TikTok users promote antidiabetic to lose weight, but there are risks – 05/31/2022

Just do a quick search on TikTok and there comes an avalanche of videos showing people who say they have lost weight quickly due to the use of semaglutide (Ozempic is the trade name), a drug used, at first, for the treatment of type 2 diabetes.

This medication is considered safe, as long as it is administered rationally, that is, in the right dose and for the pre-established time. According to experts, it should only be used once a week and should not, under any circumstances, be sold without a prescription.

“It’s a medicine that, if used in excess, causes nausea, constipation, diarrhea. And, even when given with guidance, routine exams need to be done to monitor the health of the pancreas, liver and general exams”, warns the doctor. endocrinologist Andressa Heimbecher Soares, member of SBEM-SP (Brazilian Society of Endocrinology and Metabology – São Paulo section).

In June 2021, this drug was approved in the United States by its health surveillance agency, the FDA, for the treatment of obesity and overweight, provided that these conditions are associated with at least one of the following conditions: high blood pressure, type 2 and high cholesterol, but always associated with reduced calorie consumption and physical exercise.

This approval was enough to lead to a rampant increase in usage. A report from “The Guardian” shows that the drug is in short supply in Australia after TikTok users started promoting it as a quick weight loss strategy.

THE Therapeutic Goods AdministrationAustralian organ, earlier this month issued a joint statement with several medical bodies confirming the shortage of the injectable drug semaglutide, manufactured by pharmaceutical company Novo Nordisk, due to “unexpected increase in consumer demand”.

In Brazil, semagalutide is approved by Anvisa (National Health Surveillance Agency) for the treatment of diabetes, but has been prescribed by some experts for weight loss, based on international release.

“Today, semaglutide is the most potent and safe drug we have for weight loss that exists. But it needs medical monitoring because it is an injectable medication, and there are patients who use medication together that can cause hypoglycemia”, warns Soares. “And you have to do a dose progression,” she adds.

According to the specialist, the problem is not the medication itself, which despite being “new” has been very well studied, but the people who buy and inject on their own, without a prescription. Yes, it’s wrong, but it happens a lot.

“Many people buy and use dosages more than they should. And this can cause dehydration, gastritis, diarrhea and overload the liver. There are a number of effects that, despite being ‘mild’, we do not recommend that this be done” , indicates the endocrinologist.

Not everyone can use

Semaglutide cannot be used by people who are allergic (or know that someone in their family has had a similar reaction) to its active ingredient, or to any other component of its formula.

Also be aware of the following conditions:

  • Pregnancy;
  • Lactation (breastfeeding);
  • Age under 18 years
  • Liver or kidney problems
  • History of retinopathy;
  • Psychiatric problems;
  • Type 1 diabetes;
  • Diabetic ketoacidosis;
  • Pancreatitis;
  • History of medullary thyroid cancer (personal or family).

Among the warnings and precautions indicated by the manufacturer about possible and serious side effects are thyroid cancer, known as medullary thyroid carcinoma (MTC), and type 2 multiple endocrine neoplasia syndrome.

Understand how semaglutide works

When administered subcutaneously (under the skin), once a week (there is already a tablet version, which is not yet available in Brazil), semaglutide is progressively released into the bloodstream, metabolized by enzymes (peptidases) capable of break down proteins or peptides and then is eliminated via the kidneys, mainly through the urine. The explanation is by Flavio da Silva Emery, associate professor and member of the scientific dissemination committee at the Faculty of Pharmaceutical Sciences of Ribeirão Preto.

To understand how semaglutide works it is necessary to know that GLP-1 is a hormone that signals to the brain that there is food inside the intestine and therefore that we are fed. In this way, the brain, upon receiving this information, ends up inhibiting hunger impulses and we stop eating.

Soares explains that semaglutide is, therefore, synthetic molecules that act exactly on the GLP-1 receptor, that is, on the GLP-1 lock. And, by connecting to it, they cause the effects of the hormone in the body, without us being fed.

“It’s a way to circumvent the feeling of food. In addition, they act by improving blood glucose levels in diabetic patients by improving the release of the hormone insulin, hence their initial use in diabetic patients”, says the doctor.

Specialists clarify that the time for the appearance of the desired effects can vary, but, in general, the reduction in blood glucose levels begins to be observed one week after the establishment of the therapeutic dose (treatment starts with lower doses until reaching the ideal for you).

In the other conditions, the expected results will have a longer waiting time, which can reach 8 weeks. This medication is not available through the SUS (Unified Health System).

*With information from the report published on 08/31/2021.

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