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Few medications have captured the national attention like Wegovy and for good reason. In a country with a well-documented obesity epidemic, Wegovy and other members of a new type of weight-loss drug are highly effective: In clinical trials, people on Wegovy typically lose 15% of body weight, and a similar medication, retatrutide, has shown up to 24% weight loss. There is now evidence that they confer benefit beyond weight loss, including a recent large clinical trial demonstrating protection against cardiovascular disease.

Yet Medicare does not cover Wegovy, or any other weight loss prescription. State Medicaid programs may decide to cover weight loss drugs, and only a fairly small number currently offer Wegovy.

Its easy to assume these restrictions emerged amid hesitation about cost, and for good reason: These new medications are expensive Wegovys annual list price is approximately $16,000 and patients likely have to stay on them indefinitely to keep off the weight. With trials of potential long-term benefits of these medications still ongoing, the jury is out on whether their potential benefit justifies the cost. For example, a recent informal report from the Congressional Budget Office concluded that while current evidence suggests the cost of these new medications exceeds savings from improved health, the cost-benefit picture remains incomplete with long-term trials underway.

The origin of federal restrictions of anti-obesity medications has nothing to do with these current cost-benefit considerations, however: The Medicare and Medicaid policies are three-decade-old restrictions on weight-loss medication in general a legislative legacy reflecting a different cultural and clinical understanding of obesity.

The Medicaid restriction became law in 1990 as part of the federal Medicaid Drug Rebate Program. The law states that certain classes of medications may be excluded from Medicaid coverage: In addition to weight-loss drugs it excludes a small number of other medicines, notably those used for cosmetic purposes or symptomatic relief of cough and cold. In 2003, Congress used this same 1990 Medicaid text as the starting point for Medicares restrictions under Medicare Part D, refusing to cover any anti-obesity medications.

These restrictions on anti-obesity medicines reflected the times. They reflected the attitudes of many that obesity was an individual failing: we consider obesity as the presenting symptom of a basic personality disorder, wrote one physician in the mid-20th century. They reflected a troubled history of anti-obesity medications through the 20th century, of agents introduced and later restricted after serious side effects became clear. Perhaps most infamously, the manufacturer of fen-phen pulled the drug combination off the market in 1997 after its association with heart damage. The laws also reflected the attitudes of the medical community. In 1996, the United States Preventive Services Task Force wrote that there was not convincing evidence that weight reduction decreases mortality. Or as a 1998 New England Journal of Medicine editorial summarized: we should remember that the cure for obesity may be worse than the condition.

Cultural and clinical attitudes toward obesity have since shifted. Human genetics studies have established that our DNA predisposes some of us to develop obesity. In 2004, the Department of Health and Human Services recognized obesity as an illness, and in 2013, the American Medical Association did as well. And with medications like Wegovy, there are now highly effective weight-loss agents. All the while, the obesity epidemic worsened: Between 1999 and 2017, the rate of obesity among American adults increased from 31% to 42%.

Despite this shift, the Medicare and Medicaid restrictions still remain law of the land, though there are signs of legislative change. Among the most sustained efforts at reform is the Treat and Reduce Obesity Act, federal legislation which would allow Medicare to cover anti-obesity medications; the act has been introduced annually in Congress since 2013 and currently has bipartisan support. In 2023, the Federal Employee Health Benefits Program, which sponsors health insurance for millions of government workers, directed its insurers to provide coverage for at least one drug like Wegovy.

Some might suggest that these decade-old restrictions bring unintended benefit by limiting coverage, they allow analysis of the pros and cons of the medications to proceed. Without a doubt, there are crucial ongoing discussions, most notably about cost-benefit considerations. Its clear these medications are expensive, and their long-term health effects and side-effect profiles are still emerging in clinical trials.

As this debate continues, though, we must recognize the origin of the status quo these restrictions came to be in a cultural and clinical environment surrounding obesity that today is nearly unrecognizable: Obesity is no longer discussed alongside cosmetic conditions as it was in 1990 its a disease we treat.

Ill be a resident physician later this year, and there are many legitimate reasons why my patients might be reluctant to take these medications: perhaps burdensome copays; perhaps hesitation about common gastrointestinal side effects; perhaps wariness about adding another long-term medication. What Id hate to be in our way are insurance restrictions reflecting a cultural and clinical legacy many decades out of date.

Daniel Weiner is an M.D./Ph.D. candidate at Harvard Medical School. He would like to thank Dr. Jason Block and Dr. Aaron Kesselheim for their helpful suggestions.

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Federal weight loss drug coverage is 30 years out of date - STAT

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**Draft:**

Ozempic is a once-weekly injectable medication that helps lower blood sugar in adults with type 2 diabetes. But did you know that it can also help you lose weight? In this article, we will explore how Ozempic works for weight loss, and what you should know before trying it.

Ozempic contains semaglutide, a synthetic version of a naturally occurring hormone called glucagon-like peptide-1 (GLP-1). GLP-1 is produced by the gut after eating, and it has several effects on the body, such as stimulating insulin secretion, slowing down gastric emptying, and reducing appetite. By mimicking GLP-1, semaglutide can help regulate blood sugar and promote weight loss.

The FDA approved semaglutide for weight loss in June 2021, under the brand name Wegovy. Wegovy is a higher dose of semaglutide than Ozempic, and it is indicated for chronic weight management in adults who are obese or overweight with weight-related medical conditions. However, some people have been using Ozempic off-label for weight loss, as it is cheaper and more widely available than Wegovy.

The aim of this article is to explain how Ozempic works for weight loss, how effective and safe it is, and what are its limitations. However, before starting any new medication, you should always consult your doctor and follow their advice.

## Mechanism of Action

- Explain how Ozempic works by activating GLP-1 receptors in the brain and the gut, and how this affects appetite, digestion, and metabolism

- Provide some evidence from animal and human studies that support the role of GLP-1 in weight loss

- Emphasize that Ozempic is not a magic pill, and that it requires lifestyle changes, such as diet and exercise, to achieve optimal results

**Draft:**

Ozempic works by activating GLP-1 receptors in the brain and the gut, which are involved in regulating appetite, digestion, and metabolism. By stimulating these receptors, Ozempic can reduce hunger, increase satiety, and decrease food intake. Ozempic can also slow down the movement of food from the stomach to the intestines, which can make you feel fuller for longer and reduce the absorption of calories. Additionally, Ozempic can increase the production of insulin, which can lower blood glucose and prevent fat storage.

Several animal and human studies have shown that GLP-1 can induce weight loss by affecting the central and peripheral nervous systems. For example, a study in mice found that GLP-1 can activate neurons in the hypothalamus, a brain region that controls appetite and energy balance, and inhibit neurons in the brainstem, a brain region that regulates gastric functions. Another study in humans found that GLP-1 can reduce the activity of the reward system in the brain, which is associated with food cravings and overeating.

However, Ozempic is not a magic pill that can make you lose weight without any effort. Ozempic is meant to be used as an adjunct to a reduced-calorie diet and increased physical activity, as these lifestyle changes can enhance the effects of the medication and improve your overall health. Ozempic is also not a cure for obesity, and it may not work for everyone. Ozempic is only approved for type 2 diabetes, and its off-label use for weight loss is not recommended by the FDA or the manufacturer.

## Effectiveness

- Compare the results of clinical trials for Ozempic and Wegovy, focusing on the outcomes of weight loss and blood sugar control

- Highlight the strengths and limitations of the studies, such as the sample size, duration, and design

- Emphasize that the effectiveness of Ozempic for weight loss depends on individual factors, such as adherence, dose, and medical history

**Draft:**

Ozempic and Wegovy have both shown promising results in clinical trials, but their effectiveness for weight loss may vary depending on the dose and the condition they are prescribed for. Ozempic is expected to be less effective for weight loss than Wegovy, as it has a lower dose of semaglutide. Ozempic is also designed for type 2 diabetes, while Wegovy is designed for weight loss.

For type 2 diabetes, Ozempic's effectiveness was demonstrated in the SUSTAIN 6 trial, which involved 3,297 participants with type 2 diabetes and cardiovascular risk factors. The participants were randomly assigned to receive either Ozempic or placebo injections once a week for 104 weeks, along with standard diabetes care. The results showed that Ozempic was superior to placebo in lowering blood sugar levels, with an average reduction of 1.05% to 1.41% in HbA1c, depending on the dose, compared to 0.36% for placebo. The participants on Ozempic also experienced weight loss, with an average of 3.7 kg to 4.5 kg, depending on the dose, compared to 0.7 kg for placebo. However, the study had some limitations, such as the short duration, the exclusion of patients with renal impairment, and the potential for bias due to the sponsor's involvement.

For weight loss, Wegovy's effectiveness was demonstrated in the STEP 1 trial, which involved 1,961 participants who were either obese or overweight with weight-related medical conditions. The participants were randomly assigned to receive either Wegovy or placebo injections once a week for 68 weeks, along with lifestyle intervention. The results showed that Wegovy was superior to placebo in reducing body weight, with an average weight loss of 14.9% to 15.3%, depending on the dose, compared to 2.4% for placebo. The participants on Wegovy also experienced improvements in blood pressure, cholesterol, and blood sugar levels. However, the study had some limitations, such as the lack of a comparator group with another weight loss medication, and the potential for bias due to the sponsor's involvement.

The effectiveness of Ozempic for weight loss may depend on individual factors, such as adherence to the medication regimen, lifestyle changes, and medical history. Therefore, the results of the clinical trials may not reflect the real-world outcomes for every patient. It is important to follow your doctor's instructions and monitor your progress regularly when using Ozempic for weight loss.

## Safety and Limitations

- Explain the possible side effects and precautions of Ozempic for weight loss, and what to do in case of overdose or missed dose

- Provide some information on the contraindications and interactions of Ozempic for weight loss, and who should not use it

- Mention some alternative options for weight loss, and how they compare to Ozempic for weight loss in terms of safety and effectiveness

**Draft:**

Ozempic for weight loss may cause some side effects, such as nausea, vomiting, diarrhea, constipation, stomach pain, headache, dizziness, fatigue, injection site reactions, and low blood sugar. These side effects are usually mild and temporary, and may improve as your body adjusts to the medication. However, if they persist or worsen, or if you experience any serious side effects, such as severe allergic reactions, pancreatitis, gallbladder problems, kidney problems, or thyroid problems, you should contact your doctor immediately. You should also tell your doctor about any other medications, supplements, or herbal products that you are taking, as they may interact with Ozempic for weight loss.

If you take too much Ozempic for weight loss, you may experience symptoms of overdose, such as severe nausea, vomiting, diarrhea, dehydration, or low blood sugar. You should seek emergency medical attention if this happens. You should also carry a source of glucose, such as candy, juice, or glucose tablets, to treat low blood sugar if it occurs. You should also wear a medical alert bracelet or carry a card that identifies you as a user of Ozempic for weight loss.

If you miss a dose of Ozempic for weight loss, you should take it as soon as you remember, as long as it is within 3 days of your scheduled dose. If it is more than 3 days past your scheduled dose, you should skip the missed dose and take the next dose on your regular day. You should not take two doses in the same week, or take more than one dose in a day. You should also keep track of your doses and injections, and contact your doctor if you have any questions or concerns.

Ozempic for weight loss is not suitable for everyone, and it has some contraindications and interactions. You should not use Ozempic for weight loss if you have a personal or family history of medullary thyroid carcinoma, a rare type of thyroid cancer, or multiple endocrine neoplasia syndrome type 2, a genetic disorder that causes tumors in the endocrine glands. You should also not use Ozempic for weight loss if you are allergic to semaglutide or any of the ingredients in Ozempic. You should also be cautious if you have

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How Long Does It Take For Ozempic To Work For Weight Loss 2024 - Deccan Herald

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Ozempic isn't a long-term weight-loss solution, says Marie Osmond - Conway Daily Sun

Coming soon: Newer weight loss cum diabetes drugs. Will they be more effective and lasting?  The Indian Express

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Coming soon: Newer weight loss cum diabetes drugs. Will they be more effective and lasting? - The Indian Express

The journey to weight loss is often complex and multifaceted. From diet modifications to exercise regimens and sometimes, the use of weight-loss medications like Ozempic. While these medications can significantly aid the weight loss process, they may not always yield consistent results. Some users of Ozempic, a popular weight loss medication, have reported experiencing a plateau in their weight loss progress after using the medication for a while. This article delves into the complexities of Ozempic and the phenomenon of weight loss plateau, offering valuable insights and practical advice for individuals navigating this journey.

Ozempic, known scientifically as Semaglutide, is a glucagon-like peptide 1 receptor agonist. It has been lauded for its efficacy in aiding weight loss and providing a breakthrough for long-term weight management. In fact, clinical trials such as the STEP 5 Trial demonstrated a substantial mean change in body weight of 15.2% in the Semaglutide group versus 2.6% with a placebo at week 104. Despite these impressive statistics, some Ozempic users may experience a weight loss plateau, suggesting that the initial effects of the medication may diminish over time.

A weight loss plateau is a common occurrence and typically occurs after about six months of following a low-calorie diet. This is primarily due to metabolic adaptations and a decline in resting energy expenditure. The longest study of weight loss drugs, which lasted 68 weeks, showed that weight loss plateaued and started to climb again by the end. This can be a frustrating experience for individuals on a weight loss journey, but its important to remember that this is a common hurdle and one that can be overcome with the right strategies.

Addressing a weight loss plateau requires a comprehensive approach. Its crucial to consult with healthcare providers for personalized guidance on managing weight loss. Health and wellness expert Jillian Michaels encourages a return to basics and suggests alternatives like berberine and yerba mate tea. She also emphasizes the importance of eating less, avoiding added sugars, and increasing physical activity.

As we age, weight management can become increasingly challenging. Adjustments in diet and exercise are important to accommodate changes in metabolism and body composition. Equinox, a fitness company, has developed a special program for clients using weight-loss drugs like Ozempic. The program, which includes habit coaching for long-term weight loss maintenance, is designed to help clients who have lost muscle mass due to the drugs and are experiencing weight loss plateaus.

While Ozempic has proven to be an effective tool for weight loss, it is not a magic bullet. Weight loss is a journey that requires a holistic approach encompassing diet, exercise, and sometimes medication. Understanding the possibility of a weight loss plateau during this journey is important, as is having strategies in place to address it. Always consult with a healthcare provider for personalized advice and remember the journey to weight loss is not a sprint, but a marathon.

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The Role of Ozempic in Weight Loss: Understanding Plateau and Strategies for Success - Medriva

Marie Osmond is sharing her thoughts on the Ozempic craze.

I dont think [its] long-term effective, Osmond, 64, exclusively told Us Weekly on Friday, January 5, of using diabetes medications like Ozempic and Mounjaro for weight loss.

She continued: I think you have to learn that food is not your enemy and you have to do it the right way. Thats my personal opinion. And its healthier that way. I totally believe in health and taking care of your heart and your organs and keeping this machine that we have that houses our soul healthy.

Osmond has long been singing the praises of Nutrisystem, which 15 years ago helped her shed 50 pounds and has helped her keep it off since. She even teamed up with the brand to design a weight loss program specifically designed for women ages 50 and up called Complete 50.

Ozempic has become a hot topic when it comes to weight loss with some stars confirming they have used the drug while others denied it. Chelsea Handler admitted during a January 2023 episode of the Call Her Daddy podcast that she unknowingly took the Type 2 diabetes medication, which is traditionally used to improve []

At 50, we as women our hormones go crazy, Osmond explained. That middle [body] fat, thats what ended up taking my grandmothers and my mothers life. And I knew genetically I was predisposed to it. So, [Complete 50] is the answer. I mean, if you want to go weigh it and cook it and measure it and do all the stressful things, but I just wanted to get the weight off. And they do it in such a great way that they give you foods that you crave. You dont feel like youre starving.

The singer admitted that she accepted her 50-pound weight gain as inevitable and almost gave up [before] Nutrisystem. However, everything changed when one of Osmonds sons encouraged her to prioritize her health.

My son came to me on behalf of all the kids. I was divorced, and they said, Mom, youre all we have, Osmond recalled. That was so hard, because you know youre overweight, and 50 pounds on me is a lot. And it was one of those knife-in-the-heart [moments] that I needed.

Shocking, indeed! Some celebs seek out extreme methods to shed pounds, while others transform with the aid of healthier methods. From Rosie O'Donnell's and Jordin Sparks' respective 50 pound weight losses to Biggest Loser winner Rachel Frederickson's whopping 155 lighter frame, see before and after pictures of celebrities' weight loss transformations.

Osmond emphasized that weight loss is not about being skinny for her; its about feeling her best.

Weight ages us and it causes so many other side effects, she told Us. I get on the floor, I play with my grandkids, Im out being active, Im living my best life. At 50, you kind of go, This is who I am. Like it or lump it. Im going to have fun. And to me, health is everything. I would love to have had my mother longer. I know she wouldve loved to have her mother longer.

Osmond is the mom of eight children. She shares daughters Jessica, 36, Rachel, 34, Brianna, 27, and Abigail, 21, and sons Brandon, 27, Matthew, 24, and Michael, who died by suicide at age 18 in 2010, with ex-husband Brian Blosil. She also shares son Stephen, 40, with husband Stephen Lyle Craig, whom she divorced in 1985 before remarrying him in 2011.

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He was always my best friend, Osmond told Us of Craig. He said [before we got remarried], I love you, but I need to make sure that I want to love seven more children. And boy, they love him. Oh, he is dad. They just adore him, and he is so good with them.

With reporting by Christina Garibaldi

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Marie Osmond Says Ozempic Isn't 'Long-Term Effective' for Weight Loss - Us Weekly

Losing weight and keeping it off is a long-term endeavor. There are many ways to accomplish sustained and consistent weight loss over time to positive results and they vary from person to person.

A Dec. 2023 study in Nutrition & Diabetics assessed six months of weight loss intervention, including time-restricted feeding,alternate-day fasting, and straightcaloric restriction. To measure quantitative and qualitative data, they interviewed participants two months after the six-month weight-loss period. (1)

Is motivation alone enough to achieve long-term weight loss? Not really. Nutrition scientistDr. Layne Nortondove into the studys findings in a YouTube video published on Dec. 27, 2023, reviewing the assessment ofbehavioral changesnecessary to maintain weight loss long-term. Check it out below:

[Related: The Side Effects of Probiotics for Strength Athletes to Look Out For]

This 2023 study focused primarily on thepsychologicalchanges necessary to promote consistent and effective fat loss. The most significantmental factorfor success was the development offeedback loops.

The amount of feedback or accountability at the beginning of the six months was directly related to whether participants stuck with theirdiets. Frequent check-ins with theresearchersor the support staff had a really big benefit for them being adherent, says Dr. Norton. In fact, many of the subjects didnt enjoy the diets at the start, noting thatmotivationalone isnt a foolproof initial jumpstart for long-term diet success.

Behavior change sparks motivation, not the other way around. If the participants adhered to a diet and noticed changes to their health and physiques, they became motivated about the whole process and to continue it. When they committed to the process for long enough, they experiencedthe aesthetic benefits, which motivated them to continue.

In short, feedback and accountability fuel self-efficacy and, eventually, self-ownership.

Self-ownership is basically, I have thepower. I have theresponsibility.I believe I can do this because Ive seen these changes happen over time.

[Related: 4 Ways Stress Is Killing Your Gains]

Dr. Norton says that adaptation is another key indicator of diet sustainability. Usingmeal delivery servicesor changinggrocery liststolow-carborextra proteincan shift ones lifestyle or diet to accommodateones health goals.

Small changes, sustained via help from others, can lead tomore confidenceand motivation. Thefrequencyof feedback communication is important; touchpoints throughout the week can help better navigate the first month. Then, when physical changes are noticeable, confidence skyrockets.

Remodeling alifestyle, staying accountable to adiet coach, receiving feedback from specific biomarkers, gaining self-efficacy, and taking self-ownership are necessary for a successful weight loss journey. Motivation waxes and wanes, but according to this study, changing ones behavior is the key to changing onesphysique.

Featured image via Shutterstock/Laborant

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Is Motivation Enough to Achieve Long-Term Weight Loss? - BarBend

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Ozempic isn't a long-term weight-loss solution, says Marie Osmond - Wyoming Tribune

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Updated: January 11, 2024 @ 2:14 am

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Ozempic isn't a long-term weight-loss solution, says Marie Osmond - Islander News.com

One in ten young people have used an unapproved weight loss drug at some point in their life, researchers at an Australian university have found.

Researchers from Monash University in Melbourne combined Australian data with data from New Zealand and the United States, and found that a remarkably high number of teenagers have used a non-prescription weight loss product at least once in their lives.

The analysis combined the results of more than 90 studies and about 604,000 participants, and found that the use of weight loss products occurred at high levels in all adolescents, but especially in girls. Researches warned that such products are considered to be ineffective for weight loss and can have harmful long term health consequences.

Diet pills were the weight-loss product used most frequently by adolescents, followed by laxatives and diuretics, they said.

Given the individual and public health issues associated with adolescent use of nonprescription weight-loss products, interventions are urgently required to prevent and regulate use of weight-loss products in this population.

The researchers found that low self-esteem, parental influence to lose weight and media influences were top causes for taking the drugs.

This is concerning because of the mental and physical health risks associated with the use of these medical products that are not indicated for weight loss but are often used as weight-loss products, they said.

This emphasises the need for increased regulation and restriction to be placed on nonprescription weight-loss products, especially for individuals 18 years or younger.

The researchers say that given the long term health problems, including unhealthy weight gain in adulthood, further work is needed in order to protect vulnerable young people.

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1 In 10 Young People Have Used Unapproved Weight Loss Drug - Pedestrian.TV

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