Episode 6
#6: Ozempic Explained: The Real Reason It Makes You Lose Weight, Cancer Warnings, and the Science They Skip
Ozempic is everywhere right now but most people only know the hype. In this episode, I break down what’s actually going on. We’ll talk about the real science behind how it works, why it makes you lose weight, and the cancer warnings most people never hear about. I’ll also get into what the drug was really made for, how it’s being used off label, and the risks that get skipped in the headlines. No fluff, no pharma spin, just the full picture so you can decide for yourself.
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Transcript
Hey, what's up?
Speaker A:This is the Manolo G podcast where we get curious about the way things work.
Speaker A:I'm Manolo G. And today we're diving into something that's been all over the news and social media lately.
Speaker A:The shot Ozempic.
Speaker A:You might have seen celebrities talking about it, influencers hyping it up, or maybe your doctor mentioned it.
Speaker A:People are calling it a miracle weight loss drug, a game changer for diabetes, even the future of weight loss.
Speaker A:But what is it really?
Speaker A:How does it work?
Speaker A:And what should you know before jumping on this trend?
Speaker A:Let's break it down.
Speaker A:Alright, so what's the deal with Ozempic?
Speaker A:You've probably heard the hype, maybe you've seen the before and after photos, or someone at work mentioned that they're on it.
Speaker A:Ozempic's everywhere right now, but most people don't actually know what it is, how it works, or how we even got here.
Speaker A:So let's start from the top.
Speaker A:Ozempic is the brand name for a drug called Semaglutide.
Speaker A:It was originally designed to help people with type 2 diabetes manage their blood sugar.
Speaker A:But during clinical trials, researchers noticed something interesting.
Speaker A:Patients were losing weight, and not just a little.
Speaker A:That accidental discovery changed everything.
Speaker A:All of a sudden, this diabetes drug had huge weight loss potential.
Speaker A:And for the pharmaceutical companies behind it, Novo Nordisk, it was a goldmine.
Speaker A:Obesity affects hundreds of millions globally.
Speaker A:So from a business angle, this wasn't just a medical breakthrough, it was a billion dollar opportunity.
Speaker A:So what did they do?
Speaker A:They went all in.
Speaker A:Aggressive marketing campaigns, influencer partnership, sponsored research, and a carefully crafted message.
Speaker A:Ozempic isn't just for diabetes.
Speaker A:It's the next big thing in weight loss.
Speaker A:And the explosion in popularity that came fast.
Speaker A:Way faster than the medical system could keep up with.
Speaker A:People were getting Ozempic from everywhere, a lot of the time with barely any evaluation or follow up.
Speaker A:Meanwhile, the long term risks still unclear.
Speaker A:So before we get into how Semaglutide actually works, what it does to your appetite, your gut and your hormones, let's just pause and recognize this isn't just a story about a new medication.
Speaker A:It's a story about how science, business and human behavior collide and what that means for all of us.
Speaker A:Alright, so what's Ozempic?
Speaker A:Ozempic is just a brand name.
Speaker A:The actual drug is called Semaglutide.
Speaker A:And Semaglutide is a man made version of a hormone your body already makes called GLP1 that stands for glucagon.
Speaker A:Like peptide 1, stick with me.
Speaker A:This is where it gets interesting.
Speaker A:So, naturally, GLP1 is a hormone that plays a big role in how your body handles food.
Speaker A:It helps control blood sugar, slows down how fast your stomach empties, and makes you feel full.
Speaker A:So when researchers found a way to mimic that in a drug form, they had something pretty powerful on their hands.
Speaker A:So you might be wondering, how does one go about making a hormone?
Speaker A:Interesting question.
Speaker A:Let's understand it.
Speaker A:So GLP1 is naturally made in our bodies, right?
Speaker A:That means that it has a DNA blueprint.
Speaker A:So they take that blueprint and put it into the DNA of bacteria.
Speaker A:Specifically the one found in your toilet.
Speaker A:Yup.
Speaker A:E. Coli.
Speaker A:The bacteria then grows in vats, makes the protein, and then scientists extract, purify, and tweak it chemically so it works longer in your body, resists breakdown, and requires fewer injections.
Speaker A:Am I the only one impressed that we can genetically hijack bacteria to replicate proteins in our bodies and then extract them so they can be injected into us?
Speaker A:What a beautiful world we live in.
Speaker A:So we're going to need to figure out what exactly GLP1 does in our body to understand how ozempic really works.
Speaker A:GLP1 is a messenger hormone released by your intestines after you eat.
Speaker A:As a hormone transfers through your blood, it goes to your brain, your pancreas, and your stomach.
Speaker A:So basically, it tells the body, hey, we're full.
Speaker A:Stop eating.
Speaker A:So when it goes to your brain, the hypothalamus gets the message.
Speaker A:You're full.
Speaker A:So since ozempic acts like GLP1, it activates those same receptors in your brain to bring down the hunger signals as well.
Speaker A:That means you feel less hungry, less interested in food, and are less motivated to eat emotionally or out of boredom.
Speaker A:So how about the pancreas?
Speaker A:GLP1 also helps your pancreas release insulin after meals.
Speaker A:When insulin is released, it allows sugar to go from your blood and into the rest of your body.
Speaker A:This actually lowers your blood sugar in your bloodstream.
Speaker A:GLP1 also suppresses glucagon released in the pancreas.
Speaker A:And glucagon is a hormone that raises your blood sugar by breaking down glycogen.
Speaker A:So, basically, GLP1 keeps your blood sugar low.
Speaker A:Something else that GLP1 does tells your stomach to empty more slowly.
Speaker A:This keeps food in the stomach longer, helping you feel full even hours after eating a meal.
Speaker A:So what's the big deal, right?
Speaker A:GLP1 is made naturally in our bodies, completely natural.
Speaker A:Well, the thing about it is, there's a difference.
Speaker A:The natural GLP1 hormone breaks down quickly, like within minutes quickly.
Speaker A:But the modified hormone semaglutide sticks around for days, continuously activating our receptors and constantly tricking your body into thinking that it's full.
Speaker A:Let's pause here because this is interesting.
Speaker A:Appetite isn't just willpower or self control, it's biology.
Speaker A:Your gut is communicating with your brain, your stomach, your pancreas.
Speaker A:We think that we control our bodies, but our gut is actually sending our brain signals unconsciously.
Speaker A:Alright, so now that we understand how it works, we should understand one of the main reasons that people are taking it, and that's obvious.
Speaker A:Weight loss.
Speaker A:So clinical trials show that people on semaglutide can lose around 10 to 15% of their body weight over six months to a year.
Speaker A:That's a decent amount of weight.
Speaker A:So for someone who weighs 200 pounds, that's about 20 to 30 pounds.
Speaker A:Compare that to diets which we all know how good people are at.
Speaker A:Sticking to diets where long term success rates show to be under 5% seems effective, but let's be real.
Speaker A:Ozempic doesn't just make weight fall off like magic.
Speaker A:What it really does, it cuts down your hunger and cravings.
Speaker A:So eating less and making better choices feel easier.
Speaker A:But if you want to keep the weight off long term, you still gotta put in the work with lifestyle changes.
Speaker A:Unless you plan on taking Ozempic forever, which honestly, I'm pretty sure the pharmaceutical companies would love it and wouldn't mind it at all.
Speaker A:No judgment, but part of me can't help but to wonder what happened to good old fashioned willpower.
Speaker A:But that's a whole nother episode.
Speaker A:Alright, so we've talked about some of the good things, but you can't have light without darkness.
Speaker A:So that brings us to the side effects and risks.
Speaker A:Like any drug, Ozempic has side effects.
Speaker A:The most common are nausea, vomiting, diarrhea and constipation.
Speaker A:And if you paid attention earlier, you might be able to put together why this could be happening.
Speaker A:You know what, I'll just tell you.
Speaker A:Essentially this happens because the slowing down of your stomach emptying messes with your digestive system.
Speaker A:It messes with the rhythm of it.
Speaker A:A lot of people feel nauseous during the first few weeks as their body adjusts.
Speaker A:But this is because food stays in the stomach too long, stretching it for long periods of time.
Speaker A:That sends discomfort signals to your brain, making you feel sick.
Speaker A:Another side effect could be pancreatitis.
Speaker A:Pancreatitis is an inflammation of the pancreas and too much stimulation of the pancreas can overload the system, causing the inflammation.
Speaker A:This makes sense because semiglutide was made to last way longer than the natural GLP1, which boosts results but may also overstimulate your body.
Speaker A:Some of the other side effects are kidney injury, gallbladder disease, and intestinal blockage due to how Ozempic slows your digestion.
Speaker A:I sound like AD at this point.
Speaker A:I did want to talk about another potential side effect that actually is kind of sad.
Speaker A:Okay, so you probably haven't heard this in a TikTok ad or maybe even in the doctor's office, but Ozempic actually comes with the FDA's strongest warning label possible.
Speaker A:It's called a black box warning.
Speaker A:What does that mean?
Speaker A:It's literally a big black box at the top of the drug's official label.
Speaker A:It's used only for the most serious or life threatening risks.
Speaker A:The reason why it's there is that the FDA wants doctors and you to pay attention.
Speaker A:But pay attention to what?
Speaker A:Okay, so in his epic's case, the black box warns about a type of thyroid cancer called medullary thyroid carcinoma, or mtc.
Speaker A:In animal studies, Ozempic was shown to cause thyroid tumors in rodents.
Speaker A:And while we don't fully know if that risk carries over to humans, the FDA didn't want to take any chances, hence the label.
Speaker A:You should know that this drug is not supposed to be used.
Speaker A:If you or someone in your family has a history of this type of thyroid cancer, let me read the exact black box label warning for you.
Speaker A:Risk of thyroid C cell tumors, Semaglutide causes, dose dependent and treatment duration dependent thyroid C cell tumors at clinically relevant exposures in rodents, it is unknown whether Ozempic causes thyroid C cell tumors, including medullary thyroid carcinoma.
Speaker A:MTC in humans as the human relevance of rodent thyroid C cell tumors has not been determined, Ozempic is contraindicated in patients with a personal or family history of MTC and in patients with multiple endocrine neoplasma syndrome type 2 men too.
Speaker A:Patients should be counseled regarding the potential risk and advised to report any symptoms of thyroid tumors.
Speaker A:A mass in the neck, dysphagia, dyspenia, persistent hoarseness.
Speaker A:This isn't about being fear mongering, it's about making informed decisions.
Speaker A:The problem is this level of detail gets buried under flashy marketing or online hype.
Speaker A:But I didn't even get to the best part of it, the regulatory side of it.
Speaker A:You should know that Ozempic is Often prescribed off label for weight loss.
Speaker A:What does off label mean?
Speaker A:It means the drug is being used for something the FDA didn't officially approve it for.
Speaker A:That's totally legal and pretty common in medicine, but it puts us in a gray area, especially when it comes to long term safety.
Speaker A:Ozempic is only FDA approved for treating type 2 diabetes, not weight loss.
Speaker A:Yes, people do lose weight on it, but technically that's a side effect and not the approved purpose.
Speaker A:When doctors prescribe it for weight loss, that's off label use.
Speaker A:And here's where it gets murky.
Speaker A:The long term effects of taking it purely to lose a few pounds, we don't fully know.
Speaker A:So why not just approve Ozempic for weight loss too?
Speaker A:Because the FDA requires specific clinical trial data for each intended use.
Speaker A:The trials for Ozempic focused on blood sugar control, not weight loss.
Speaker A:So instead of trying to repurpose it, the manufacturer ran separate studies at a higher dose, 2.4 milligrams instead of 0.5 or 1 milligram in Ozempic, and branded it as WeGovy.
Speaker A:WeGovy is FDA approved for weight loss, but only for people with obesity or weight related health issues, not just anyone who wants to slim down for a vacation.
Speaker A:Ozempic got trendy for weight loss before Wegovy was readily available.
Speaker A:That led to a surge in off label prescriptions driven by social media hype and subtle marketing.
Speaker A:The result?
Speaker A:Drug shortages for diabetics and people using it with little to no medical oversight, sometimes just for vanity weight loss.
Speaker A:To be clear, Ozempic can lead to weight loss even at lower doses, but it also comes with risks.
Speaker A:Nausea, vomiting, pancreatitis, intestinal blockage, and yes, even a potential cancer risk.
Speaker A:The FDA didn't approve it for widespread cosmetic use, likely because the benefit didn't clearly outweigh those risks.
Speaker A:So, yeah, Ozempic works for weight, but using it off label is a lot more complicated than people think.
Speaker A:So what does it mean that Ozempic is everywhere now?
Speaker A:Being used by celebrities, influencers, and people trying to drop a quick £10?
Speaker A:Are we actually addressing the root causes, like the kinds of foods we eat, our lifestyles, or even our mental health?
Speaker A:Or are we just suppressing symptoms and calling it a fix?
Speaker A:Look, I get that some people genuinely need this drug, and I'm not here to judge that.
Speaker A:If it helps someone reclaim their health, great.
Speaker A:But my gut, no pun intended, says true, lasting help.
Speaker A:Probably looks a little different.
Speaker A:This goes beyond biology and Big Pharma.
Speaker A:Ozempic opens up social and ethical questions.
Speaker A:We live in a culture obsessed with being thin, being in shape, finding shortcuts.
Speaker A:But keep in mind, Ozempic can cost over a thousand dollars a month without insurance.
Speaker A:So who's really able to get it?
Speaker A:Mostly wealthier people are those in countries with better healthcare coverage.
Speaker A:Meanwhile, the people who actually need this drug, those with diabetes or serious obesity, might be facing shortages.
Speaker A:So yeah, it works, but who's benefiting and who's getting left out?
Speaker A:It's not just about weight loss, it's about how we define health and who gets access to it.
Speaker A:I'm not saying life is fair, but it's definitely something to consider.
Speaker A:So what's the takeaway?
Speaker A:Ozempic is a legit tool backed by real science, but it's not a magical fix.
Speaker A:If you're thinking about it or know someone who is, get informed and ask the hard questions.
Speaker A:Talk to a doctor you actually trust, not one that's just pushing a trend.
Speaker A:Don't get caught up in the hype.
Speaker A:The there's always more to a story than what's trending on your feed.
Speaker A:And really, this whole conversation is a reminder that health is complicated, biology is powerful, and it's not something to be underestimated.
Speaker A:Thanks for riding through this deep dive with me.
Speaker A:If this episode gave you something to think about, share it with someone who needs to hear it.
Speaker A:You can always reach out on socials if you got questions.
Speaker A:Want me to dig into another topic?
Speaker A:Until next time, I'm Manola G. Reminding you to stay curious and to keep asking questions.
