Weight loss seekers depriving Miami diabetes patients of Ozempic

A diabetes medication popularized by celebrities and TikTok stars for its rapid weight loss effects is becoming harder to find in Miami for patients in need, local doctors and pharmacists warn.

The big picture: Shortages of Ozempic — a brand-name injectable drug called semaglutide — have been reported in the U.S. and around the world over the last several months as manufacturer Novo Nordisk scrambles to keep up with increased demand.

• Novo Nordisk recently announced a shortage of a similar medication, Wegovy, which is also made with semaglutide, and is advising that new patients not start on it at this time due to the supply crunch.
• The rise in demand comes as celebrities like Elon Musk and social media influencers have been touting the drugs' weight loss effects. Variety reported that Hollywood stars gossip about Ozempic on Signal, calling it "the worst kept secret in Hollywood."

Why it matters: Off-label use of Ozempic, designed for patients Type 2 diabetes, is "pulling the supply from people who really need it," Jonathan Fialkow, a cardiologist at Baptist Health's Miami Cardiac and Vascular Institute, told Axios.

• Plus: Fialkow warned that researchers don't know whether semaglutide's use is safe for the general population in the long term.
• "These medications have been studied in certain populations of people with certain medical conditions," he said. "When we start using medications and other populations that haven't been studied, while they may be safe, we don't know."

Zoom in: The Baptist Health hospital system has received a recent influx of calls from patients who can't find Ozempic, Fialkow warned in a statement last week.

• "The pharmacies are out of it, and we're jumping through hoops to have them be able to continue on the medication," he said.
• Brandee Lam, a pharmacist at an independent pharmacy in Dania Beach, told Axios that the medication has been out of stock recently as non-diabetics have been using it as a "fashionable" weight loss drug, paying full price to purchase it out-of-pocket. It costs $1,070 for a month's supply, Lam said.

Context: Fialkow explained that Ozempic, which was approved by the FDA in 2017, is a type of drug called a GLP-1 receptor agonist that causes patients to feel satiated. Such drugs were developed for people with Type 2 diabetes to manage blood sugar levels.

• Wegovy was approved last year for chronic weight management in adults with obesity.
• "Individuals who received Wegovy lost an average of 12.4% of their initial body weight," the FDA noted.

Between the lines: The medications can make people lose their appetites. Some report being repulsed by food.

• Side effects can include nausea, diarrhea, slurred speech and drowsiness, as well as kidney problems, increased risk of thyroid cancer and allergic reactions.

What they're saying: "The medication is only going to work as long as you take it," Fialkow said. "So if you stop it, you're just going to gain all the weight back because … you're not making lifestyle changes or any other metabolic changes."

• Both Fialkow and Lam noted that demand for Eli Lilly's weight-loss drug Mounjaro, which is based on another medication called tirzepatide, is also rising. Mounjaro was approved by the FDA this year for diabetes but some physicians are prescribing it off-label for weight loss.

Zoom out: A 2019 study published by the New England Journal of Medicine estimates that by 2030 almost half of American adults are expected to be obese.

• Rapid weight loss drugs are being developed to meet the growing need. U.S. revenues for high-efficacy obesity medicines could jump to $31.5 billion in the next eight years, up from $0.8 billion in 2021, according to a Morgan Stanley report.
• Fialkow said increased obesity is due to "simple sugar consumption in the United States and ultra-processed foods which have all these ingredients and chemicals that our bodies are just not evolved to handle."