglutide group this was 2% v 1.2% placebo for gallstones however all recovered,” says Mr Winnett.

“Common side effects included diarrhoea and nausea and there were some serious gastrointestinal side effects (9.8% in control group v 6.4% in placebo).” Semaglutide has also more recently been linked to the stomach paralysing condition gastroparesis, which has resulted in 87 lawsuits in the US.

“Gastroparesis disrupts regular, spontaneous muscle movements in the stomach,” says Mr Winnett. “This prevents proper stomach emptying and can be very uncomfortable and cause symptoms of feeling full, vomiting, weight loss, tummy pain and bloating. It tends to be a chronic and painful disease. Whilst not usually life-shortening and a condition which can be managed, it cannot be cured.”

He says that while weight loss drugs can rarely cause the condition, viruses, thyroid issues, and autoimmune conditions, including Type 2 diabetes, also increase the risk of gastroparesis.

“Despite gastroparesis being a rare side effect of semaglutide, patients still need to know the risks which should be discussed and carefully managed by an experienced GP, or weight loss specialist physician or surgeon,” he says.

“Any side effects must be carefully considered and weighed up against the “side effects” of not taking medications. This includes premature death for the morbidly obese as well as increased risk of heart attacks, cancer risk, joint pain, immobility, infertility and depression.

He also says Semaglutide should be prescribed and used judiciously. “It has a place for extreme obesity, for surgical patients and for patients with diabetes. However, given the supply issues and the need by these specific patients it should only be used for appropriate reasons.

At Winnett Specialist Group, we understand that there are no magic or instant solutions for weight loss support. If you would like expert advice, please contact us or call us at (03) 9417 1555 to learn more about how we can help you achieve your weight loss goals and improve your overall health through a holistic approach.

Disclaimer * This article is for educational purposes only. Mr Jason Winnett has no financial arrangements or clinical trial arrangements with any pharmaceutical companies that manufacture the above weight loss medications.